Last Fall, COVID-19 was weighing so heavily on our minds that simply keeping health benefits available during the Pandemic was the top priority. Today, with many people needing medical care they may have postponed and pressure to maintain sufficient staffing, keeping your health plan both effective and affordable is a must.
The fact is that after a year unlike any other, your organization needs to huddle with its broker/advisor and TPA to do all it can to fight back against rising healthcare costs. Remember that your organization transitioned to self-funding to take control of rising costs and gain the flexibility needed to compete successfully in a rapidly changing world. So, with 2022 right around the corner, let’s revisit a few steps that could keep your organization on the path to high quality, affordable healthcare.
Question Everything – For self-funded employer groups, there are no off the shelf plan designs. When a plan year was successful, we want our clients to know what made the difference. If claims were higher than expected, we help you understand where your healthcare dollars went and what your plan can do to bend the curve.
Be a Disruptor – Annual rate increases of 5 to 7 percent should never be accepted as being par for the course. Solutions to rising costs are in your claims data and the right advisors can help you explore new options. Carve-outs for Specialty Pharmacy and Referenced Based Pricing are just two of the ways we’re helping health plans achieve significant savings.
Blocking & Tackling – Monitoring claims and utilization data day in and day out takes industry-leading technology and skilled claims analysts. Digging deeper into claims will help your plan uncover billing errors and find hidden revenue in your health plan.
Communicate, Educate, Advocate – Because managing the cost and quality of employee healthcare is a year-round responsibility, we do our best to keep employers, plan members and broker advisors informed and supported throughout the year. This is especially critical given the costs associated with chronic healthcare conditions and the rising frequency of high-dollar claims.
These measures may not be new, but when implemented consistently, they will produce significant savings, not only for your health plan but also for the members your business depends on.