Direct Contracting

Our Secret to a Successful Reference Based Pricing Plan

After Creating and administering Proactive RBP plans for employers all across the country, Achieve Health Alliance understands that the transition to RBP needs to be done thoughtfully and adapted to the needs of an employer's population.

Our Success is Built on Creating Direct Facility Agreements

How does it work?

Any care facility can join the program. For local hospitals to provider organizations and speciality care facilities, the key is partnering with local facilities that are willing to accept a reasonable multiple of Medicare that would ensure the savings to the plan before members receive care. Once established, members can then receive care at these facilities with no out-of-pocket facility expenses or balance billing.

Who benefits?

Employers, employees, and hospitals. Direct Facility Agreements allow employers to offer lower out-of-pocket costs to employees and keep care in the local community.

How will members know to use the Direct Agreement Facilities?

Achieve Health Alliance has proven strategies, including our Patient Advocates who help plan members understand the financial benefits of using the Direct Facility Agreements. Patient Advocates ensure that communication and guidance to the facility is constant and clear to the the employees and their families. 

The Result?

No balance billing and lower costs for the members and the plan -- a win-win for everyone involved. At Achieve Health Alliance, we believe in proactively educating members on the benefits of Direct Facility Agreements, not litigating with providers after the fact.

Patient Advocates Help Members:

Navigate our online pricing tools to determine the best combination of price and quality for procedures

Understand the value and savings associated with going to a directly contracted facility

Locate providers in their area

Understand and reduce medical bills

Initiate cash pricing deals that could save members money on expensive procedures.

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