Who We Serve
ACOs - IPAs - PCPs - PCMHs
The Affordable Care Act included various provisions that established incentives, performance guidelines and quality metrics that has led to or otherwise influenced the formation on new models for healthcare delivery. Accountable Care Organizations (ACOs) and Patient Centered Medical Homes (PCMHs) have emerged as highly visible model for the new age healthcare deliver. Equally important, Primary Care Physicians (PCPs) and Independent Physician Associations, which are more traditional providers in the healthcare space, have also been directly influenced by impacts of the ACA. In each care, the new environment presents new challenges and opportunities. Cofactors' team is well positioned to assist these healthcare providers in dealing with the challenges and capitalizing on the opportunities. We offer a variety of services and solutions that will be of value to providers.
Chartered under provisions of ACA
The federal Department of Health and Human Services, under provisions of the ACA, awarded loans and grants for CO-OP Insurance startups that began providing health insurance coverage during the first enrollment on the Healthcare Marketplace. Substantially all of the activities of the qualified nonprofit issuers must be in the individual and small group markets. The issuers are licensed in the State(s) in which they operate and are subject to provisions of section 1322(c) of the Affordable Care Act. Section 1322(c)(4) provides that an organization cannot be a qualified nonprofit health insurance issuer unless any profits made by the organization are required to be used to lower premiums, to improve benefits, and for other programs intended to improve the quality of health care delivered to its members. Cofactors' team assists Co-Op Insurers by providing innovative care coordination and management programs that deliver substantial value by helping to manage healthcare risks of patients that affect an Insurer's insurance risks.
Public Health Entities
FQHCs - Free Clinics - Municipal / State Public Health Agencies
In the short term, many Public Health Agencies and Free Clinics have adversely affected by the implementation of the Affordable Care Act. A number of these adverse impact are the result of changes in funding mechanisms that disrupt the way these entities have traditionallly been supported. As a result, they have had to adjust to the new circumstances by changing their "business models". One strategic change has been to adjust by making arrangements to accept Medicaid patients. Cofactors' team offers resources to assist public health agencies and free clinics in making the transition to new delivery models and payment strategies that are sustainable. We offer care coordination services, health IT solutions and consulting services to enable and ease the transition.