Support from Top to Bottom

Establishing a provider-sponsored managed care plan is a significant undertaking.

Taking on the role of provider-sponsor means long-term care providers must take responsibility for multiple tasks that are traditionally outside of their expertise. With so much at stake, choosing the right partner is critical.

Collaborations should be led by people with an understanding of the long-term care and provider-sponsored plans industries. People with a strong knowledge of all the moving parts, the complexity of the continuum, and an ability to lead through change.

AllyAlign Health was built for this purpose – to partner with and support high-performing long-term care providers with the capital, infrastructure, expertise, and proprietary technology essential to the successful formation and ongoing profitable management of a provider-sponsored managed care plan.

While our partner focuses on the patient, we concentrate on the successful operation of the managed care plan.

Ours services include:

  • State HMO Licensure

  • Full Medicare Advantage Application Submission

  • NCQA Model of Care Approval

  • Plan Implementation

  • Staffing

  • Provider Contracting & Network Management

  • Medical Management

  • Sales/Marketing & Member Enrollment

  • Claims administration

  • Technology

  • Regulatory reporting

  • Financial & Actuarial Management

Rewards Outweigh the Risks

  • Innovative contracting and administrative solutions complement the long-term care provider’s core capabilities and strengths

  • Engages with payers in quality-based contracts that recognize and reward out-of-the-box care delivery options for medically complex patients.

  • Model mitigates risk for long-term care providers by aligning payment methods with desired patient outcomes

  • Financial models include shared risk arrangements in which quality is tied to financial performance

  • Data-driven model improves patient outcomes while reducing costs for risk-bearing long-term care providers

  • Creates revenue and gain sharing opportunities for our provider partners by delivering value to payers and patients in the form of better quality and lower cost