Conveners

Conveners facilitate direct contracts to mostly larger self-funded employer groups. A convener contracts with the employer directly, promotes the services to the members, handles the referrals, and acts as the plan administrator for this “carve-out” program. Conveners are essentially in this business and nothing else.
Benefits to conveners partnering with Luminary include:
  • Expanded access to a high-quality, surgeon-led surgical network
  • Transparent, episode-based pricing with defined reimbursement
  • Lower total cost of care through site-of-care optimization
  • Seamless coordination with existing case management or navigation teams
  • Securing contracts and handling payments with downstream entities

This approach allows the aggregator to focus on the relationship with their client while Luminary handles the care management.

Overview:

A convener obtains direct provider contracts with key surgical specialties in larger marketplaces around the country. Concurrently, they market to larger, self-funded employers, with the idea that an employer will hire the convener to put the entire program into action.

How It Works

Luminary Health has longstanding partnerships with many of the nation’s leading self-insured employers and third-party benefits administrators. When you contract with Luminary Health, employees from these organizations will be referred to your practice for surgical care.
Luminary offers a “bundled” reimbursement model where you control the downstream contracts and reimbursement to your facility, anesthesia group, and pathologist. Alternatively, you can opt for Luminary to control distribution of downstream reimbursements on your behalf.
01
Self-Insured Organizations

Many of the nation’s largest companies and government organizations now self-insure their workforce. Instead of paying monthly premiums to an insurance company, these “self-insured” organizations directly reimburse the healthcare services consumed by their employees. Most of the fortune 500 and may SMB companies are now self-insured.

02
What is a convener?

Most self-insured organizations partner with one of several third-party benefit administrators (otherwise known as a convener) to control and predict healthcare expenditures. Some conveners specialize in guiding employees who need surgical care.

03
Care Advocates

Most convener organizations employ care advocates. A care advocate works one-on-one with the employees of an organization to recommend where they and their family members can go to receive appropriate healthcare services. Care advocates recommend preferred surgeons to the patient whenever surgical services are required. Once the patient makes a selection, the care advocate communicates the referral to the practice.

04
Luminary Health Providers

Luminary Health is a collective of surgical practices, hospitals, and ambulatory surgery centers. As a group, Luminary Health has contracted with many of the nation’s top convener entities. As a result, Luminary Health providers are recommended to employees from hundreds of self-insured companies each and every day.

05
New Patient Referrals

Once you contract with Luminary Health, your practice will receive patient referrals from many of the nation’s largest self-insured companies and government organizations.

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