Products & Services160927
The Right Solution, Tailored to Your Needs
Healthcare Highways (HCH) offers employers, payers and brokers/consultants; industry competitive PPO networks and customized health plan solutions.
PPO Network Services
HCH owned and affiliated PPO networks are comprehensive networks of hospitals, physicians and other providers throughout the country with discounts competitive with national health plans.
- Healthcare Highways Oklahoma Network – Our proprietary PPO network developed and owned by HCH, rounded out throughout the state of Oklahoma by PHCS.
- Oklahoma Health Network (OHN) – Acquired by Healthcare Highways May 1, 2014, OHN has been a strong Oklahoma based PPO network for 9 years, developed in cooperation with participating VHA Oklahoma hospitals. OHN provides an excellent complement to the HCH Oklahoma network.
- Healthcare Highways of Louisiana / Verity HealthNet – Healthcare Highways acquired 50% ownership in Verity HealthNet April 16, 2015. Verity HealthNet has been a top quality, well-known and respected PPO network in Louisiana since 2002.
- Healthcare Highways Texas Network – Our proprietary PPO network being built throughout the state of Texas, beginning in late 2015.
- National PPO Network – Through our strategic partnership with our national network partner, MultiPlan/PHCS, HCH offers members access to quality providers outside of Oklahoma and throughout the U.S.
Funding Advantage for Growing Employers
For Employers with 10-100 lives
Our core product for employers with 10 to 100 employees is HCH Funding Advantage. This fully integrated solution allows employers to maintain flexibility with employee rates, plan design and deductible levels, which are limited under traditional fully insured environments. HCH Funding Advantage provides an innovative solution that allows employers to have the cost certainty of a fully insured program with the opportunity to keep the savings when their claims are lower than expected.
Additional benefits of the program include:
- Employers continue to offer composite rating and meet the essential benefit requirements associated with healthcare reform
- Small employers avoid the Health Insurance Industry Fee beginning in 2014, estimated to range from 2 to 5% over time
- Returns 100% of claims surplus to employers unlike competitors’ products that return only a portion
- Avoids most state insurance taxes and PPACA fees equal to 4-5% of premiums
- Not subject to PPACA Community Rating provisions responsible for many of the 20%+ renewals currently being experienced in the fully-insured market
- Employers can frequently save 10-25% on overall health insurance premiums
Customizable Health Plans
For Employers over 100 lives
For employers with more than 100 employees, HCH offers fully customized plan options. Using the HCH PPO network as the “core” product, employers are free to add additional services covering the healthcare benefit spectrum to create a fully integrated solution. All HCH product partners are carefully selected based on quality, cost and service securing pricing competitive with industry leading health plans.
Working with our preferred partners, HCH offers mid-range to large size employers competitive health plan administration options. HCH has vetted what we believe to be the highest quality administrators in the country who specialize in customized administration and offer high-touch customer service.
Today, many employers elect to self-fund their employee health plans to take advantage of benefits such as plan design flexibility, and savings. But the potential risks can be as significant as the rewards. Stop-Loss insurance is a critical consideration for employers of all sizes who may decide to self-fund their medical plan benefits while limiting the associated risk. Embedded in our partially self-funded, small group Funding Advantage product, and customizable by mid-to large size employers; HCH has competitively priced partners who deliver exceptional service for employers.
Offering competitive network discounts certainly helps to reduce employers’ overall health plan costs; but equally important is the selection of a comprehensive disease management program designed to control costs associated with chronic and complex medical conditions. Through our specialized disease management partners, HCH offers customized disease and maternity management programs as well as health and wellness programs to help employers be proactive with their employee’s health, and addressing rising healthcare costs.
Pharmacy Benefit Management Services
Healthcare Highways Rx is a comprehensive Pharmacy Benefit Management (PBM) program available to employers with 10 or more employees. Healthcare Highways Rx offers:
- Customized, competitively priced programs to meet clients’ economic and clinical needs
- An expansive network of well-known and respected, local-community pharmacies
- Real-time system access to assist employers with managing their pharmacy benefit program
- Visit our HCH Rx website for more info
Healthcare Highways provides a cutting-edge, user friendly, fully integrated health information system which includes population health management tools designed to measure individual member and overall organizational health risk levels as well as assess the effectiveness, quality and utilization of healthcare providers. Our web-based systems are capable of generating reports easily and quickly to meet the growing demands for information and solutions. We stratify our approach across each plan’s data, initiatives and strategy with a keen focus on utilization trends, Rx benchmarking/formulary, catastrophic case analysis, disease management review, claims analysis and predictive modeling.