Keeping health spending local benefits your hospital, local business, and your community.

We provide:
  • Outreach to local employer contacts
  • Expert review of current claims and spend to spot opportunities
  • Coordinated communication with hospital employees
  • Contact negotiations where there’s mutual interest
  • Hospital advocacy with plan’s TPA for optimal modeling, reimbursement structure and contract administration
  • Design and support for business development activities with local employers

The Benefits of Direct Contracting

For rural and community hospitals

REDUCTION

in patient bad debt due to benefit plan design changes in the form of reduction or fully waived cost share.

INCREASED UTILIZATION

and revenue created by patient steerage through employer benefit plan design changes, and incentives.

PROTECT

current utilization, market share, and revenue by being proactive before other area hospitals implement it first.

DEEPER RELATIONSHIPS

with local employers builds stronger community support.

REDUCED

administrative denials, payment delays and payer bad debt.

For local/regional employers

LOWER

out of pocket expenses for employees when utilizing the higher tier provider

POTENTIAL

for lowering overall health plan cost by keeping more services local. Accomplished in one of two ways:

  1. Services in the local facility may be less costly than similar services at a tertiary care hospital or provider in a larger market.

  2. Reimbursement with the local provider when directly contracted should be more competitive than large network rates for the same provider.

CONVENIENCE

care closer to home may lead to faster return to work.

For Both

PATIENT EXPERIENCE

for local employees is convenient and better overall

PLAN SAVINGS

accrue to the local employer while at the same time enhancing revenue for the local provider. Both can benefit instead of a national carrier keeping the margin.

KEEPING MORE

health plan dollars local will benefit the employer, hospital and community as a whole.

RHIA Works for Rural