Link Healthcare - Link Choice

What is it?

The Link Choice program is a set of highly discounted health services offered by area health care providers to employers and individuals who cannot afford traditional health insurance coverage. The program is not an insurance plan; rather, it is an agreement by local health care providers to provide services to program participants at a highly discounted rate carefully calculated by Link Healthcare to cover direct costs and overhead. A wide variety of services are available to members, including hospital services, physician visits, lab work, and certain tests and procedures, such as x-rays, CAT scans, and MRIs. In addition, prescription drugs are available at discounted prices through Express Scripts, a major pharmaceutical benefit management company. The program is not free; a per-member-per-month access fee is charged for participation in the program to cover operating costs.

Who is it for?

The program can be purchased by employers or individuals. Originally, the eligibility guidelines required that individuals who enroll in the program must be under age 65, work at least 30 hours per week, and be ineligible for any other health plans or public assistance programs. These rules have been simplified to require that the individual is not currently enrolled in any other health benefit plan. Income guidelines require an annual income of less than $30,000, but a family with income greater than $30,000 also may qualify if their income is at or below 350 percent of the federal poverty level. Link Choice is also available to spouses and family members of individuals who receive health insurance through their employer but do not have access to insurance for their dependents.

Why do they do it?

Beginning in the 1990s, Tioga County faced a multitude of health care-related issues, including a spike in unemployment, significant growth in the county’s uninsured population, and low reimbursement rates facing the local medical community. To address this combination of challenges, Laurel Health System, Tyoga CareNet and local employers in Tioga County collaboratively developed Link Healthcare, which offers “Link Choice.”

Impact

Laurel Health System’s Soldiers + Sailors Memorial Hospital has experienced significant results, reporting that patients continue to receive the care they need while the hospital saves on administrative and collection costs. Patients provide positive feedback about the program as well. Providers also experience significant administrative and collection cost savings because they do not engage in prolonged and costly collection efforts; as a result, they have seen their revenues increase despite offering large discounts to patients.

Contact: Ron Butler
Tyoga CareNet
Telephone: 570-723-0503
E-mail: rbutler@tyogacarenet.com