Company Information...
THE REASON FOR NAPP
In fiscal 1994, the U.S. health care industry will generate
more than $875 billion in medical services expenses and
processing costs associated with the payment of those services.
As the agent for physicians and hospitals - now more than 60,000
- NAPP has an essential role to play in defining and redefining
how health care will be administered, processed and paid as this
century comes to a close. NAPP has created TEAM 2000 in order
to establish a national network of hospitals and medical groups
who will be linked electronically and be able to economically
serve patient members who elect to use this new health care
delivery system. This system will be more economical and of
higher quality than the delivery systems of the past decades.
TEAM 2000 is a core group of Health Care Providers and Member
Service Representatives (MSRs) who play key roles in reforming
and refining the health care industry in the United States and
their work will make it possible for both patients and health
care providers to maintain control over their own health care
decisions in privacy and with integrity.
NATURE OF OUR BUSINESS
NAPP solicits memberships from patients, doctors, hospital,
local preferred provider organizations ("PPOs") and independent
agents. The NAPP organization helps patients and physicians to
work out the most efficient and economical health care system
possible. The basic idea is that relationships between patients
and their doctors, and policyholders and their agents is long
lasting. And if these different classes of NAPP members are to
solve the problems of getting good quality health care at
reasonable prices using sound in insurance plans, they must
work together. Doctors, and the hospitals they serve, need to
give NAPP members the best policies and insurance plans for the
patients' needs. The patient members need to pay close attention
to their health maintenance, to budget their medical expenses
carefully so that they can pay for their health care and
insurance, and to tell NAPP, their doctors, and their agents,
what changes would improve the organization and the services
provided by the them as patients. Member doctors and hospitals
allow NAPP to bind them to fee schedules acceptable to member
patients and quality assurance programs that are required in
most of the insurance and HMO contracts. NAPP makes contracts
with insurers and HMOs so as to include NAPP member medical
providers in the health care plans of the patients, either as a
supplement to their insurance policy or within the benefits of
their group health plan or trust. In the contracts, NAPP
negotiates for fees that are to be paid to health care providers
by whatever method is required by the plan:
discounted fee--for-service fees based on relative value
systems fees based on capitation, DRGs and Per Diems
The average discount from the usual charges of a hospital or
physician is 20%. Hospitals usually discount less if there are
fewer people using their facility and more if the business
produces substantial revenue, as in Exclusive Provider
Organization (EPO) contracts. The range of discounts from
hospitals is from 15% to 35%. Physician fees which are based on
relative value systems are about 80% as much as their usual
charges. Fees paid by the states and federal government in the
Medicare and Medicaid programs are usually about 60-70% of the
usual charges. These are the current fee levels in managed care
programs and as an association we want our member doctors,
hospitals and patients to deal fairly with each other within
this Marketplace.
ADVANTAGES OF NAPP
For medical care providers, the essential advantages of NAPP
membership are more patients, retention of patients who might
otherwise leave their practice because they changed insurance
plans and faster reimbursement of claims. For independent agents
, the advantages are the retention of health insurance business
and new clients. For insurers, employer trusts, and patients,
the benefits are lower costs for health care, less paperwork in
claims handling, and better quality patient care.
NAPP AS A PURCHASING GROUP
Since NAPP is a large organization, its members can form
purchasing groups for insurance and other needed services.
NAPP arranges for those products and services with qualified
suppliers. These benefits bind the members more closely to the
association and enable NAPP to offer discounts more easily to
insurers and government agencies.
MANAGEMENT
PPO Association Managers, Inc. is the management company for
NAPP. It runs the day-to-day business of the association for NAPP
members -- physicians, hospitals, PPO organizations, agents, and
patients. Through direct individual memberships and a national
network of PPOs, NAPP now has 60,000 physicians and 8,000
hospitals and other medical care facilities in its association.
The average savings of 20% from NAPP and its affiliated PPO's
doctors and hospitals is not insurance. It is a discount from
their usual fees which is passed directly to the patient as an
incentive for them to use the preferred providers in order to
improve the quality of care and control the overall costs.
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