If you're like many hospitals, health systems, and doctor groups,
then the answer is probably YES.
Most likely, there are self-funded employers using Apaly, who are already requesting to contract with you.
People covered under self-funded employer health plans in the United States as of January 2019.
Percentage of insurance "card-holders" who are actually covered under self-funded plans where the carrier is the administrator. They are not really carrier plan members.
The annual healthcare spend of self-funded employers in the United States.
Percentage of these employers who are planning to direct contract with providers and implement centers of excellence, causing a shift in where your revenue will come from.
Connecting is key.
Create your account to learn who is requesting to contract with you. On the flip-side, you can also invite employers to directly contract with you.
Our tool makes it easy.
There are several different types of contracts that you can choose from, each with different rate types. The software will help you decide what rate makes sense for you.
No operational changes required.
Deliver care to contracted employer plan members and submit your claims through your billing system (just like you would with an insurer). Get paid your contracted rate, only quicker.
There is a major movement underway.
Almost 80% of self-funded employers plan to implement some form of direct contracting with healthcare providers over the next few years (Source: Willis Tower Watson). Hospitals, doctor groups, and other types of healthcare providers have the opportunity to participate NOW.
Our software can help you establish direct contracting as a new product line that you can package and market to the self-funded employers in your area, and fulfill a tremendous market demand. Remember, just because an employer isn't headquartered in your community, doesn't mean that they don't have employees and families there that need your services. Think about the major big box retailers, delivery companies, home improvement stores, and fast food vendors.
Intermediaries add layers of unnecessary cost, and often try to leverage their size (i.e. their membership numbers) to strong arm you into taking lower contract rates. However, they don't typically pass these lower rates on to the employer... This means employers pay more, while you get paid less.
When you contract direct, employers pay less, while you get paid more. There's no middleman to add their markup.
You decide what rate(s) are acceptable to you. Our software gives you the tools to guide you along the way. Based on the rates you enter, we'll show you how much of the self-funded market you're likely to capture. You can even create multiple levels of carve-outs, exclusions, and even participate in bundles. Decide what makes the most sense for you.
We've created a simple, flexible, modular, and scalable way to contract.
Want to expand your presence but don't have facilities or providers beyond your core markets? Collaborate with other healthcare providers nationally, then filter and define those hospitals and doctors that you want to participate, and offer a comprehensive solution to clients with broad, distributed work forces.
Extend your offering nationally, or even globally.
The Apaly Health platform is designed as an ecosystem and marketplace for healthcare innovation, to help providers continually deliver value to patients, payers, staff and other partners.
Innovation that you can leverage.
Direct relationships with self-funded employers positions your organization as the center of their healthcare universe. This creates a sticky relationship that can be continually expanded upon to gain and retain market share.Learn more about Apaly Health's features >
Lowering costs, enhancing quality, and improving the health and wellbeing of employees are goals for all self-funded employers. Apaly Health is an innovative, cutting edge solution that manages to balance these sometimes conflicting priorities.
Innovation is a daily topic in healthcare, but very few are focused on the core issue of healthcare, provider networks. Similar to the hotel industry, there are many locations to receive services but they fall under a handful of controllers, the large insurance companies. Disintermediating this design, similar to VRBO or Airbnb in the hospitality industry, has the ability to return healthcare to a free market design resulting in lower cost and better outcomes. Apaly Health is the only solution I have seen with a turn-key solution to enact the disruption needed to make this a reality.
Direct contracting is the wave of the future, and direct contracting with providers has been shown to save employers sometimes 75% or more. Apaly Health scales direct contracting to a national level, and can extend this value to the masses allowing the disintermediation of the middlemen in our current, archaic healthcare system. Apaly Health should be an essential cost containment / risk mitigation component in any health plan that utilizes high-performance healthcare solutions like our FairCo$t Health Plan.
Apaly Health makes direct contracting scalable by enabling many-to-many relationships between employers and providers. Every provider or employer that signs up, can deliver or receive healthcare services with everyone else on the platform. It’s like crowdsourcing provider access to benefit everyone.
Given the on-going shift towards self-funded employer health plans in the U.S., Apaly Health’s decentralized provider contracting platform seems to be a logical use case of blockchain technology. Disintermediating high cost gatekeepers through direct, peer-to-peer contracting between employers and providers is an ideal use case of the self-sovereign trust mechanism of blockchain technology.
“Apaly Health has created a simple and seamless solution that allows physicians (and other providers) to directly contract with self-funded employers, without any operational or practice work flow changes. It’s designed to feel just like any other payer relationship, except we get to set our own payment rates and get paid faster.”