Three great ways you can control rising health care costs

This one health care strategy always saves money

After reading about Zenefits' recent struggles, I started thinking about the state of the health insurance industry in 2016. It seems like our industry has come down with a case of the "shiny metal object" syndrome.

Every day, we are bombarded with new information about the latest and greatest in software and technology that will revolutionize the health insurance industry. Employers across the country are looking to implement software that will streamline the benefit administration process.

Technological advancements are helping benefit managers save time and a few headaches. All these new "shiny metal objects", however, are distracting employers from focusing on the one strategy that has stood the test of time: managing risk. Let's look at three ways you can effectively manage your group's risk and control rising medical costs. 

Population Health

Population Health can be defined as "the health outcomes of a group of individuals, including the distribution of such outcomes within the group". It starts with data. Data is king and its importance to the health insurance industry is paramount.

Having the ability to review your group's medical and pharmacy data provides you with the opportunity to identify current and future risks. Population Health is about looking forward and targeting those individuals who will be tomorrow's high-cost claims and then implementing the right programs to assist those at-risk members. Done successfully, you will not only reach members before the onset of a chronic condition, you will increase your chances of containing future health insurance dollars.

Care Coordination

Why do you offer health insurance benefits? If you were to ask an employer this question, a likely response would be, “To take care of my employees." So how well are we taking care of our employees, specifically those with chronic conditions?

Unfortunately, they are lost in the health care system visiting multiple doctors who are providing treatments for different symptoms with little communication. This is where care coordination is vital.

If you want to take care of your employees, make sure those in need of medical care are receiving a helping hand. Give them a resource to guide them through their health care journey from the point of entry to post-admission ensuring that appropriate, necessary procedures and treatment plans are performed. Care coordination solutions like Quantum Health can help your members navigate the rough waters of the health care system and help you eliminate much of the monetary "waste" inside your medical plan.   

Access to Quality and Cost

Let's face it, your plan members are going to have claims. So if they are going to have claims, make sure they have access to high-quality, low-cost facilities. As you know you by now, costs between two facilities can vary by more than 500 percent. By no means does higher cost equate to higher quality.

Quit relying on the network "discount" and start providing your members with tools to make educated cost and quality decisions. The only way to pay less for health care is to pay less for health care. Solutions like The Zero Card, MediBid, Health care Bluebook, Patient Care, and others are doing just that. Equipping members with the right information is powerful and leads to reduced claims dollars.

Remember, the health insurance industry needs software and technology to improve efficiency within the benefit management process. However, do not get distracted by all of those "shiny metal objects" out there. Center your focus on managing risk and you will have a successful health insurance plan that will stand the test of time.


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