![]() So here are those action steps we derived from talking about the “Flume Community”. And Proactive Member Provider engagement makes this process more palatable during a major change. Obviously the member experience is better then there is no disruption on the day of a doctor’s appointment. We really like the way that Flume approaches it Proactively & Reactively. There are so many items that the video covers, but the biggest item and the one that we strive and struggle with most is Direct Contracting. In the most recent interview, we asked all kinds of questions to help you understand where they fit, how you could leverage them as a partner, and where they feel a client can really thrive with their solution set. One of our other partners that we’ve been vetting not only internally, but in partnership with some of our peers in the Health Rosetta cohorts has been Flume Health.įlume Health, as the name implies, is a TPA that administers Health Plans for the Self-Funded or Level-Funded (sometimes call Partially Self-Funded) Employers. If you follow our social media at all, you know we have some really deep love for Aither Health and have been migrating our more complex plans to their platform with our “ Aither + EHIMRx + OneBeacon” strategy for self-funded clients. ![]() Naturally, with this kind of decision, we do lots of due diligence to avoid the pitfalls. And often, there are very central themes that distinguish a good TPA versus a Bad TPA, or a Good TPA versus a TPA with a train-wreck of service issues ready to drop any day. You may think of this in terms of “Oh, Aetna runs all aspects of my health insurance”, but in reality, there are really segments that a TPA or Plan Administrator executes. ![]() Now, a TPA typically refers to the health plan administrator as the entity that writes the check to pay medical claims and the company staffing the member service line to support all the complexity that is healthcare. One of the most complex and most strategic decisions anyone can make is deciding who is a good TPA partner.
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