Risk and Reward: Challenging the Health Plan Status Quo
Centiments is a monthly newsletter from Centivo, an innovative health plan for self-funded employers, on a mission to bring affordable, high-quality healthcare to the millions of workers who struggle to pay their medical bills. In this issue, we explore risk – how it shapes health plan decisions and healthcare behaviors and how taking the right calculated risks can mean big rewards.
Is it time to consider self-funding?
If you’re an employer offering a fully-insured health plan, you’re probably looking at a hike in renewal rates for next year, with no clear data to explain why (other than?“inflation” or COVID-19). A self-funded health plan can provide a clearer lens into cost drivers. However, many companies are wary of assuming the financial risk of providing benefits. Centivo’s latest blog post explores the benefits of self-funding and why it’s not the risk you may think it is.
The stop-loss safety net
Being on the hook for huge and unexpected claims is the key reason many employers shy away from the self-funded plan model. But with tools to limit exposure, any risk becomes minimal. Read about the established practice and growing popularity of stop loss insurance for self-insured health plans.
Skipping care: A risky roll of the dice
Even with the number of insured Americans at a historic high, patients are forgoing needed medical care or prescription medications to avoid being hit with punishing out-of-pocket costs. According to a 2022 survey by Gravie and Wakefield Research, 59% of Americans have experienced negative consequences from delaying medical exams, treatments or procedures. And that’s not only a risk to employees’ health; it also impacts employer productivity and the overall well-being of the economy. But employers have the chance to stop the spiral by offering health plans employees can afford to use.
领英推荐
Come to terms with health plan terms
Since many employees make decisions about benefits based on what they can afford, inflation could be a game-changer this open enrollment season. Employees will likely be spending more time exploring plan options to make the most of their benefit dollars. However, simply opting for the lowest-premium plan to take the least bite from their paychecks is a risky approach, especially if that low-premium plan comes with a high deductible. Having a clear grasp of health plan terminology is key to understanding the total cost of care and making an informed, affordable health plan choice.
Risky business costs
Talk about a health scare: The Centivo stat of the month from WTW’s?2022 Best Practices in Healthcare Survey shows employers are bracing for a risky future when it comes to health plan cost increases. What to do about it? Ask about Centivo’s proven model that saves self-funded employers 14-27%.
Take our health plan risk assessment
Employers: With record-breaking inflation, ever-climbing renewal rate hikes and the Great Resignation, it may be time to re-evaluate your current health plan. But where to start? Download our free guide, “How Healthy is Your Health Plan?” It walks through seven key areas for evaluating affordability, access and quality and offers a prescription for improving both employee health and your financial outcomes.
Centivo: A health plan with no surprises
Centivo built a health plan employees can actually afford to use, with no deductibles, free primary care, simple copays and real savings for employers. The next online 20-minute live Centivo demo is October 25 at 2 pm ET. If you can’t make that session, sign up for a future one. Register here.
Retired: Large Group Health Plan Professional ( 1972-2022)
2 年Self-insurance has been in Wisconsin since the early 1980s and has grown substantially as Brokers are ultimately faced with self-insuring or losing the client when the Renewal is rejected by the client because "we can't afford the Renewal". Historically the 1st Year Group Health Plan Expense is low, because the annual Paid Claims ( 90% of the Annual Expense) are not 12 months. Regardless, the issue is the acceptance of financial Risk over at least a 2 year period and denied claim blame must be considered by the CEO or Public Sector Administrator. Stop-Loss Insurance and PPO In-network contracting; along with choice of TPA, become of importance to the Decision-makers.