WHAT WE DO

Build levels of provider networks based on quality and strength of contracts, then build a plan design that incentivizes members to seek medical care at high level facilities.

 

• First level:  High performance narrow PPO contracts with reimbursement contracts at or below 200% of Medicare

• Second level:  Direct hospital contracts with reimbursement contracts from 150% - 200% of Medicare

• Third level:  PreAdvance Payment with reimbursements around 130% - 140% of Medicare

• Fourth Level:  Aetna’s National PPO network with a built in plan design to offer richer benefits at hospitals with better reimbursement contracts