Partnership
At its spring 2005 meeting, the Board of Directors approved the Alliance entering
into a partnership with the Gateway Medical Resource Alliance. This organization
was formed by a cardiology group at St. Vincent to market high quality physicians
and their hospital and for these physicians to accept case rates, i.e., accept some
risk for their patient management. Gateway, over its 10 years, has expanded to
add Orthopedics and Cancer Care and is now marketing in Kentucky, Ohio, Illinois
and Indiana. The current Gateway product also includes automated enrollment
and patient information capabilities, a risk assessment and wellness program and a
pharmacy benefits manager. Their current client base includes 1100 small to
medium sized employers representing approximately 50,000 employees. This
spring Gateway acknowledged that, to become more effective for employers, they
needed to expand to form a broad, multi-specialty (including primary care)
physician organization – based on documented quality – with a multi-hospital
network included. The Alliance-Gateway partnership is developing this network
and currently has over 1,000 physicians committed to participation (including the
quality assessment required).
Gateway and the Alliance will offer this high quality network for access fees that
begin at the lowest levels in the market and then go down as employers participate
in programs and design benefits that will further reduce health cost exposure.
Additionally, there will be no utilization management or disease management,
since high quality physicians will already have been documented to address these
areas adequately, obviating the need for this additional bureaucracy and cost.
A number of Gateway clients have expressed interest in the product, as have
coalition members and a number of brokers and TPAs. Controlling, rather than
creating, the market will be the primary need in order to assure that all support
systems are functioning at a high service level. It is likely that this product will be
available in the second quarter of 2006. It is the plan to expand the network
throughout Indiana, into neighboring states, into areas required to service Indiana
companies in other parts of the country and to areas represented by other business
coalitions that have already indicated interest.
For more information on Gateway go to:
