Solutions to Improve the Quality and Affordability of Healthcare

TurningPoint Healthcare provides a comprehensive suite of innovative Surgical and Implantable Device management solutions that support health plans, employers and accountable care organizations to improve patient care and significantly reduce costs. We manage billions of dollars of surgical procedure charges annually with proven and effective results.

Phone

(855) 253-1100

Location

1000 Primera Blvd,
Suite #3160
Lake Mary, FL 32746

Hours

M-F 8a–6p

Challenging Trends

Implantable Devices & Surgeries

The implantable device industry has grown rapidly with health plans having few controls and little transparency to manage their costs. Expenses have increased over 100% in the past ten years, while recalls with serious adverse events have increased 900% over the same period. Payment integrity and utilization challenges continue to rise, while physicians have limited understanding of device costs and few tools available to support savings and quality. Additionally, health plans and their members often experience dramatic cost variability of $10,000 to $20,000+ for the same medical procedure, even within the same metropolitan market, depending upon the surgical facility where the surgery is performed.  

Our Services

TurningPoint has developed an innovative and unique set of services and capabilities that enables us to work collaboratively with physicians, hospitals, surgery centers, and implantable device manufactures to better manage healthcare costs and quality than traditional utilization management solutions.

We help payers to Significantly Reduce Healthcare Costs

• Reduce clinically inappropriate utilization of surgical procedures, biologics, and implantable devices

• Optimize implant costs and therapeutic interchange opportunities

• Enhance provider contracting and management capabilities

• Promote quality based site of service optimization

• Enable enhanced analytics and implant cost transparency

• Improve claims payment accuracy and controls

• Surgical cost transparency and education for Patients

• Episode, Bundled Payment, Carve-out and Fee-for- service solutions

• Identification and management of high risk patients

• Reduced readmission, revision and patient complications costs through better outcomes and improved quality

We Improve Safety, Quality and Affordability for your members

• Product recall and safety monitoring

• Implantable Device and Biologics manufacturer accountability

• Evidence based treatment plan management and interventions

• Clinical transparency and measurement support tools

• Surgical best practices and comorbidity management

• Improved outcomes

• Lower out of pockets costs

We Work collaboratively with Physicians, Hospitals and Surgery Centers

• Reduced administrative work for doctors and practices

• Pay for performance awards

• Enhanced network support

• Practice analytics and performance monitoring tools

About us

Industry Leaders & Clinical Experts

The foundation of our company is TurningPoint’s industry leading clinical staff and executives. Our team of highly specialized Industry Experts, Medical Directors, Peer Reviewers, and Clinicians have an unparalled level of depth, expertise, and passion for clinical excellence:

• Four former presidents of the American Academy of Orthopaedic Surgeons (AAOS)

• Former presidents of the American Board of Orthopedic Surgery

• Past president of the North American Pediatric Society

• Two of AAOS’s former Board representatives to CMS for all Spine related billing and coding changes

• Multiple past regional and state orthopedic association presidents, including the former President of the New Jersey Orthopaedic Association, and AAOS Board Members

• Former Chief of Staff for the Houston Shriner’s Children Hospital

• Past President and Current Board Member of the North American Spine Society

TurningPoint manages 23 million covered lives throughout the country. We are a compliance-driven, trusted partner to health plans, certified by NCQA, URAC and HiTrust.

Contact Us

Whether you are a provider of care or health insurance, or just a patient looking for more information on what we do, we're here to help.
TurningPoint Healthcare Solutions, LLC offers members and providers TDD/TTY as well as Language Assistance Services.

Our Office

1000 Primera Blvd.
Suite 3160
Lake Mary, FL. 32746

(855) 253-1100