Providing Efficient Health Insurance Options Is Not an Impossible Dream

Follow these five tactics to reduce medical costs and improve health care service for your team

Providing Efficient Health Insurance Options Is Not an Impossible Dream

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After working on his own as an independent health care insurance broker for several years, Ryan recently took a job with a bigger brokerage. When he broke the news to his wife that the company he joined did not offer a traditional PPO or HMO insurance plan, she wasn’t thrilled. After all, Americans have been conditioned to these models for years.

A few weeks later, Ryan’s wife woke up and found one of their three children not feeling well, and she immediately grew frustrated as she knew what that meant: She would have to cancel her plans for the day and arrange alternative plans to carpool her other two children to school so she could take her sick child to the doctor.

She immediately went to the mobile app on her phone to schedule an appointment at her child’s doctor’s office, only to learn that a telehealth consult with a physician could be scheduled remotely within the hour. So she gave it a try.

From the couch in her living room 10 minutes later, a physician conducted a telehealth appointment remotely via the mom’s mobile phone. After asking a few questions of the mother and child, the doctor advised that he had written a prescription for the child and it would be available for pick up within 30 minutes at her regular pharmacy.

It turns out mom didn’t have to cancel her carpool schedule at all, or rearrange her schedule for the day. That was it.

The irony of this story? The American health care delivery model is fragmented and broken, yet our innate desire to resist any sort of change keeps us clinging to ineffective plans such as a PPO or HMO. Stories like this exemplify how inane that resistance to change truly is. 

Don’t Be Afraid To Ask

New alternative approaches to providing employees and employee family members health care are sweeping the country, and even the smallest company can take advantage of those changes. But you are not likely to ever hear about them unless you ask your broker. Why? Your broker is like a Realtor: The more money you pay, the more they make.

So, it’s time to ask. When you do ask, you will learn that the more employees who engage in smart health care decisions, the more your company and the employee both stand to save. Creating a work environment that encourages smart, engaged health care decisions is key. Many of these corporate offerings simply require your company to contract with an organization and move forward.

Here is a list of several offerings that could provide improved care and access to your employees while drastically reducing your company’s overall health care costs.

1. Telehealth options:As discussed above, when used as an alternative to a primary care visit, both telehealth and 24-hour call lines can reduce wasteful spending and eliminate unnecessary delays in care.

2. Disease-specific programs: The old saying that 10% of your employees account for more than 90% of your overall spending is never truer than in health care. Expenses on chronic diseases like diabetes can be reduced drastically if your company invests in and offers a prevention program for employees at risk for diabetes.

3. DNA testing: Companies offering voluntary DNA testing or genome sequencing for employees are finding that the potential to save thousands on unnecessary medications and preventable chronic diseases has a swift return on investment. DNA tests identify which medications are ineffective on an individual and also identify those who are predisposed to acquire several forms of cancer.

4. Integrative, functional or naturopathic medicine consults: The reemergence of natural methods to live healthier and prevent increased likelihood of chronic disease by better understanding each individual’s body composition has proven to provide a quick return on investment as well. 

5. Local medical tourism: Employees who choose a regional “center of excellence,” or in-network provider, may save a few thousand dollars, but your company can save anywhere from $40,000 to $80,000 on major procedures. Making sure employees understand that the quality of care at both facilities is comparable often is enough to convince them to choose the in-network provider. And if not, why not offer to pay their personal copay if it saves the company $20,000 or more?

Reducing Costs

Employees often have to drive only 35 miles or less to find a center of excellence. This provides savings for the employee and the employer. It’s just a matter of the employee engaging and asking for a list of in-network providers, or centers of excellence. Often the employer will offer to pay the employee’s copay if the employee chooses a center of excellence. Why? Well if the employee share of costs is only $1,000 and the employer stands to pay an additional $20,000 for the procedure if the employee does not choose the center of excellence, then this is an easy financial decision.  

Companies all over the country are proving that simple tactics like this can produce quick results. Not only will the employee and employer save significant dollars in year one, but you are also likely to see enhanced access to care, improved quality and an increase in overall employee morale as a result.

And each of these tactics still apply to small businesses. In fact, they can generate more savings per employee if you have one or two high-cost employees with manageable chronic diseases or expensive medications.

Keep in mind that you don’t need to implement all of these ideas in the first year. Many companies have had great success starting with two or three of these tactics and adding others later.

Of late, companies like Walmart, Disney, Apple, Amazon, J.P. Morgan and Berkshire Hathaway have declared a war on health care costs. Isn’t it time that you and your small business declare a tipping point on wasteful and excessive health care spending?

About the Author

Dr. Josh Luke is a speaker, futurist and former hospital CEO and author of Health-Wealth: 9 Steps to Financial Recovery. For more information, visit www.drjoshluke.com.



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