Pillars of a Transparent Health Plan
At Bluegrass Health Plan's, we believe that everyone should have access to affordable, high-quality healthcare services. That's why we have rebuilt the traditional model with innovative, transparent service providers throughout. Our goal is to provide members with clinical data to aid in the decisions of where, how, and from whom they receive care. We've found that the ability to eliminate employee out of pocket costs is a well received byproduct, but it all starts with purchasing top quality healthcare.
The resource you use to access pre-contracted providers at pre-contracted prices so there aren’t surprises.
Access to Providers
i.e. Network
Advisors must be contractually obligated to only receive compensation from the client and no other source. Advisors must work only for YOU.
Transparent Advisor
The only Insurance piece. The financial protection that ensures your annual expense doesn’t exceed the claims limit budgeted. Gives you a policy for Stop-Loss in the event of something unforeseen.
Stop Loss Insurance
The Nurse Team that serves as the “Director of Traffic” accessing quality metrics of providers using objective data reported to the Centers for Medicare and Medicaid Services.
Medical Management
Must only receive compensation as a per member per month fee or per script charge and be contractually obligated to pass 100% of rebates onto the end-user with no mark down.
Transparent PBM
Handles the administrative tasks for a disclosed monthly fee without prejudice to other service providers and can only be paid directly from the client with full disclosures compliant with the CAA.
Independent TPA
Why Now?
The consolidation of the pharmacy and health insurance industries has exacerbated the problem of overspending. When Humana announced their exit from the commercial market in 2023, it was the straw that broke the camel’s back. We are left with only four major nationwide carriers dominating the market.
Several significant laws and executive orders have addressed and continue to address the issue of price transparency in healthcare, specifically hospital transparency and compensation disclosures. When coupled with the market pressure of businesses and individuals of all income levels truly not being able to afford their premiums and out of pocket exposures, the market is at an impasse.
Many options are being considered by legislators and the American people, including the review of healthcare finance systems around the world with significantly higher government involvement. However, with true price transparency now available and easily understood, the private market solution is shockingly simple. Early adopters, many fortune 500 companies, have been on the path to transparency for over a decade and BHP is extending those solutions to independently owned businesses across the country.
