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Provider Newsletter


Summer 2023

Thanks for playing an important role in serving our employer-members. Here’s the latest updates from The Alliance that may interest you.

Membership Numbers
The Alliance consists of more than 115,000 lives from over 340 employers across the Midwest.
Expanding The Alliance Networks

As of May 2023, The Alliance’s Smarter NetworksSM include over 38,000 healthcare providers and doctors across the Midwest, offering a broad range of choices for self-funded employers, their employees, and their families. In the last year, The Alliance added 130 clinics and five hospitals in Wisconsin and Illinois, about 3,500 new healthcare practitioners, to offer even more choice and access to care. Our networks also include alternative care options like independent primary care, telehealth options, and bundled services.

Recommending New Providers
The Alliance regularly reviews requests to add providers to our network from our clients, partners, and consumers. The provider contracting team reaches out to providers that are a good fit for The Alliance and our employer-members. Requests to be added to The Alliance network can be made by filling out the new provider contract intake form.

Contracting Bundled Pricing
The Alliance is contracting additional bundled pricing for specific procedures so patients can know the cost of their care upfront and have one payment for the episode of care. In May 2023, The Alliance added bundled pricing for gastric bypass procedures performed by Northwestern Medicine in Chicago, IL. We also partnered with Orthopedic & Spine Centers of Wisconsin to provide bundled pricing for in-office carpal tunnel and trigger finger release procedures beginning July 1st, 2023. If you are interested in contracting bundled pricing with The Alliance, contact the Provider Contracting team.

QualityPath Program

After careful consideration, The Alliance has decided to sunset our QualityPath program. Beginning January 1, 2024, the QualityPath program will no longer be supported, and you will not need to administer the program. The market has evolved since QualityPath’s creation, and The Alliance is continuously working to adapt to best serve our employer-members. We are shifting our provider recommendations from QualityPath to Smarter HealthSM analysis so we can better tailor recommendations to employers’ needs and shifting market dynamics.

Important Dates

  • Beginning January 1, 2024, the QualityPath program will no longer be supported, regardless of employer or plan renewal date.
  • The last eligible date for hip or knee surgery is September 30, 2023. This date ensures that patients can complete the required physical therapy before January 1, 2024.
  • MRIs, CT scans, and colonoscopies can be performed through December 31, 2023.

If you have any questions, you can reach out to The Alliance’s Sales Operations team.

Provider Responsibilities Update

We have updated the language in the “Access to Care at In-Network Providers for Alliance Enrollees” section of our provider responsibilities. This section acknowledges that The Alliance enrollees have the right to freedom of choice of providers including primary care and specialty services.
Improve the Value of Healthcare in Wisconsin: Avoid Low-Value Care Webinar
Wednesday, September 13, 2023, 10:00am – 11:00am CT

When patients receive low-value care, meaning care that is not supported by research or is duplicative, they pay more for unnecessary or inadequate care. Not only does low-value care cost patients more money, but it also means higher costs for their self-funded employers. This is a problem because when employers have a higher healthcare spend, they cannot allocate as much of their budget toward other employee benefits, including wages.

In this session, you’ll learn from representatives of the Wisconsin Health Information Organization (WHIO) Low-Value Care Committee how to identify low-value care and what you can do to encourage your employees to participate in shared decision-making with their providers to avoid it.


2023 Fall Symposium and Annual Meeting

Tuesday, October 24, 2023 | 9:30AM - 4:15PM CT

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5510 Nobel Dr, Suite 200, Fitchburg, WI 53711