Tri-State Health Care Purchasing Coalition
The Tri-State Health Care Purchasing Coalition provides its consumer-only perspective to many of the health care issues facing the tri-state area. The Purchasing Coalition sponsors educational programs designed to evaluate new ideas to lower health care costs. Examples include the quarterly wellness roundtable where employers meet to discuss the successes and failures of local wellness programs and a speaker series focusing on new techniques to control health care costs. The Purchasing Coalition also analyzes statistical data to determine trends in the medical care provided in the tri-state area. This analysis will identify high cost areas and abnormally high rates of negative outcomes in an effort to reduce health care costs.
Health Care Vendors
The Purchasing Coalition has worked with health care vendors to develop competitively priced products and services that fit the needs of the tri-state area. These products and services include:
MyCatalyst is an organization that specializes in providing clean, accurate, and robust data for employers, empowering them to make informed decisions in order to achieve optimal healthcare and financial outcomes. MyCatalyst focuses on providing system and service support for data warehousing, integration, population health, prescriptive and actionable analytics, and meaningful reporting. They have multiple platforms that can be customized to fit within the scope of a company’s desired goal. With a focus on clean and accurate data integration and collaborative problem solving; the MyCatalyst approach can play a key role in your company’s cost containment initiatives. As the winner of two C. Everett Koop awards for Excellence, MyCatalyst presents solutions that get results.
Employer purchasing power is important in today’s pharmacy benefit marketplace. That’s why we’ve chosen to align with Employers Health Purchasing Corp. to deliver our employer members a market-leading PBM arrangement.
Working with best-in-class vendors, CVS Caremark and OptumRx, the PBM group purchasing solution brings hundreds of plan sponsors together to better purchase and manage the increasingly complicated pharmacy benefit. Plan sponsors get the most from the PBM relationship, while implementing their own plan design strategies, managing vendors or working through established consultants.
Here’s the program overview:
- Approximately 215 individual plan sponsors headquartered in 34 states.
- Collectively spends more than $1 billion on pharmaceuticals.
- Covers nearly 900,000 lives.
- Contract oversight by legal experts and claims audit at no cost to the plan sponsor.
- Dedicated account management team from the coalition to ensure the PBM relationship is meeting/exceeding expectations.
- Clinical oversight by coalition pharmacists to monitor new drug launches, analyze trends and provide information on plan design strategies.
- Participating employers receive objective ad hoc reports from a dedicated analytics team to help interpret plan performance metrics.
The coalition has an arrangement with Delta Dental of Illinois and Missouri to offer self-insured and fully-insured dental plans to our members.
Delta Dental PPO combines freedom of choice with cost-savings incentives. Network dentists agree to reduce fees, lowering out-of-pocket costs for enrollees and claim costs for employers. Nearly 107,000 dentists nationwide participate in Delta Dental PPO.
Delta Dental Premier is a managed fee-for-service plan with a difference. Unique agreements with network dentists generate the industry’s most effective cost controls. Three out of four dentists nationwide (184,248 dentist locations) and 70% of dentists in Illinois and 95% of dentists in Missouri participate in the Delta Dental Premier network.
Employee Assistance Program
Our preferred EAP vendor is ComPsych, Chicago, IL. ComPsych is one of the largest EAP service providers, which can accommodate your needs locally, regionally, as well as nationally. The program is easy to implement and requires very little ongoing maintenance from the employer perspective. You will find our rates to be very competitive.
ComPsych Presentation 2021. Enter Passcode: 36=qa%QC
Through an arrangement with Vision Service Plans (VSP), the nation’s largest provider of vision plans, companies may choose to offer vision care as an employee benefit. The VSP arrangement offers various plan options, at extremely competitive prices.
Tri-State Coalition Open Access III and PPO Network
Our members have access to HealthLink’s Open Access III and PPO Networks that provides an extensive network of providers. Currently, the Open Access or PPO networks are the choice for thirty-three coalition employers, representing over 18,000 covered lives in the Quincy Area.
Employers have found HealthLink’s Networks to be a cost saver. A claims data collection and reporting system provides extensive reporting about utilization, cost and quality.