Managed Care Contract & Consulting Services
~ Multiple ways - Again, it makes the pool bigger. People whose income is above 138% of the poverty level and up to 400% will be eligible for subsidized health insurance (Health Benefit Exchange) through tax credits.
~ These patients will be now be insured and that also means more managed care patients!
~ Managing managed care patients can be challenging for Skilled Nursing Facilities if they are not used to working with health plans or HMO’s.
~ Learn more about managed care and how Mix Solutions can offer contracting and consulting help to your facility.
HMO Patient vs Medicare Patient
• Revenue changes
• Cash flow
• Administrative changes
• Additional hands in the pot- they are directing the stay, not you
• New folks to market to
What is The Health Benefit Exchange?
~ The Health Benefit Exchange (HBE) is where individuals, families, and small businesses can shop online for health insurance plans. They are a state-based health insurance market, which is also called exchanges.
~ The insurance plans can be compared side-by-side and an online calculator used to find the best deal. Another feature of the HBE is that depending upon a person’s income, there are some up-front discounts in the form of tax credits to help pay for the premiums and some out-of-pocket assistance too.
~ As of April, 2014, over 7 million people had a selected health plan through health insurance marketplaces.
~ Four Types of "metal plans"
~ There are several choices among the plans with higher and lower deductibles, co-pays, and higher or lower premiums. This also informs applicants if they qualify for premium discounts and subsidies for out-of-pocket expenses.