Rebuilding the broken healthcare model

Based on Cost

NexGen PT & Health Solutions is a unique answer to significantly decreasing premiums and downstream costs.

Scroll to read how healthcare has broken and how NexGen rebuilds it.

How Healthcare Billing & Reimbursement Fractured

  • Health care providers extending care to capture revenue
  • Mid 80’s implementation of DRG – Reimbursement based on diagnosis not cost of service delivery
  • Indexed fee schedules based on percentiles – not on cost. Fees become a moving target between providers, insurance companies and patients
  • Medicare makes indiscriminate cost reductions to providers for services
  • Increased patient responsibility in the form of higher deductibles and copays creates another barrier to care.
  • Dissonance and decentralization of the reimbursement model leads to labor cost reductions by providers creating another barrier to care

This is where rebuilding comes in.

How the NexGen Model Works

  • Working with employer groups and insurance providers we reduce barriers to system entry which increases patient participation (see study here)
  • We reduce excessive and unnecessary testing which reduces cost (see study here)
  • We reduce downstream cost with early preventative care (see study here)
  • We reduce opioid use by up to 89.4% (see study here)

Fragmentation of healthcare payment has uncoupled service delivery for PT and other OP services from the cost of delivery. Our model gives the patient what they need, when they need it and provides interventions that reduce cost by decreasing testing, appropriately decreasing the use of specialist, and by removing insurance patient cost and referral barriers. These add up to a reduced payor cost and patients recovering quicker.

Not only is NexGen’s model more affordable and more cost effective for both members and insurance providers, but it also increases membership participation, increases member satisfaction, and decreases the number of barriers of entry that often impede health services. By emphasizing preventative care and basing monthly premiums on cost, NexGen’s model keeps members healthier and happier at a low cost without requiring additional infrastructure. 

NexGen's model is the next step in evolving healthcare.

Why choose NexGen's model?

  • We increase participation in care by reducing member entry barriers and costs
  • We decrease downstream cost of imaging and specialist referrals
  • We increase positive clinical outcomes
  • We decrease opioid use
  • We emphasize on preventative care further reducing member 

We deliver what other models talk about but can't deliver.

Sean Shire, MS, PT, MBA

Director of Business Development

Let's talk about how NexGen can help your company, employer group, or insurance carrier.

Contact Sean Shire NexGen PT & Health Solutions Director of Business Development at 816-803-3695  or leave a message below for us to contact you.

Disclaimer: NexGen PT & Health Solutions is unable to offer coverage for all specialty services at this time. Please contact a NexGen representative for more information on the specific services we can offer your group.