Third-Party Payment Program Generates Annualized 2.2X Return on Investment
Texas-based health plan launched sponsorship (aka Payvider) model which demonstrated how health plans can collaborate with hospitals to improve community health while generating strong returns.
Community First Health Plans (CFHP) launched a Third-Party Payment (TPP) program to address gaps in coverage for low-income individuals in Bexar County, particularly targeting frequent emergency room visitors. The hospital-sponsorship program, which helps reduce uninsured rates, was piloted in 2022, focusing on enrolling members who met subsidy qualifications but faced affordability barriers.
Results:
🏆2.2X ROI in the first year of the third party payment program.
🙌🏻87% of CFHP enrollments in 2022 came from sponsored members.
💰The net profit from the first year far exceeded implementation and service fees.
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