ARMS

Introducing a Business Model That GUARANTEES Improving Margins on Medicare and MAKING money on Medicaid Business

Is your Healthcare System considering any alternative financial management solution that can drive higher revenue dollars to you and not to the commercial HMO/MCO companies you deal with today?

If you are, allow us to draw your attention to your Investing and owning a major Strategic Asset referred to as a Provider Owned Healthcare Plan MCO:

Advance Risk Management Solutions, Inc. (ARMS or the “Company”) along with its consortium members (the “Consortium”) has a business model that delivers a fully licensed Provider Owned Managed Care Organization (POMCO). This is the next healthcare risk sharing model for hospital and health care systems of all sizes.

We deliver all back room operations including a certified IT platform designed to adjudicate Medicare, Medicaid and self-insured employer group claims. The Advance Benefits USA/ SynthCare Health System will rival any IT health care system both in operational capabilities but also with very favorable cost factors that can substantially lower the cost of managing any size licensed health insurance company. Often we will expect to have multiple healthcare systems joining together to form the POMCO.

Our business model has proven that a high likelihood of success can occur when using all of our analytical and patient management tools.All solutions are built on a completely integrated management platform.

To accomplish this, we focus on the following eight (8) major areas:

  1. THE RIGHT RESOURCES 

Do you have the right resources?

  • The MCO goal is to deliver you a greater share of managed care revenue and profits that meets your needs and not the needs of the contracted HMO/MCO systems you currently depend on. 
  • Do you have the right resources for the development and management of a turn-key system with dedicated professionals to manage YOUR Managed Care Organization (MCO)?
  • Complete CMS integrated reporting for all mandated reporting requirements required by your state Medicaid authority and CMS. 
  • Preparation of all National Association of Insurance Commissions (NAIC) mandated statutory financial reporting required for all quarterly and annual reporting. All results coordinated with the provider owned financial department as may be required. 
  • Customized Clinical Analytics to help you monitor key performance indicators not only for Medicaid patients but for your total population. 
  • The ability to have other hospital systems in the same state demo graphical areas to join you with their own Medicare, Medicaid and commercial healthcare management opportunity. We do this at no additional cost to you through a network of captive reinsurance facilities owned by each hospital, thereby substantially reducing their cost of entry to the financial risk sharing MCO plan. 
  • Management Assistance with contracting of additional providers which may be necessary to fulfill network access requirements and or expand the geographic reach for Medicare/Medicaid and employer self-funded insurance plans. 
  • Assistance with the administration of global risk contracts and other incentive based arrangements.

A VERY IMPORTANT FINANCIAL BENEFIT WE CAN ARRANGE

  • Our Consortium has the ability to provide financial assistance to help raise as much as 70% of the regulatory surplus to help form your MCO, subject to Insurance Regulatory approval.