Theralta helps you
Solve Healthcare’s Biggest Problems
Fiduciary Defenses
The CAA has accelerated a years-long health plan conversation around fiduciary exposure when comparing employer scrutiny of health plan expenses to 401k and pension expenses. Theralta enables employers to join the top 1% of health plans with sophisticated fiduciary protection in place to save money, stop waste, and stay compliant.
Centers of Excellence
Employees can’t afford their out of pocket expenses, going into debt or worse to get needed procedures, surgeries, or therapies. It doesn’t have to be this way—employers can steer to value and split the savings with the employees so the employers and employees both win, along with rewarding top doctors and hospitals who are doing the right thing for the right price. Every employer should offer a CoE benefit atop their standard network.
Behavioral Health Network
It simply takes too long to get a good therapist or psychiatrist. Employee Assistance Programs (EAPs) are at best spotty and at worst complicit in blocking people from accessing needed behavioral health services. Theralta makes a national network of in-person and virtual therapy and psychiatry available to all employees without a monthly fee; just pay when used through the claims. People in desperate need receive same-day service, or schedule it with an average five-day wait, solving the access problem and providing a compelling case for experiential mental health parity compliance.
Drug Hazards
One of the most overlooked dangers within health plans is the self-inflicted wound of bad pharmacy. Dangerous drug combinations are accidentally prescribed each day by a fragmented system. Pharmacists—who are in the best position to catch and avoid these dangers—are relegated to punching the cash register across from public countertops. No more: by enabling telemedicine pharmacists to review pharmacy and medical claims from their office and make outreach to physicians to resolve bad mixes, plans benefit from reversing medically and financially hazardous drug fills and potentially saving lives.
Hospital Readmissions
Hospitals send patients home from a wheelchair at the curb, and often don’t speak with them again for weeks, if ever. We know these patients often misunderstand their discharge instructions, fail to get or take the prescribed medication, and jeopardize their recovery. It’s a miracle that only around 1 in 11 end up with readmissions and complications, but these are often the highest claims in any health plan. By having a team check in with discharged patients daily to make sure patients follow discharge instructions, have (and take) their meds, and closely observe the wounds, we can halve the incidence, severity, and cost of complications and save lives.
Advanced Primary Care
Independent primary care is at its lowest level in 20 years, even while the demand for it has never been greater. Unfortunately, the best new primary care in most cities and towns does not take insurance, but is paid on a monthly subscription. Theralta changes this by making advanced primary care payable by the employer so employees can afford to receive great care, and employers receive huge savings by solving this critical access gap.
Prior Authorization
Prior authorization of medical services hasn’t changed much since the dawn of the fax machine, but medicine has. It represents one of the best opportunities to engage with a patient and confirm the safety of the requested service. It’s also the best chance to exercise the employer’s voice with the provider and request needed changes or the state of the art in therapy and surgery. Theralta makes standard a prior authorization overlay to review the most commonly obsolete surgical practices and therapies to ensure the most up to date therapies are requested for patients.
Heart Attack and Stroke
Although heart attack and stroke survivors make up less than 2% of the working population, they experience massive risk and cost every year, and unfortunately less than 10% are taking the right combination of medications to prevent the next heart attack or stroke. Theralta ensures all these patients have a careful expert review of medications and that the specialists involved (and patient) together update the patient’s therapeutic regimen to prevent catastrophic future health events.
Dialysis Care
Most employers unnecessarily pay double what they should for dialysis because they don’t follow a law that says, effectively, that employers do not have to pay more than the Medicare allowed amount after three months of dialysis services. Furthermore, the mortality rate of this disease in the first year can be reduced by over 70% with some basic precautionary measures. This strategy saves lives and millions of dollars.
Imaging Network
Imaging is the most common major healthcare service most people will purchase outside of a basic lab or doctor’s visit, and represents 5% of total medical spend. It also represents a significant expense for most families who need to purchase imaging, because it almost always falls below the deductible. Theralta’s imaging network enables employees to get zero-cost imaging from high quality, high tech, high service imaging centers at low fixed prices for the employer, so everyone wins.