Creating a New Way to Buy High Quality, Affordable Health Care

Founded in

2015

50

Participating Employers

January to July 2018

542

Scans

$350,649

Total Employer Savings

58

Surgeries

Covered at

100%*

*Excludes individuals on high-deductible health plans

Patients Have Lower Out-of-Pocket Costs

(sometimes nothing!)

“One of the best things about going through the QualityPath program was that I had no medical bills to pay.”

Lonnie Miller

QualityPath patient, Roscoe, Ill.

2018 QualityPath® Providers Meet or Exceed Quality Standards

Surgeries:

Beloit Health System
UnityPoint Health Meriter
Monroe Clinic
Sauk Praire Healthcare
Southwest Health
Gundersen Health System

 

Tests:

Upland Hills Health
OrthoIllinois
Fort HealthCare
Midwest Open MRI
Smart Choice MRI
Turville Bay

Coming Soon:

Look for more information about colonoscopy providers

New Products and Platforms Answer Employers’ Needs

What do a program for first-time self-funding and an updated claims processing platform have in common?

They position The Alliance to meet the needs of self-funded organizations, now and in the future.

A Simpler Way to Self-Fund

Single Source Self-FundingMoving to self-funding can often overwhelm small employers. The Alliance created Single Source Self-Funding to offer structure and support that makes it simpler to get started.

Single Source Self-Funding prepared to serve small employers by:

  • Selecting Auxiant as our third-party administrator (TPA) partner and Serve You Rx as our pharmacy benefit management (PBM) partner, based on criteria specific to smaller employers moving from a fully-insured to self-funded plan.
  • Launching Single Source Self-Funding in 2017 for effective dates beginning Jan. 1, 2018.
  • Certifying 15 brokers to offer Single Source Self-Funding to small employers.

A Platform for the Future

Repricing claims to meet members’ needs takes a specialized claims processing platform.

The Alliance‘s claims processing system was written and maintained by internal staff to provide reliable and flexible claims processing, year after year.

In March 2018, The Alliance launched a major upgrade to the system to:

  • Update the programming language.
  • Provide flexibility for future development, an absolute requirement in this era of health care payment reform.
  • Create a relationship with an external programming consultant, Yahara Software, to provide ongoing support.

A team of Alliance staff helped design, refine and launch the system to ensure it would maintain the cooperative’s high standards for claims processing efficiency and accuracy.

“I think of The Alliance, our organization, like this watering wand, we unite employers to help them change health care. Turning a mist, into a jet spray. We are taking control of high health benefit costs through self-funding.”

Cheryl DeMars

President & CEO, The Alliance

The Alliance

Annual Report 2018

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