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In every industry sector, organizations are rewarded when they improve the value of the services they deliver or products they make. This is not the case in healthcare. In healthcare, for the most part, only the volume of transactions is rewarded, irrespective of the quality of care delivered. Imagine Health® develops Smart Employer Network (Smart E Network®), which are quality performance networks designed to recognize and select healthcare providers dedicated to improving clinical care and reducing the cost of care. We accomplish this by:
- Using standard clinical performance measures
- Using nationally recognized, independent third-party organizations to measure the performance of healthcare providers
- Offering healthcare providers clearly defined benefits which help the healthcare provider determine the value of participating in a quality performance network
- Encouraging healthcare providers to adopt better systems of care, including health information technology, to systematically improve the delivery of care and patient outcomes
Smart E Networks are created by Imagine Health expressly for Employer Sponsors with a large concentration of employees in a geographical area or areas. Smart E Networks often compliment employer-sponsored primary care centers.
After healthcare providers are recognized and selected, Imagine Health contracts with the healthcare providers who successfully compete to supply services for the Smart E Network. Healthcare providers discount their rates in exchange for the inherent and large increase in the Employer Sponsor's patient volume.
The Smart E Network return on investment is high—generally 75-80% of savings is retained by the Employer Sponsor. On average, Employer Sponsors can save between $1,200 and $1,500 per employee per year. For a group of 5,000 employees, the healthcare provider savings could be between $6,000,000 and $7,500,000 each year.
Imagine Health owns the Smart E Networks and holds hundreds of contracts with healthcare providers specific to each Employer Sponsor. We ensure the healthcare providers in the Smart E Network maintain required credentials and quality recognitions. We hold the errors and omissions insurance required for a provider network. We maintain and renew the healthcare provider contracts and reimbursement schedules, modifying the composition of the provider network as the Smart E Network matures.
Imagine Health accepts, prices and submits electronic claims to the Employer Sponsor's healthcare administrator. We work with and educate the Employer Sponsor's healthcare claims administrator, utilization management organization, benefit consultants and stop loss insurance carriers to take full advantage of the Smart E Network.
Imagine Health Employer-Sponsored Networks include: Toyota's Innovative Health Network, Micron Health Partners Network, Sinclair Health Services Network and the Casablanca Casino's Resorts Network, among others.