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Benefits of a joint venture11/29/2023 ![]() By partnering these patients with forward-thinking primary care doctors who are rewarded for high-quality, efficient care, members and their families are supported during a critical period in their health care journey.įor health plans offering joint venture resources like a locally-based care team, the benefits include a dedicated medical director, nurses, pharmacists, diabetes educators, social workers, and behavioral specialists who support the members and their families with their complex needs-often face-to-face. These rising risk members, which often generate as much as 70 percent of healthcare costs, often do not have primary care providers that help them manage their care conditions. When it comes to health maintenance and ensuring the overall health of each member, the integrated health plan includes care navigation support, providing proactive and timely guidance and support particularly to those who have chronic care conditions or have recently been discharged from an acute care facility. This multi-directional goal tends to various needs without ignoring the core of health care. This structure also aims to increase the number of patients, taking the initiative one step beyond the member and employer savings, and draws in additional business on the back end. This model goes beyond the focus of per procedure costs and access to competitive provider network rates and focuses on timely identification of member needs on a holistic level-saving time and money for the employer. The amount of savings offered through a joint venture directly stems from the business model that aims to decrease members’ total cost of care. ![]() On the employer side, the question of savings and how this impacts members is one of the main concerns. When determining if a joint venture is the right structure to recommend for an employer group, consider the following benefits that allow joint ventures to simplify the process for patients while perfecting the quality of care. Compared to an Accountable Care Organization (ACO), joint venture health plans align the economic incentives of the insurance entities with the provider organization that allow it to take the member experience one step further through personalizing the care experience from pre-enrollment to claims processing.Īdditionally, these efforts aim to connect the members with a long-term primary care provider who can typically cover the majority of a person’s health needs throughout their life, from prevention and treatment to rehabilitation and palliative care, according to the World Health Organization. These partnerships take business one step further by redefining the healthcare experience through combining the clinical expertise of one with the stability of coverage from another to create an affordable, high-quality, integrated solution at the local level. Joint venture health care plans are creating a new dynamic for patients, brokers and employers without compromising standards of care.
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