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If your clients are like 93% of employers, affordable and cost-saving health benefits are important to them. On average, about a quarter, or $760 billion of US healthcare spend is wasteful or inappropriate.
Fortunately, there are ways your clients can combat inappropriate care and sustainably contain costs, while simultaneously improving quality health benefits for their employees.
At Healthcare Highways, we are equipped to work with you and ensure that your clients' employees only receive appropriate and necessary care, helping boost their bottom line in the long-term.
First, Let's Define "Appropriate Care."
“Appropriate care is care that is (generally) delivered at the right time, the right place, and by the right provider for the appropriate patient condition.” Chief Medical Officer, Creagh Milford DO, MPH FACOI*
Why does inappropriate care matter?
Inappropriate care not delivered at the right time, the right place, and/or by the right provider for the right condition has a negative impact on everyone, including:
- Raising the total cost of care for employers.
- Increasing future out-of-pocket costs for employees.
Put simply, inappropriate care is just not efficient.
Are YOUR clients paying for inappropriate care?
Three Guiding Questions
- Is the cost-benefit analysis of their health plan and health plan options based on the Total Cost of Care (TCOC) or does it rely on discount comparisons alone?
- Are performance guarantees based on the TCOC (which considers both discounts and the appropriateness of care)?
- Is the company’s health plan primarily composed of value-based (or capitated) provider contracts that guard against inappropriate care by shifting the financial risk from the employer to the providers?
A recent study by global risk mitigation firm Willis Towers Watson revealed that companies that implemented superior network and provider incentive-based programs paid an average of $1,393 less per employee per year than companies that didn't.
The key takeaway: Companies that integrate curated networks of quality providers into their health plan design are better positioned to save money while improving care for employees.
Healthcare benefits are a critical factor in this balancing act — but what makes a balanced health plan?
Download The Five Parts of a Balanced Health Plan.
*C.Milford was CMO at the time this article was written