What is The Bottom Line? Commercial Health Plans and Controlling Your Costs
At the end of the day, contracting in this day of pay–for–performance and adding value to the relationship is about the bottom line. What is the bottom line? The Spend!nnIn most states, including Colorado, the commercial health plans have to tell the state what their premiums are. Their premiums come from their estimate as to what their network and covered population will cost. I find it fascinating to look and see what the various payers are declaring! You can tell a lot about a network and its management by looking at these numbers.nnCan a provider help a payer lower its spend? Can you control costs? Not necessarily your own costs but the costs of those you refer to? You may be surprised!n
The bottom line, don’t give it (this ability) away!
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Stay tuned for more Todd’s Tips!
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About R. Todd Welter • MS, CPCnFounder and President of Welter Healthcare Partners
nMr. Welter has over 25 years of healthcare industry experience assisting physicians and other providers, hospitals and other facilities with the business side of medicine. Through strategic planning and analysis, Mr. Welter’s main focus is to strategically increase revenues and profitability in this radically changing health care environment. Mr. Welter has a Masters Degree in Organizational Leadership from Regis University in Denver where he has had an appointment as affiliate faculty in the School for Professional Studies for over ten years. In addition, Mr. Welter holds a faculty appointment at the University of Denver’s University College. In the Health Care Leadership program he teaches Macro Economics in Health Care and Innovative Strategies and Change in Health Care to graduate students.
Transition InformationnOn March 1, 2017, Hewlett Packard Enterprises (HPE) will assume fiscal agent operations on behalf of Health First Colorado (Colorado’s Medicaid program) and Child Health Plan Plus (CHP+). These operations include the transition to the Colorado interChange (a new claims payment system) and a new provider Web Portal.nnYou must be enrolled in the new Colorado interChange. All providers must be enrolled (and approved) in the Colorado interChange system by March 1, 2017. Those who are not enrolled and approved will not be able to submit claims or receive payments. Visit 
With just over a week before it was scheduled to take effect, a federal judge blocked the implementation of an Obama administration overtime pay rule that would have extended overtime eligibility to some 4 million Americans.nnThe Labor Department’s sweeping overhaul to the overtime rule required employers to pay time-and-a-half to their employees who worked more than 40 hours in a given week and earned less than $47,476 a year. That salary threshold is about twice what currently allows workers to be exempted from overtime. As NPR’s White House Correspondent Scott Horsley told our Newscast Unit, supporters of the rule called it “long overdue” as inflation took its toll on overtime protection.nn”The rule was one of the administration’s most far-reaching efforts to boost pay for workers at the lower end of the income ladder. It’s one of many administrative actions that was already facing the threat of reversal from the incoming Trump administration.” The measure, which had been set to take effect Dec. 1, was intended to send a jolt to slow-growing U.S. incomes.nnOn Tuesday, U.S. District Judge Amos Mazzant III issued a preliminary injunction in the case, siding with plaintiffs who said the new overtime rules would have caused an uptick in government costs in their states and made it mandatory for businesses to pay millions in additional salaries. Business groups said the new rule changes would have eventually led to layoffs.nnThe timing of the block brings an early answer for workers who were wondering about the rule’s fate after the election. As NPR’s Business Correspondent Yuki Noguchi reported earlier this month: “In any presidential transition, previous policies are subject to review. Trump has pledged to undo President Obama’s executive orders, dismantle the Affordable Care Act, reverse policies on clean air, immigration and on Dodd-Frank financial reform. This [month], the Congressional Budget Office said canceling the overtime rule would reduce employers’ compliance costs and boost profits, a point advocates refute. This leaves businesses wondering how they should proceed on rules that might be unwound.”nnWith Republicans controlling both houses in Congress and the Trump administration set to take office in less than two months, the new overtime rule’s long-term future remains in limbo. The Department of Labor issued the following statement regarding the federal court’s preliminary injunction.n
Happy Thanksgiving! We are very happy whenever the season of Thanksgiving is fast approaching because we consider this as a wonderful holiday that permit us the best opportunity to thank all our valued friends, supporters and clients. These previous years have really been good to our company, and so we thank all of you for continuing to patronage us and for experiencing our remarkable service.nnWishing you and your family a wonderful Thanksgiving!n— Welter Healthcare Partners