Community Based Healthcare
Always seeking a better way, WEB-TPA has developed the Communitas Program to empower local healthcare providers and employer coalitions, who want to drive the management of the premium dollars within their own communities.
Community Issues
- Fewer insurance carriers
- Increased leverage of carriers to further reduce provider reimbursement
- Little carrier competition
- No data sharing between carriers and providers
- Local providers not involved in delivery strategies to control costs
Strategy
- Capture and distribute comprehensive market data
- Competitively price proprietary provider network
- Cultivate local provider infrastructure
- Move related health plans to controlled network and TPA
- Transition additional self-funded lives to controlled products
- Expand products to include insured products
- Ensure accountability of care & finances
Services
- Contract administration
- Benefit administration
- Referral/authorization management
- Claims adjudication
- Capitation administration
- Member services
- Network re-pricing
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