Any prospective CO-OP sponsor must recognize the costs and risks inherent in the effort of starting a Health Plan. The good news is the successful applicant will have most of the funding of the initiative borne by the federal government. The direct outlay by an initial sponsor or steering committee revolves around the use of …
Read MoreRent a Plan 0
Development of a CO-OP need not be overwhelming to an interested provider group. A CO-OP, like any Health Plan, has essential operating needs consisting of the following functions: Claim processing and payment; Provider network development and contracting; Sales and Marketing; Underwriting and Actuarial projections. Medical Administration Management of Strategy and Operations Here’s the Good News: …
Read MoreCompetition in Health Insurance 0
In preparation for a speaking engagement, I had an opportunity to review the most recent Competition in health insurance study published by the American Medical Association (AMA). Even as a person who has been involved in health care for a long time on both the payer and provider sides, I find the results of the …
Read MoreComments regarding the CO-OP Program 0
CMS recently requested comments regarding the provisions of the Consumer Operated and Oriented Program (CO-OP). Beam Partners LLC submitted a lengthy response to various provisions relating to the CO-OP Program and practical considerations relating to the establishment of these entities. The Federal Register notice and the Beam Partners LLC response are attached. Terry 20110303 CO-OP …
Read MoreProviders are Consumers, aren’t they? 0
Providers are the perfect Consumer Sponsor of a CO-OP Those interested in the evolving nature of the Accountable Care Act (ACA) have been generally not quick to recognize the potential for Consumer Operated and Oriented Plans (CO-OPs). The sponsors of the ACA gave birth to the concept, funded it, and then generally left the details …
Read MoreWhy Providers Should Consider CO-OPs 0
The Affordable Care Act (ACA), as many of you know, is a massive piece of legislation, and contains many far-reaching provisions. One of the less well-known aspects of the ACA is the seed money to establish Consumer Operated and Oriented Plans (CO-OPs). What are CO-OPs? Simply put, they are health plans, but with a twist. …
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