TAMPA, Fla., June 4, 2019 /PRNewswire/ -- As more people sign up for health insurance through individual marketplaces, their employer, Medicaid expansion or the growth in Medicare, health plans work diligently to serve their members' needs. Toney HealthCare Consulting (THCC), a clinical, quality and regulatory healthcare consultancy, today announced the launch of the company's Insource Partnership program to help health plans best serve their members. Insource Partnership is a service provided to health plans in which a highly experienced, ready-made clinical and administrative THCC team assumes responsibility for a specific healthcare service within an insurer's Line of Business (LOB) or a defined population that may be expanding or underserved. The THCC team becomes an extension of the health plan, fully integrated within the health plan's clinical operations.
The Insource Partnership program is a long-term solution for health plans that have needs in discrete healthcare service areas. As an example, take case management where clinical teams help severely ill individuals navigate the healthcare system. A health plan may be growing its Medicaid membership, but is unable to quickly bring on case managers to serve these most vulnerable of members. With Insource Partnership, a dedicated, expert THCC unit rapidly deploys and operates within the policies, procedures and systems of the health plan for an extended period.
"As health plans continuously strive to best serve their members, we've recognized an opportunity to offer our expertise and experience in a way that enables a health plan to confidently assign a healthcare service to THCC while maintaining visibility, transparency and control," said Sam Toney, M.D., CEO of Toney Healthcare. "Our clients have told us that the beauty of the Insource Partnership program is that our teams are fully a part of the health plan's clinical operations, operating within the same information system, following the same procedures and taking the same training as their own employees. Furthermore, THCC brings a level of proficiency and experience in managed care that is unparalleled in the industry."
With great depth and diversity of managed care skill sets, THCC provides services in:
- Medical and Behavioral Utilization Management to ensure the right care is delivered at the right time in the right way
- Medical and Behavioral Case Management to help members who are acutely or severely ill to navigate the healthcare system
- Population Health Management to most appropriately manage the health of different risk segments of the population
- Special Needs Plan Model of Care Clinical Management to serve particularly vulnerable individuals who often have significant physical, behavioral and social needs
- Network Development to ensure members have adequate access to healthcare providers
THCC's highly seasoned managed care professionals include: nurses, social workers, other behavioral health clinicians, allied health professionals, primary care physicians, psychiatrists and more.
About Toney HealthCare Consulting
Toney HealthCare Consulting (THCC) is a leading, clinically oriented consulting firm providing services in strategy, compliance, management and clinical operations for healthcare organizations. The team of over 140 consultants includes nationally recognized subject matter experts across the spectrum of the healthcare industry who, through years of hands-on experience, have in-depth understanding of the issues that impact performance and organizational success. Our mission is to enable our clients to realize their fullest potential and attain sustainable success by sharing knowledge, developing leaders and collaborating on the implementation of innovative, enterprise-focused strategies. Headquartered in Tampa, FL, THCC serves clients nationwide. For more information, visit www.toneyhealthcare.com.
SOURCE Toney HealthCare Consulting