Third Party Administrator Seeking ASC Partners

ASCA has been working with HealthSmart, the nation’s largest non-carrier owned third party administrator (TPA), on several research-related strategic initiatives to support our advocacy of the ASC model. HealthSmart administers benefits for self-insured employers with more than one million covered lives and manages over six billion dollars ($6B) in claims annually. They have recently embarked on a new health benefit bundled price program called MyDecision and are seeking ASCs to partner with them.

MyDecision empowers self-funded employers and their beneficiaries with decision support tools that navigate patients to providers who participate in the MyDecision Program. The program combines three fundamental elements: 1) price and quality transparency; 2) bundled price methodology through partnerships with high quality providers; and 3) strong member engagement and navigation tools.

Program attributes include:

• Claims being paid within 10 business days from receipt.
• Allowing employers to modify plan design and pay 100 percent of the bundled rate leaving no patient payments to collect.
• Allowing members get a personalized advocate to navigate into MyDecision providers.
• Concierge services to assist members through the entire episode of care so patient throughput is streamlined.
• Narrow provider access to maximize patient/procedure volume.
• Allowing providers to publicize and promote best-in-class quality metrics to members.
• Engaging members prior to health care services being requested.

If you are interested in learning more about this program, please contact Leslie Haase with HealthSmart at 214-574-2675. You can also email inquiries to MyDecision@healthsmart.com.

If you have questions about ASCA’s prior experience with HealthSmart, please write Steve Miller.