HPA is a prominent part of payor contracting negotiations. This represents national healthcare services that may also be represented by very specific finance companies. They will combine together many different disciplines in the health industry which will include optometry, dental, and medical practices, each of which will receive some form of agreed-upon compensation. Once this membership group is formed, and the Practices are identified, it is then that the negotiation process can begin. When doing payor contracting for a group, that will work with this group of professionals, this is where the negotiation process becomes complex. Let’s look at how payor contracting by HPA works today.
Why Use HPA?
The Healthcare Professional Alliance has been around for many years. It is designed to create a conglomeration of professionals that can offer medical services at specific prices for self-funded employers. This is sometimes referred to as group insurance. You can see a list of all of the accredited providers, and the health plans that they represent, as well as information about partners and shareholders. Accreditation information is also provided, along with the states where they will provide their services. Therefore, due to the size of HPA, it is good to work with an established group of people willing to provide insurance to self-funded providers.
How Does Payor Contracting Fit In?
This process of examining existing contracts that are currently held with multiple insurance companies is needed for the purpose of providing funding. There will be a list of healthcare providers, and insurance companies that may have already formed a relationship, with ones that pertain to certain states. In the midst of all this is the payor, who will assume some of the financial risk, associated with providing these benefits.
The Reason For The Negotiations
By negotiating with the payor and Healthcare Professional Alliance, agreements can be made. These negotiations will determine how much the premiums will cost and what type of coverage will be provided to those that will have it. This will include treatment options, services rendered, and healthcare coverage for all involved. As with most payor contract negotiations, it may take months, but eventually, agreements can be made to provide the much-needed healthcare that groups deserve to have at an affordable price working with the HPA.
There are other facets of the negotiations, including providing specialty care and high-value services as part of the package. There should always be full visibility when creating these contracts, making them much easier to manage and change. If you are currently involved in a payor contracting by HPA negotiation, it will likely end well for you in the group that you represent. The negotiation process is always long and difficult, but will inevitably lead to a good contract.
