Health Systems
Health Plan Administration Built for Health Systems
From employee benefits to health system-owned plans, BHPS provides the administrative infrastructure and hands-on support that keeps your health plan running smoothly.
Why BHPS
We Handle the Complexity. You Focus on the Care.
Most TPAs are built for straightforward employer groups. Health systems operate at a different level entirely, and they need a partner built to match. BHPS brings the depth and infrastructure to handle what standard administration wasn't designed for.
Diverse job classifications, multiple facilities and around-the-clock staffing create eligibility and enrollment complexity that requires real operational depth. BHPS has the infrastructure and experience to manage it with precision.
Whether you're administering a self-funded employee health plan, supporting a health system-owned health plan or exploring direct contracting arrangements with local employers, BHPS provides the administrative backbone to make each model work.
Our concierge member services operation answers calls in an average of 31 seconds and resolves the majority of issues on the first call so your workforce gets the support they need without it becoming a burden on your HR team.
Core Services
Every Service Your Health Plan Needs. One Partner to Deliver It
From employee eligibility and claims to reporting and compliance, BHPS handles the administrative complexity so your team can stay focused on workforce strategy and patient care.
We manage the full scope of health plan administration for health system employee populations including eligibility tracking, enrollment, claims adjudication, ID card production and member services with the precision and responsiveness a large clinical workforce requires.
For health systems that operate their own health plans for community members or employer partners, BHPS provides independent TPA infrastructure built around your plan's specific goals. We focus entirely on administrative performance so your team can focus on the clinical and strategic priorities that matter most.
Health systems exploring direct contracting arrangements with local employers need an experienced administrative partner to manage the health plan side of those relationships. BHPS handles eligibility, claims and member services so your business development team can focus on building and growing employer partnerships.
With an in-house Chief Medical Officer and clinical team, BHPS provides utilization management, case management and disease management for high-cost conditions. Better clinical decisions on high-cost cases mean better outcomes and lower costs for your employee population.
Through our Create® platform, health system HR and benefits teams get real-time visibility into plan performance, utilization trends and cost drivers. That data gives you what you need to manage your benefits program strategically and demonstrate value to leadership.
Frequently Asked Questions
Common Questions From Health System HR and Benefits Teams
Yes. Managing benefits for a 24/7 clinical workforce with variable shifts, multiple locations and diverse job classifications is one of the most operationally demanding challenges in health plan administration. BHPS has the eligibility infrastructure and account management depth to handle that complexity accurately, tracking enrollment changes, managing contributions and keeping your plan data clean without adding burden to your HR team.
Absolutely. BHPS can help you design and administer a self-funded health plan built around your own provider network, using benefit tiering and lower cost-sharing to guide employees toward your facilities. This keeps healthcare dollars within your system while giving your employees convenient access to providers they already know and trust.
BHPS takes a multi-layered approach to cost management. Our claims adjudication process applies proactive payment integrity oversight to catch billing errors before they become overpayments. Our in-house clinical team manages high-cost conditions through utilization management and case management. And through the Create® platform, your benefits team gets real-time data on cost drivers and utilization trends so you can act on issues early rather than reacting after the fact.
BHPS manages HIPAA compliance, ERISA requirements, ACA reporting, COBRA administration and other regulatory mandates as part of standard plan administration. Our eligibility tracking, claims handling and reporting are built to meet legal standards, reducing your team's compliance burden and keeping your plan audit-ready without requiring additional internal resources.
Yes. Through our Create® platform we can administer benefit tiering, center of excellence programs and custom reimbursement models including system-specific fee schedules and out-of-network options based on CMS, Fair Health or other arrangements. For health systems with unique clinical programs, BHPS can incorporate those programs into the health plan design and support member communications that drive utilization.
Resources
Insights on Smarter
Healthcare Administration
Let's Put Your Network to Work for Your Employees
BHPS can help you design a health plan built around your own providers and administer it with the precision your workforce deserves.
