Make it Happen!
In 2009 we started a heritage driven post-acute care (PAC) network, Access Advantage, to capture managed care contracts.
Providers were starting to get Medicare Advantage (MA) Plan admissions referrals they could not accept. Five big payers told us they were growing their enrollments and “out of network” was getting to be a problem. Once our Members saw the complexity of managed care contracting, credentialing and revenue cycle problem solving it took almost no time to efficiently establish a consolidated, managed care services company, Access Advantage. They shared a common set of values: business transparency, clinical excellence and efficient, progressive work solutions with robust relationships of longevity.
We soon found we were contracted with twenty-five payers. Some are MA plans, others are Medicaid and more recently dual plans. Each with different rules and requirements.
Most every PAC provider now needs a contract and needs help with managed care. We provide the resource, deploy it to staff and assume the back end “wheelhouse” activities to make it work. This take the infrastructure burden off our Membership, allowing them to truly focus on patients, their families, and their communities.
Access Advantage consolidates high performing providers with best-in-class service and resources. Some networks offer only access to payer contracts, leaving complex managed care navigation to the facility. Less effective over time, auth/precert issues, incorrectly billed claims, uncollected revenue, lost appeals and continual data collection requirements are considerably more costly to your organization over time.
We also provide individualized consulting through our consulting firm, Access Elite for providers of all kinds. Past and current clients include MDs, ambulatory surgical centers, assisted living and adult day services.
In 2014 we decided we needed to know how to do Value Based Care contracting. We became a CMS Bundled Payment Model 3 Convener with twelve PAC providers. A quite small national Convener, our Access Innovations company has positive clinical and financial outcomes! We accomplished this by listening to our remarkable PAC providers who wanted to champion true care redesign. We deployed nationally recognized evidence based care guides and big analytics and got right down in the clinical weeds with a PAC transitions model, care coordination into the home, a strategically driven performance dataset and culture change staff coaching. The “big data people” are right, now that our Member’s can actually “see” their data, care redesign activities naturally occur.
In 2017 we deployed our own strategic performance measurement set, vetted by national resources. A value-add service to our Membership, our goal is to make every Member hospital, payer and consumer preferred in their marketplace.
Making it Happen for Those We Serve,