Traditionally, healthcare contracts between jails and their medical providers have always included healthcare performed inside and outside the facility’s walls. However, correctional facilities can deliver quality care at a more affordable rate by “carving out” a standalone contract specializing in outside-the-wall care.
Health care costs for inmate populations are among the most expensive budget line items for jails and prisons. This is often due to the increased likelihood of incarcerated individuals suffering from one or more chronic health issues. In addition, correctional facilities’ healthcare costs are rapidly rising in non-Medicaid expansion states, markets with little-to-no provider competition, and rural areas.
However, sometimes facilities are simply paying more than they should be for off-site services and can save money by utilizing standalone contracts for outside-the-wall care. Heritage’s experience managing outside-the-wall care for correctional facilities means we can reduce your medical costs by negotiating pricing with providers upfront. In addition, our Preferred Provider Network Strategy increases transparency in medical claim costs and provides a higher standard of oversight in the claim adjudication process.
Heritage’s approach to providing quality, affordable outside-the-wall care to inmate patients is based on our Preferred Provider Network Strategy. We establish a custom PPN for all off-site medical procedures in the community in which your facility is located. After selecting local, licensed medical providers, we use our extensive knowledge of medical claims costs to negotiate the best possible contracts so that we can guarantee you competitive pricing. Our negotiations help to ensure that your facility will always have transparency and visibility into your off-site costs. Once your PPN is in place, we manage the entire claim adjudication process from start to finish. You get the benefit of competitive network rates and having Heritage manage the contracting and claims processing. Your off-site providers benefit from timely payment and having a dedicated team to contact if they have questions.