Protecting your profit margins, avoiding furloughs, and retaining top talent with affordable, quality health benefits is critical in turbulent economic times. As the economy struggles to recover from the pandemic, flexibility will be key for employers.  


Consider these five ways to transform your company’s health plan to increase cash flow, protect long-term profits, and improve employee health outcomes. 

1.Broad isn’t always better. Choose quality over quantity. 

Don’t pay for bloated networks, when healthcare savings demand better networks. High-performance networks represent one of the innovative strategies designed to deliver better outcomes and reduce costs. A high-performance network is a carefully curated, select number of high-quality, cost-effective providers who have agreed to be measured by specific metrics to maintain high patient outcomes and efficiency in practice. Our options can save up to 26% in certain markets. It’s no wonder that the number of employers implementing high-performance network-based models has jumped 267 percent since 2014.[1]   

2. Financial incentives: Choose Value-based Care over Fee-for-Service  

The four most costly health conditions in the U.S. are: 
  • chest pain,  
  • high blood pressure,  
  • diabetes,  
  • and heart attack  
— all potentially preventable with early detection and care management.[2The current healthcare system is based on a fee-for-service model, which incentivizes providers based on the volume of care, visits, and tests—necessary or not. New, value-based care models incentivize primary care physicians, supported by a team of healthcare professionals, to help patients make more proactive, primary care-level changes to improve their health. When members comply with preventive care treatment overseen by a proactive, engaged care coordination team, the cost of insuring them goes down long-termsustainably lowering premiums (and predictably increasing cash resources). 3. Identify and manage the health of high-risk populations. High-risk populations (individuals with diabetes or heat disease, for example) disproportionately drive up premiums for employers[3]. Health plans with embedded care coordination to help identify those who might be suffering from a chronic disease or are at risk for developing one. Care coordination programs supported by a robust data analysis analytics platform and utilize predictive modeling algorithms to: 
  • identify risk profiles for employees,  
  • and track the coordinated interventions made by primary care physicians, nurses, and specialists to improve their long-term health outcomes. 
This reduces premium costs to employers over time by reducing hospitalizations, emergency room visits, and prescriptions creating a lasting, positive impact on employee health and employer budgets.

4. Take back control of your data.

Employers lack visibility into what’s causing the rise in healthcare costs. Organizational politics limit access to data that could help employers identify gaps in care and their biggest cost drivers (the previously mentioned high-risk populations). Healthcare Highways coordinates data from all access points of care, including pharmacy, converting that data into useful information to identify future high claimants, patterns of excessive use, and wellness tracking to empower employers to determine the cost effectiveness of their benefits plan.   Remember: There’s no accounting for value without data. 

5. Bring on the competition.

Disruptive innovation in an industry often delivers a new level of value for consumers, and the healthcare industry is no different. The absence of a transparent healthcare marketplace contributes to dissatisfaction, limited choice, and a confined understanding of available options. Thise lack of transparency and competition in the market is detrimental to the employees who need it, the businesses that sponsor it, and the providers who deliver the greatest value.   Employers should: 
  • invite competitive bids on health plans 
  • iInsist on having more than one option for their employees, 
  • demand data transparency and access, and 
  • require embedded care coordination.  
    REFERENCES  [1]  [2]  [3