Drive revenue through custom programs

Health systems can differentiate themselves by developing unique programs that benefit clients and patients. They will gain increased utilization and higher patient volume.

Brighton Health Plan Solutions can administer custom programs and reimbursement models, including:

Benefit tiering

We can help you design tiering to guide patients to your preferred providers, including facilities such as labs and imaging centers, by offering lower copays or cost shares. We indicate tiering on your network’s ID cards, and we can set up your provider directory to keep preferred providers at the top of the search results.

Center of excellence programs

We can incorporate your center of excellence programs into health plan design and promote your programs through effective member communications.

Other reimbursement models

We can also reimburse based on your specific system fee schedules and accommodate custom reimbursement for out-of-network using CMS, Fair Health, or other options.

On-site services

We can help administer claims associated with on-site clinics at the employer’s location, which add value by providing convenient care during employees’ work hours. The clinics can offer preventive care or acute services, and may be temporary or long-term.

Our Create® Technology platform enables health plan administration according to unique services and pricing models.

For a health system, there is marketing value in being able to distinguish itself with niche programs