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30,000 Feet with CEO Andrew Saltoun
First of all, thank you for being part of our network!
Healthcare is evolving rapidly and the changes precipitated by President Obama are having broad impacts to our healthcare system. While the constant challenges of increased documentation standards, reimbursement pressure, and too much news to read and digest can be daunting, I thought I would take a few minutes to share a more positive perspective.
There are a multitude of demographic tailwinds that make P&O and DME an attractive place to be. I am sure many of you are aware that Obamacare structured a program to generate coverage for about 30 million, previously uninsured, individuals who will be included in our healthcare system as a result of the ACA. It is estimated that between 1 and 2.5 million new members will be insured in New York starting in 2014, which will increase our Medicaid eligible population by over 20% (the vast majority of these individuals will be in our state’s Managed Medicaid programs). In addition, the baby boomer generation’s growth is exploding and seniors are in significant need of P&O and DME. Obesity levels have reached all-time highs and the CDC projects diabetes will affect 1 in 3 Americans by 2050 – we see these patients every day as they are 10x more likely to see P&O professionals than non-diabetics and much higher utilizers of DME. Lastly, the healthcare system has recently embraced homecare as a more cost effective model of care than hospitalization. This trend, above all else, will make our providers some of the most important caregivers for our nation’s patients over the next 5 years.
With all of this demand and a system that we all know is economically strained, now is the time to focus on the fundamentals of great patient care, efficiently delivered. At Integra, we are constantly thinking about how we can generate more value for our network of providers. We know that you want, and need, access to insurance companies so that you can serve your communities, and that is what we are doing. As you know, this quarter, we announced a Preferred Provider partnership with CenterLight and an increased relationship with Aetna, adding 1 million New Jersey members to our coverage area. In addition, we expect to add 1-2 additional plans in New Jersey and are constantly adding plans in New York.
Also, I am pleased that so many of you have taken advantage of our direct deposit program, which has resulted in a 3-5 day reduction in your outstanding AR and no interruption of payment during Hurricane Sandy or other such future issues. Over the course of this year, we hope to continue to create efficiencies for you. We are exploring technological improvements to our billing system that will further speed-up provider receivable collection and payments, we are working with payors to further streamline our interfaces, we are developing patient eligibility solutions to reduce errors in eligibility checks, and much more, all in effort to improve your working capital.
I recognize that our system presents a lot of challenges as well, but I thought it would be refreshing to hear a positive point of view. I wish you all a great spring and please keep us posted if you have ideas, suggestions, improvements, etc. – we want to hear from you!
Contributed by Andrew Saltoun
CenterLight Selects Integra Partners as its Preferred Provider
As of March 1, 2013 Integra Partners will be the preferred provider for Orthotics, Prosthetics, and Durable Medical Equipment for all CenterLight members. For more than 90 years, CenterLight Health System, formerly Beth Abraham Family of Health Services, has been working to improve the quality of life for New Yorkers in need, from all backgrounds and all walks of life. CenterLight currently ranks among the nations leading resources for long-term residential and community-based healthcare. It is with great pleasure to have been selected as their preferred provider and we hope that you are as excited as we are to begin servicing their member population!
Integra Adds 1 Million Covered Lives in New Jersey
We are happy to announce that in addition to our Aetna contract for the State of New York, Integra Partners network providers may now also see Aetna members in the State of New Jersey. The new contract with Aetna NJ went into effect on March 1, 2013 and covers more than 1 million members in the state. Integra is committed to growing its New Jersey network and we are looking forward to procuring additional value added contracts for our providers.
WellCare Expands its MLTC Coverage
On March 5, 2013 WellCare Health Plans Inc. announced the New York State Department of Health’s (DOH) approval of its MLTC expansion. Previously serving the Bronx, Kings, Queens, New York, Buffalo, Orange, Rockland, Erie, and Ulster counties WellCare’s MLTC plan has expanded is coverage to include Nassau, Richmond,Suffolk, and Westchester counties.
What this means for you: You may begin to see increased volume in these areas as WellCare continues to actively recruit new members. Open enrollment in these geographies began on March 1st and will continue to grow. As a participating provider on the Integra network (once given a WellCare ID), you may service this new population utilizing our existing WellCare contract!
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