XiMED IPA, Key Benefit Administrators (KBA), and Scripps HealthCare (Scripps), have come together in a new physician-driven product targeted at the small employer group market. The product, known as XiMED Healthy Partners, is a self-funded employee health benefits program for private employers. Companies enrolled in the program will have access to a pricing advantage for in-network services provided by XiMED physicians at Scripps Hospitals. In addition, XiMED IPA physicians will work in collaboration with local employer groups, not only to improve employee health, but to also reduce the dollars spent on healthcare. This approach will help stabilize employer healthcare budgets year over year and provide a better mechanism to determine future costs. KBA support will include timely medical data with comprehensive reporting, enrollment & benefit determinations, prior authorization, chronic case management, financial analysis and accurate claims payments. For the past seven years, KBA has partnered with multiple organizations across the country and currently has over 1.5 million members under contract. This new direct contract relationship between XiMED and the employer groups will foster data transparency, stabilized rates, and improve the health and wellness of employees. We are very excited about bringing this new product to market.
XiMED IPA has entered into contractual relationships with Medicare Advantage Plans (MA) through Anthem Blue Cross. Enrollment in such plans has been steadily increasing each year and currently stands at over 17 million seniors nationwide, with over 450,000 in eligible members in San Diego alone. Medicare Advantage plans provide patients with complete Part A & Part B benefits and typically offer additional benefits beyond traditional Medicare. Physician reimbursement for MA plans can either be on a capitated or FFS payment basis. By contracting with such plans, IPA physicians will now have access to a greater number of patients and new business relationships with national carriers. While such plans carry a higher level of risk, XiMED is excited to add the Medicare Advantage population to our patient membership, and is looking forward to working collaboratively with the MA health plans that offer benefits in the San Diego marketplace.
To shop for XiMED/Anthem Medicare Advantage Plans, click on the Anthem link below (https://www.anthem.com/ca/shop), or call Toll-Free 1-855-306-4537 (TTY) 711: