Bingham Health Care



 

Our Services

Bingham Health Care provides strategic and operational consultation and planning, and helps payers with filing and reporting requirements related to the Affordable Care Act (ACA). We work with national, regional, state, and local payers, including well-known brands, start-ups, CO-OPs, and county health systems.

We offer the following services to address your organization's needs & goals:

  • ACA Exchanges / Marketplaces
    • Planning
      • evaluate participation
      • participation preparation
    • Operation
      • begin participation
      • operating on an exchange
      • efficiencies/improvements/optimizations
    • Exit
      • analyze the decision
      • execute exchange exit
    • Other assistance
      • marketing, messaging, and brand image
      • member/consumer outreach, customer service, and public relations
      • organizational restructuring
      • vendor search and support
      • staff augmentation
  • Programs
    • QHP certification
    • 3 Rs: reinsurance, risk corridors, & risk adjustment
    • EDGE servers
    • IRS 6055/6056 (1094/1095)
    • mandated reporting
  • Plans, Networks, and Providers
    • benefit plan design
    • essential health benefits (EHBs)
    • cost-sharing reductions (CSRs)
    • network/plan types (PPO, EPO, HMO, POS, ACO, PCMH, etc.)
    • provider contracting and retention
    • rent-a-net
    • telehealth / Teladoc
    • specialty providers & service offerings
  • Regulations
    • provide overview and training to:
      • executive team
      • management
      • staff (department/function specific)
    • guided assistance with:
      • state regulators (DOI, DOBI, OCI, DMHC, etc.)
      • federal regulators (HHS, CMS, Treasury, IRS, etc.)
      • exchanges/marketplaces (federal, state, hybrid, private)
      • certifying organizations (NCQA, URAC, etc.)
    • case-specific review and recommendations
  • Private Exchanges
  • Small, Mid, Large, and Custom Group Markets (integrating with ACA business)
  • Medicare & Medicaid (as they relate to the ACA)
  • Custom consulting engagements and assistance

Our expertise extends to virtually all areas of the ACA, much of which Mr. Bingham discusses in an ACA whitepaper, authored while assisting another consulting practice.


Please contact us for help optimizing your business operations, and obtaining or maintaining a competitive advantage.

 

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Please contact us at info@binghamhealthcare.com with questions or to schedule a call.

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