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up to 60%
Reduction in claims costs.
20-30%
Overall reduction in employer benefit costs
Reduce
Employee premiums & out-of-pocket cost
$1,500
Average annual savings per employee
The U.S. healthcare system has a billing problem.
We’ve developed partnerships to provide a proactive healthcare cost containment strategy to address medical billing, negotiating with medical providers, prior to service, to get the lowest possible cost. We understand and use the cost difference between network prices as well as the medicare allowed amount to negotiate a steeply discounted cash price. And typically we’re able to eliminate your employees out of pocket costs as well.
We’re saving our clients an average of $1,500 per employee, each year.
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Direct Agreements
A common approach for proactive pricing or value based pricing plans focus on the four primary cost drivers that make up 90% of the cost of your health plan.
- Hospitalization & Surgery
- Outpatient Services
- Prescription drugs
- Physician Services
Administrators use a strategy to form direct agreements with; hospitals, specialist and labs where group members live for pre-arranged pricing that eliminates the need to negotiate on a case by case basis.
Rx Watchdog
Prescription drug costs make up 30% or more of the total health benefit costs.
There are rebates and discounts that are paid to Pharmacy benefit managers from the pharmaceutical companies, and it's probably the most convoluted part of the whole healthcare system, when you pull back the curtain and see what is actually going on.
Plans will handle this differently but our plans use a transparent pricing model on drugs and pass all discounts and rebates back to the plan holder / the employer. This practice in itself can reduce prescription drug costs by as much as a third.
Healthcare Consumer Advocates
In-house HealthCare Advocates help you and your employees to navigate through the healthcare system and find the best care.
- Employees can see any medical provider that they would like.
- Employees are NOT limited by in-network providers, or by a specific list of providers.
- Pricing is negotiated with the provider prior to service so employee knows what their out-pocket-expenes will be prior to their visit.
- Most proactive value-based pricing plans include healthcare advocates.
Only licensed administrators have access to the most accurate data.
Concierge Medicine / Direct Primary Care
Where some on-call services are covered by a registered nurse, a PA or a Nurse Practitioner our plans provide direct access to a medical doctor made available, 24-7, by phone, video chat, and even by text messaging. These services don’t replace any doctors that members want to see. The added benefit to doctor provided services vs. the Nurse Practitioner or PA is a member has 24-7 access to a doctor who knows them, has their medical history and can coordinate their care between their other medical providers. To further differentiate this service some plans assign one doctor to a group so members interact with the same doctor every time.
Doctors can also get wholesale pricing on labs and imaging, and they can negotiate with the specialists, surgeons, anesthesiologists, hospitals… whatever care is needed. Keeping the claims costs down, way down.
Members can use concierge medicine as a centerpiece for their health plan and many wind up primarily using their concierge doctor as they can access them easier than their primary care physician who’s next available appointment may be a month out.
Request a free Healthcare Plan evaluation.
As the labor market shifts the more important a rich employee benefit package becomes.
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