Alithias works closely with our broker, TPA and Network partners to support cost saving strategies for creative benefit plan designs, including tiered, RBP, or incentive based plans. We are often the single point of contact for members to call for questions about nearly every aspect of their benefit plan. Our proprietary incentive program is proven to save money, which is why we keep 95% of our clients year over year. Unlike large national solutions, we understand that all healthcare is local, and that our job is to make the broker or TPA look good while saving the client money. We will even build virtual narrow networks within each metropolitan area, specific to your clients' needs. Offered savings are guaranteed. If we screw up, we always make it right for the client. Alithias helps our broker and TPA clients grow their book of business.
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1101 N Market St
Suite 2M
US，WISCONSIN，MILWAUKEE，53202
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?? ??? ??????? ??????? ?? ??? ?????? ??????? ?? ??? 2025 ????? ????? ???????? ????????? ????????? ?? ?? ??????? ????? ?? ????????? ????????? ??? ???, ???????, Ross Bjella ?? ???????, ??????? 28??! ??
Our fourth session of the 2025 Alera Group Employer Symposium will be a health care panel. Moderated by Ross Bjella of Alithias, Inc. Kelly Macken-Marble of Osceola Medical Center, Steven Massey of Westfields Hospital & Clinic and Emily Dilley, MBA HSL of Cumberland Healthcare (Cumberland Memorial Hospital) will serve as the panelists. To sign up and learn more: https://lnkd.in/gFAE-iQN #HumanResources?#EmployeeBenefits?#Compliance?#HealthCare?#Sustainability?#Strategy?#Change
If your a #SelfFunded #Employer (or anyone else who really wants to understand #healthcare) take a few minutes to listen to Eric Topol, MD interview Mark Cuban! Mark discusses much of what Solstice Health and a few others have been doing for nearly 13 years, before it was cool! When you are at the 1?? yard line, it’s great to have the additional muscle of his voice and platform to help carry the ?? over the goal line! From #cashpay #surgery and #WholesaleAcquisitionCost meds to even #DirectAccessLabs (without a doctors order), I was listening to myself over the past decade?, broken record educating everyone in my path. With all of those pieces and services, we built the Solstice Health structure to disrupt the traditional healthcare system business one-way ?? sales funnel model to higher cost care, and created and inverted two-way ?? care funnel opening a world of lower cost and higher quality options, tearing away the veil of insurance and corruption! Today, many parts of our model have grown in many different ways across #Wisconsin and the puzzle ?? is actively being completed with brokers and new self funded plans joining the cause to fix our broken #sickcare system! FORWARD Wisconsin! https://solsticewi.com/ Self Fund Health Jonathan Baran Benjamin John Matt Ohrt Keith Smith Marty Makary M.D., M.P.H. Azucena Murray Jessa Cisewski, RN Phillip Blair, SHRM-CP Dutch Rojas David Contorno Emma Fox, CHVA Todd Catlin Steven Borene MD MHCDS Nicole Hemkes MD MPH The Coral Platform Ross Bjella Alithias, Inc. The Alliance R&R Insurance Services Inc. M3 Insurance Brown & Brown Insurance Savvos Health Holista Prairie States Enterprises, Inc. Lesley Hobson, BSN, RN Allie Duenow RN, BSN Jacinta M. Avergent Drew Leatherberry Kami Wein Corey Palmer #DirectPrimaryCare #DPC #DirectSurgicalCare #DSC
You don't need to wait for Mark Cuban to scale up his direct contracting approach (listen about 2/3 into the episode). If you're in Wisconsin, you can work with Drew Leatherberry and his team at Avergent. They are doing the things Mark is talking about already, making sense of the nonsense of health insurance, and saving clients and their employees a lot of money. https://lnkd.in/gARTEdEJ
? ?? ??? ???????, ???? ??? Alithias family to yours, ?? ????? ??? ??? ???????? ?? ???? ???? ???? ??? ???????? ?? ?? ?? ???? ?? ???? ?????????? ???????. ???? ?????? ??? ????-????? ?????? ??? ???????? ?????, ????????, & ??????. ? ?? ??? ?????? ???????? ????????????, ?? ??? ????????? ???????? ??? ???? ????????? ??????? ??? ???????. ???? ??? ????????????? ?????????? ?? ??? ?????? ??????? ?? ??????? ????, ?? ????? ??? ??????? ????????. ????’? ?? 2025!
The Truth About Hospital Price Transparency. Dr. Miles Varn wrote a nice article in Employee Benefit News this week highlighting the issues with the price transparency data posted by hospitals for Cares Act compliance. As my friend Leo Wisniewski at HealthCostLabs (healthcostlabs.com) says, "The published data and procedure descriptions are nearly impossible to interpret unless the user is well versed in hospital coding and the exact codes that are commonly billed for each procedure." Hospital compliance with the Cares Act requirements, in my opinion, is less than 30%. I don't blame the hospitals. The Act did not provide sufficient guidance or requirements to make the data decipherable to lay persons. For example, would a layperson looking for the cost of a screening colonoscopy know the correct CPT code? (45378) Would they know to also include the anesthesia CPT code? (00812). Would they know that the hospital might code the procedure as diagnostic? (45380) and if a diagnostic code was used, would that person know to add the lab and pathology code? (88305). Lastly, would they know that they would also need to add the professional fees for these codes? Dr. Varn's recommendations to help patients get the most value for their healthcare are spot on: 1) Get a second opinion, 2) Use a Care Coordinator or Care Advocacy company (like Alithias!), 3) Review your medical bills. Employers, brokers and healthcare disruptors wanting to use this information for care navigation must lower their expectations about completeness and accuracy of the hospital's published prices. Even respected researchers like Ge Bai at John's Hopkins often can't tell which published data is good and which should be thrown out. (For example, a hospital representing the facility fee for an MRI through a commercial carrier (and not Medicare/Medicaid) at $312 is clearly a reporting mistake and should not be included when averaging costs or identifying "high value" facilities.). If Ge Bai (who IMHO is brilliant) struggles with this, do you honestly think an employee or HR manager is going to figure this out? If you are trying to save money on a common surgical procedure, do not use a large health system. Seek high quality, independent practices, ambulatory surgery centers, imaging centers, or testing facilities. If you want to know exact prices, use a bundled network like Holista, Amplify/Solarte, or doctors who aren't afraid to publish prices. Some great ones are listed below. Orthopedic and Sports Institute OSMS Green Bay Chippewa Valley Orthopedics Twin Cities Orthopedics Summit Orthopedics SolsticeHealth Orthopaedic Associates of Wisconsin Orthopaedic Hospital of Wisconsin Renovo Health Wellbridge Surgical, Surgery Center of Oklahoma Self Fund Health Jane Sanford Keith Smith Timothy Murray, M.D.Steven Borene MD Josh Johnston Kenneth Strmiska Robert Pfeiffer Jory Zunich Kate Grohall Dirk Carson RoryWright Marty Makary M.D., M.P.H. Jake Nolin Patrick Blackaller
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I was having coffee with a client and overheard a woman next to me say, “I agree, but she is a bit much!”… and well, I guess my phone heard her as well ?? because this post popped up on my Pinterest feed - and I have to say, I just loved it ?? Be ‘a bit much’ today!! It’s also Red Cup Day at Starbucks! ?? Happy Thursday!