MSSC rolls out new group health plan option

In Affiliates, MSSC News by admin

The new ProviDRs Care-NexUS level-funded health plan – created in partnership with the Medical Society of Sedgwick County and administered by Medova Healthcare – is officially open for business.

Two years in the making, the ProviDRs Care Nexus group health plan was designed especially by and for MSSC physician members and features a powerful benefit package and a robust wellness program that offers access to corporate level benefits with significant savings over small group plan options.

“One of the biggest pain points for physicians is their health insurance benefits,” said Karen Cox, chief executive officer of ProviDRs Care Network. “We can provide a unique, level-funded health program that not only addresses employee health but achieves deep discounts thanks to the ProviDRs Care Network.”

The new ProviDRs Care NexUS group health plan, which opened to MSSC members this month, is not a typical association health plan. Designed for employer groups from two to 500 employees, members are individually underwritten and rated, which means that physician groups will earn their own rate plus the advantage of saving on administrative costs through membership in the Medical Society.

Karen Cox

Cox said the new group health plan is particularly effective because it doesn’t just base its performance on the evolving fee-for-service, managed care programs of the past. The NexUS platform is designed to support value-based care in which cost-containment incentives are aligned between physicians and members to better manage care, cost and members’ health, she said.

In addition, the plans feature a strong lifestyle and wellness improvement component.

Key features of the ProviDRs Care-NexUS group health plan include:

  • Lower unit costs, which combine price transparency with the deep discounts offered through ProviDRs Care Network to achieve a lower net cost on a unit-of-care basis.
  • Physician-led service utilization in which medical service is provided at the right place at the right time and the right price.
  • A productive lifestyle improvement and wellness program with advocacy coaches and a deductible credit incentive program.
  • Fixed costs that support program sustainability and that can be budgeted by the practice.
  • A unique benefit design structure that promotes using primary care physicians and the valued-based benefits structure of NexUS.

“I believe we have something very unique,” Cox said. “For this population, it’s so important for the MSSC to have this available to its members, because it’s developed by their peers.”

Groups can get plans based on their size, with multiple benefit plan designs for their employees, all with the integrated benefits of NexUS in each plan option. An eligible physician group must be an active member of the MSSC to be eligible to participate in the NexUS program.

Members interested in learning more about the new product or who would like to receive a group quote can contact Cox at KarenCox@ProviDRsCare.net.


NexUS plan value-added features

The unique benefit structure of NexUS Health is designed to promote the utilization of primary care physicians and the value-based benefit structure of NexUS Health. In addition, NexUS Health provides the following value-added benefit components:

  • ProviDrs Care Network for in-network benefit savings
  • $0 copay for all lab services provided through preferred vendor(s).
  • $0 copay for diabetic supplies provided through preferred
  • Benefit incentives for utilization of free-standing facilities and services.
  • Pricing transparency tools for selecting the most cost-effective facility for services.
  • Rx concierge services for non-covered prescriptions.
  • 16 plan design options for benefit and premium options.