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Total
Benefits Solution
We apply a combination
of critical analysis and technology to every aspect
of your employee benefit program. Through the combination
of expertise and technology, we are able to implement
comprehensive and affordable solutions. Total Benefits
Solution is an approach
that evaluates and measures your group medical insurance
plan. We use technology to find inefficiencies, understand
and manage cost drivers, improve communication and education
flow, develop consumerism and promote heath and wellness
programs. Total Benefits Solution is a critical
part of executing a comprehensive strategy for controlling
healthcare costs. In most cases, the key objectives
of an employee benefit plan are:
- Overall cost control through
efficient plan design(s)
- Reduced current and future
medical plan related cost trends
- Productivity (healthy employees
equal productive employees)
- Maintain or increase ability
to attract and retain quality employees
Comprehensive Strategy for Controlling
Plan Costs: return
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A. Establish
guiding principles
- Understand and support
your business strategy
- Engage employees
- Establish financial and
cost control objectives
- Efficient delivery
B. Benchmark
- Analyze and adjust costs
for design, demographics and geography
- Benchmark adjusted costs
to competitors
- Compare value
- Evaluate current position
versus the marketplace
C. Make choices
consistent with guiding principles
- Structure
- Plan design(s)
- Pricing/contribution
amounts
- Partner management
- Education and communication
D. Execute
- Implement
- Communicate
- Verify
Basics of an Effective
Group Medical Plan: return
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A.
Efficiency
Utilizing the
latest techniques to conduct a critical analysis of
all aspects of your employee benefit plan typically
results in the discovery of certain inefficiencies.
Inefficiencies can occur in all aspects of employee
benefit plans:
- Utilization review
- Large case management
- Disease management
- Health and wellness promotion
- Plan design
- Insurance and reinsurance
companies
- Provider networks
- Third party administration
- Stop loss coverage
- Prescription drug coverage
- Employee communication
- Broker fees
- HIPAA compliance
The elimination
of inefficiencies in these areas will result in substantial
improvements in controlling skyrocketing costs.
B. Consumerism
In addition
to the elimination of inefficiencies, it is necessary
to concentrate on improving “consumerism”
among your members. Consumer driven healthcare plan
designs such as HRA’s and HSA’s put the
consumer in charge by providing the incentive and
information necessary to best purchase healthcare.
Those employers who elect not to establish an HRA
or HSA can still benefit from plan designs that promote
smart consumer choices. Education and access to the
tools necessary to be a “good” consumer
allow individuals to get the best care at the best
price.
C. Cost Driver
Management
Cost driver
management entails aggressively managing the 27% of
your population generating 85% of your costs. Establishing
programs in the areas of predictive modeling, large
case management, disease management and health promotion
are keys to controlling the skyrocketing cost of healthcare.
D. Health and
Wellness Promotion
The best way
to reduce the cost of healthcare for your organization
is to dramatically reduce the need for healthcare
services. Health insurance costs are a direct result
of general inflation, advances in drugs and other
medical devices, rising hospital and doctor expenses,
government mandates, increased utilization, cost shifting,
litigation and fraud. We have seen estimates that
almost 40% of all healthcare expenses result from
preventable conditions. These preventable conditions
are caused by lifestyle choices such as tobacco, obesity,
stress, lack of exercise and poor diet. Realistically,
we are never going to eliminate all lifestyle related
healthcare costs. However, a reduction in demand associated
with improved lifestyle choices will result in a corresponding
reduction in the cost of healthcare. Your return on
investment in effective health and wellness programs
will be as high as 2:1 in the first year.
E. Technology
The proper
use of technology is essential to having an efficient
plan. Our investment in technology and information
systems allows us to provide “best practice”
assistance to our clients in the following areas:
- Plan evaluation
- Communication
- Employer web technology
- Employee web access
- COBRA administration
- HIPAA compliance
- FSA administration
- HRA and HSA administration
- Benefit statement creation
- Employee self service
opportunities
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