Optimal Care Management Is Done In Primary Care but Health Plans Try To Take a Larger Role.

May 20, 202400:00:57

Optimal Care Management Is Done In Primary Care but Health Plans Try To Take a Larger Role.

Full episode here: Let’s Talk About TPA and Health Plan Inertia Instead of Jumbo Employer Inertia
https://youtu.be/f3YF33Mc8S4

Health plans like to take on larger and larger roles in the management of healthcare. So they retain more and more money trying to take on a larger role. Many health plans will not unbundle it even when employers say that they would prefer my primary care partner to take this. They say nope. It's all or nothing. If they just paid the claims in a timely manner, and provided
transparent information and cost data and managed the contracts, that would be great but that is not happening today. Unfortunately when you find an effective TPA they typically get bought by a larger insurer, then they go in a different direction.

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