Managed Care Strategies

TriNet has been actively involved with hospitals, physicians, group practices, IPA’s, PHO’s, foundations and other provider groups in dealing with the financial and operational implications of the managed care contracts being presented. TriNet’s experience includes:

Evaluation of Commercial HMO and Medicare Risk Products/Contracts

  • Distribution between providers and payors
  • Primary care capitation rates
  • Specialty fee schedule comparisons
  • Surplus/deficit distribution models

IPA/PHO Contract Reviews (Risk and Non-Risk Contracts)

  • Primary care capitation rates
  • Specialty care capitation rates
  • Specialty fee schedule comparisons
  • Surplus/deficit distribution models
  • Decision support system models to evaluate new payment rates