In
1999, a large employer asked Michael Jenike to take a look at
the company's self-funded health plan to see whether anything
could be done to reverse the alarming, upward cost trend. At
the time, Jenike was in the business of running profitable hospitals
and therefore, intimately involved in negotiating network rate
contracts with national carriers and Third Party Administrators
who offered Managed Care products. As a result, he knew he could
help the company seeking assistance simply by negotiating direct
contracts with service providers. Since that time, this large
employer and several others have each realized a 7-digit cost
reduction of health plan expenditures without cutting employee
benefits.
"The first step in
giving employer-consumers the power to control health care costs
and quality," explains Jenike, "is to understand that
health care is a business that will respond to market forces.
The second step is willingness to allow genuine competition
to work. GM&A is owned and operated by health care insiders
who have enjoyed successful careers in both the business and
clinical aspects of health care delivery. Our first-hand knowledge
and experience have prepared us to `level the playing field'
by negotiating rates that are fair for service providers and
employers."
Jenike notes qualifying
employers have a few things in common:
1. A self-funded health plan or ability to become self-funded; |
2. At least 1 geographic location area with a
concentration of 500+ employees;
3. A competitive health care marketplace (2 or more full-service
hospitals);
4. A financial interest in reducing health plan costs;
5. A desire to preserve benefits and contribution levels.
6. A goal to have a genuine partnership with health care providers.
"GM&A is partnering
with The Seller's Group LLC of The Woodlands, to market our
services concept to the Houston area," Jenike states. "Together,
we represent qualified employers in competitive negotiations
that result in clientspecific provider networks that help client
companies reduce costs and gain control over their plan expenditures,
while reducing out-of-pocket expenses and preserving benefits
for employees.
"Our compensation is
based strictly on plan performance," he continues, "So
our team reviews and/or audits all claims for accuracy of paying,
billing and reporting. If actual plan costs for our clients
do not decrease, GM&A does not get paid.
"We offer a real, proven
solution to those who want to fix a broken system," asserts
Jenike. "Using competitive, fixed rate, direct contracting
to build custom provider networks gives employers with self-funded
health plans control over the way they purchase health care.
GM&A's health care insiders have crafted a viable solution
for employers that will ultimately make health care better and
more affordable for everyone." |
