Choose to be Proactive when it comes to Managing Health Care for your Employees and their Families
The Trump administration is continuing to take steps to improve Healthcare Pricing Transparency. People generally have no idea what they are paying when it comes to healthcare, and then they are presented with a non-negotiable bill by their provider. The White House steps are an attempt to require insurers, physicians, and hospitals to provide patients with better information about the cost of care before they receive it.
The two regulatory changes Trump announced on Friday would provide patients more information on what health care actually costs them. By January of 2021, hospitals would have to tell patients upfront what they have to pay for their services and what discounts they negotiated with the health insurers. Also, patients would know their expected out-of-pocket expenses before and not after their care is received. These changes are expected to upset the status quo and would help to take steps towards putting patients first.
The Trump administration wants patients to know what to expect to pay before and not after they walk into their doctors’ office. “Americans have been getting ripped off for years, a lot of years,” said President Trump. He added, “We will not rest until every American has access to high quality healthcare.”
Healthcare per Warren Buffet is a hungry tapeworm feasting on the US economy – 18% of what Americans spend each year is on health care, with 20% of it being unnecessary. We need transparency. Every year employers want to keep cost down and increase or maintain the same level of benefits for employees and their families. We try quick fix/band aid solutions. We are all part of the problem. Cost continues to be the #1 issue with no end in sight. Carriers will continue to consolidate, providing less options, shrinking access and increasing prescription drug costs. Telemedicine will also continue to rise in terms of utilization, so, you MUST have a strategy whether you are self-funded or fully insured.
Self-funding - this can be a scary concept for some. Your organization/company would begin paying its own claims. In essence, if you are fully insured, you are paying for your own claims today, just paying after the fact. When you are self-funded, you are paying claims as you go. Many groups large and small are looking at options that are safer methods of self-funding like medical captives, buying groups and level-funding. Employers that are self-funded should analyze claims data to determine savings opportunities, and they can guide employees to make better decisions regarding health care. In network charges vary widely, and employees should be aware of low cost in network options.
Here are a few tips to consider when it comes to health care for your company:
1) If you offer multiple plans, guide your employees to make better decisions (either through an on-line platform or during open enrollment).
2) Implement a health and wellness program. This is tricky because the measurable return on investment is not easy, but there are still some ways to attack health and wellness that will tremendously impact your employee satisfaction and overall health and well being in a positive way.
3) Reference Based Pricing – you can save a lot on cost with this initiative. However, you can also create a lot of noise for your organization. Plan ahead and know the risks, be flexible, make sure your contract language is clear on access and backend billing/collection actions.
4) Have a multi-year strategy. Is your health care plan in place today because of a strategic 3-5 year plan or is your current benefit your offering to your employees the result of reactionary decisions made every 12 months.
Bottom line, there are ways to be proactive in managing the cost of health care for your employees and their families.
Have a great weekend!
Dan from Indiana