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Our Services

AJL - ServicesAs the recognized leader in the field of direct contracting, A.J. Lester & Associates, Inc. has saved its employer clients millions in health plan costs without short-changing medical providers. By carefully analyzing client needs and daring to think outside-the-box, we create unique client solutions through a wide range of specialized consulting strategies for employers and medical providers.We also provide consulting services to consultants, brokers, and TPAs.

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AJL - Employers

Employers

We help self-insured employers reduce medical plan costs and problems by eliminating the managed care middleman. By negotiating direct "win-win" agreements between employers and medical providers, we create direct provider networks that the employer can count on to provide affordable, high-quality medical care to employees and their dependents.. More...

AJL - Medical

Medical Providers

As a pioneer and leader in the field of direct managed care contracting, A.J. Lester & Associates offers hospitals, physician groups, healthcare systems, ACOs, and other medical providers professional consultation on designing, developing, negotiating, implementing, and managing direct agreements with employers in their communities. More...

AJL - Brokers

Consultants, Brokers, & TPA's

A.J. Lester & Associates, Inc. can develop direct networks in locations where commercial managed care networks are not fulfilling the clients' needs for access, savings, or service. This helps solidify the client relationship so consultants, brokers, and TPAs give clients what they need. More...

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Services for EmployersServices collapse

AJL - Employers

A.J. Lester & Associates, Inc. helps self-insured employers reduce medical plan costs and problems by eliminating the managed care middleman. By negotiating direct "win-win" agreements between employers and medical providers, we create direct provider networks that the employer controls. In each case, the employer-owned network facilitates better access to providers; saves claim dollars; reduces service problems; and improves employee satisfaction.

Whether your company's employees are concentrated in a few metropolitan areas or are spread throughout many small to mid-sized towns and rural areas across dozens of states, direct managed care contracting may provide the solution you're looking for.


Top eight reasons to use direct managed care contracting:

bullet Total Access to Network Providers for Your Employees Everywhere
bullet Never Pay Full Retail for Medical Claims
bullet Eliminate Network Access Fees
bullet Full Disclosure of All Contractual and Financial Terms
bullet Immediate Savings of Health Plan Claim Dollars
bullet Greater Savings for More Employees
bullet Improved Employee Relations
bullet Better Community Relations

Services for Brokers, Consultants, & TPA'sServices collapse

AJL - Brokers

As health plan costs continue to surge, direct provider contracting is a valuable strategy for brokers, consultants, and third party administrators (TPAs) to recommend to clients for reducing costs and improving service. A.J. Lester & Associates, Inc. can develop direct networks in locations where commercial networks are not fulfilling the clients' needs for access, savings, or service.

Our strategies solidify the client relationship so brokers, consultants, and TPAs give clients what they need. It also helps defend the predatory practices of managed care companies and carriers of taking business away with promises of better networks or greater savings.


Frequently asked questions about direct provider contracting:

bullet Why not handle direct contracting ourselves?
bullet What is your relationship to the broker, consultant, or TPA in regard to the client?
bullet Do you remunerate brokers, consultants, or TPAs for providing services to their clients?
bullet How can we learn more about direct managed care contracting?

Services for Medical ProvidersServices collapse

AJL - Medical

The cold, hard reality for doctors and hospitals is that commercial managed care companies still control the means by which medical providers do business with employers. In the process, providers have been forced to accept adversarial contracts, dwindling reimbursements, and greater practice restrictions. Cutting out the middleman and contracting directly with employers is a viable alternative that every medical provider should consider.

As a pioneer and leader in the field of direct managed care contracting, A.J. Lester & Associates, Inc. offers physicians, hospitals, health systems, ACOs, and other medical providers expert consultation on developing direct agreements with employers in their communities.


We offer medical providers the following consulting services:

bullet Review and evaluate existing marketing efforts to determine new opportunities for direct contracting.

bullet Analyze current managed care contract participation in HMOs, PPOs, and other third party payor networks.

bullet Analyze contractual and reimbursement terms of existing commercial managed care contracts, assessing the value of each contract to provider.

bullet Analyze new and renewal managed care agreements solicited by HMOs, PPOs, and other managed care vendors. Recommend proper course of action (accept, reject, negotiate, etc.).

bullet Identify potential contractual and market obstacles to direct contracting. Recommend actions to overcome them.

bullet Develop strategies and action plans for implementation of direct provider agreements and integrated marketing plans.

bullet Develop all contractual and reimbursement tools specific to providers' needs.

bullet Identify and contact local self-funded employers to introduce provider's desire for direct contracting.

bullet Represent provider in negotiation of direct agreement with employer, including all initiatives related to value-based care, population health, and shared-savings.

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