Individual and Small Group Health Insurance Market Data for Health Plans, Hospital Accountable Care Organizations and Industry Analysts

Accountable Care Organizations Need Competitive Data to Compete

Accountable Care Organizations

Oxlo Healthcare Insurance Solutions provides vital market intelligence for anyone contemplating an Accountable Care Organization, including Multi-provider Networks, Payer Collaborations, and Integrated Delivery Systems (IDS).

The customary distinction between Health Plan payers and the Health Care providers is changing. Providers are forming new risk taking relationships, including networks among competing providers, as well affiliations with Insurers. Growing networks of Hospitals across the country are unveiling plans to get into the health insurance business outright. The first target markets are direct employer contracting and small group insurance as small employers are struggling with the burden of rising premiums. The strategy of making benefits more affordable based on a more limited, but recognized local provider network is gaining momentum. By capturing the full employee benefit dollar, providers are able to control the flow of patient volume for a wide variety of both inpatient and outpatient profit centers.

accountable care organizations

In addition Hospitals, physician practices, and insurers across the country are announcing various plans to form versions of Accountable Care Organizations (ACOs), not only for Medicare beneficiaries, but also for commercial patients. Acting independently, neither hospitals nor health plans may have the optimal mix of resources and incentives to significantly reduce costs. The bet is that controlling the plan coverage and delivery will help make hospitals more profitable. Provider executives are busy segmenting their regional health insurance markets and considering the degree of risk they are willing to assume. To succeed in such a rapidly changing market, providers need market intelligence and a detailed understanding of their regional health insurance markets, as this change day to day.

Now emerging networks can get instant access to comprehensive insurance plan benefits and pricing data via subscription service vendor Oxlo Systems. Hospitals and other providers are obtaining more “critical mass” and their network footprints are growing via mergers and provider consolidations, intending to reach ever broader geographic markets. Competitive insurance plan information is essential to managing these aggressive strategies.

The race for hospitals to form ACO’s will cause a cascading effect on the market, where Hospital ACO’s (as they evolve) will clearly be positioned to compete with health insurance carriers for Commercial Small Group as well as individual subscribers. Alternatively, ACO’s may work collaboratively with existing health insurance providers, creating united contracting and risk funding organizations. Either way, the new challenge for each of these hybrid models will be real time market insight and competitive pricing precision.

Background
Oxlo helps Healthcare organizations manage the risks of a rapidly changing competitive landscape. Oxlo enhances their ability to remain nimble and release well-timed competitive plan rate and coverage’s for precisely defined market segments. OXLO HEALTH INSURANCE INSIGHT™ is a logical comparison tool used for maintaining/releasing new Health plan offerings. The ease of use of Oxlo “Visual Dashboards” also aid the decision process for evaluating Health Care Plan Insurers relationships or continued monitoring of specific Insurance market offerings.

ACO’s can access and collaborate on local, regional or national competitive markets with timely information from Oxlo. Oxlo provides industry wide Insurance Plan Data Aggregation, Plan Review & Rate Monitoring, Data Feeds, and a Reporting Engine, all currently used by the leading national Health Insurers. The bet is ACO’s overall health care services business and any related insurance plans offerings will benefit with new insurance products launched and marketed. All such providers have the option to offer price savings opportunities to encourage more patients / commercial groups to participate as insurance customers, but also to participate in their own healthcare management. Such products will likely include unique plan and network features such as “tiered” payment structures, higher deductibles… all requiring access to market wide insurance carrier plan benefits and health plan cost data, all currently available from Oxlo Systems.

Oxlo’s Health Insurance Insight is uniquely affordable, based on Oslo’s proprietary Software as Service SaaS platform. Just as Hospital ACO’s have the purpose of lowering costs by sharing resources, any organization offering health plans now also have the incentive to use Oxlo’s competitive tools, without having to add additional infrastructure. Oxlo processes massive amounts of health Plan data, and can make comparison plan rate data instantly available to heath care and insurer customers. See http://oxlo.com/download-health-insurance-reform-whitepaper.html for white paper.

Oxlo Provides Healthcare Insurance Transparency Solutions, OXLO HEALTH INSURANCE INSIGHT™
Industry Wide Insurance Plan Data Aggregation, Monitoring, Normalization, Data Feeds, and Report Engine Software as a Service solution for the Health Insurance industry, used by the leading Health Insurers and Hospital ACO’s.

 

 

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