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Healthcare Contractors
Integrated Medical
Solutions (IMS) continually develops networks of physician providers and
hospitals to service our correctional facility clients throughout the United
States. Affiliate providers are positioned to significantly increase their
revenues by directly participating in multi-million dollar contracts executed by
IMS.
MORE INFO
Integrated Medical Solutions, Inc.
99 Regency Parkway
Suite 105
Mansfield, TX 76063
E
info@imsi-usa.com
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Correctional Health
Management, LLC (CHM) conducted a case study on the potential
savings Medicare based contracts provide over the traditional
discount off charges contracts negotiated by most correctional
institutions.
CHM, working together
with an existing client, a large international private operator of
correctional institutions, identified four target institutions that
would represent a sample of their overall network of facilities.
These institutions included two federal facilities where the
customer was at full risk for health care costs, and two state
facilities where the customer had a cap on their risk.
These institutions were
also spread throughout the country, one in California, one in North
Carolina, and two in Florida. The populations ranged from just under
1,000 inmates to over 2,000 inmates.
The customer had
established networks in all four markets. Typical contracts with
providers were negotiated at a discount off of charges. Their
typical discount was 10% to 20% off of charges. Their best contract
for inpatient services was 30% off of charges. The customer also
utilized a stop-loss insurance policy to guard against catastrophic
care cases.
In a period of less than
two months, the customer was able to establish Medicare based rates
with the majority of their providers in all four markets. The
negotiated rates for most outpatient community based providers
ranged between 100% of Medicare and 130% of Medicare. The
negotiated rates for inpatient services ranged between 125% and 150%
of Medicare. Outpatient facility based providers were contracted at
rates ranging from 125% and 150% of Medicare as well.
For the next 12 months,
CHM received all of the Medicare based medical claims from these
four facilities. CHM processed a total of 1,875 claims for these
facilities during that time. The total of all billed charges for
these claims was $2,406,793.55. The total Medicare allowable amount
was $946,350.76, a $1,460,442.79 difference, or less than 40% of
billed charges.
Using a Medicare based
contract, with a 60% premium added to the benchmark, the total
savings when compared to typical institution healthcare contracts is
$411,273.62. These significant savings represent an impressive 21.4%
reduction in healthcare expense that transfers directly to your
company’s bottom line. (See attached analysis)
The results of this case
study show that Medicare based contracts make sense for all
correctional institutions. Even facilities where the contractor is
not at risk for external medical costs can benefit from this
contracting strategy. By utilizing Medicare based contracts, they
can save their customer a significant amount. |
