It can be a bumpy road for employers who are searching for the right health plan for their employees. Medical costs continue to grow, yet the workforce’s health and performance aren’t improving. Both employers and employees struggle to contain their medical spend. Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2006-2016, multiple indicators point to an unsustainable situation:
With low national unemployment rates, increasing benefits expected in new-hire compensation packages
Staggering increases in cost: over the past 10 years, employers’ total contributions to premium costs is up 58%, and employees’ total contribution jumped 80%
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A workforce where 48% have at least one chronic condition.
Where over the past 10 years, employers’ total contributions to premium cost is up 58%,
and employees’ total contribution jumped 80%.
Waste accounts for 37% of the US’s total spending on healthcare.
Our flexibility and collaboration allow your company to create a custom program for its healthcare needs, using some or all our options--in any combination. Build a plan with pharmacy benefit solutions and other healthcare service offerings that offer measurable value and savings. Small, large, or hourly—we work with businesses of all sizes to help them take back their business from inflexible, expensive plans filled with confusing and low-value service options. We build plans that work for your company—not a one-size-fits-none definition.
Our dedicated account managers learn your company’s unique needs and actively guide your organization through your tailored enrollment process, with easy-to-understand materials that streamline your internal communication and implementation processes, support your busy HR team, and engage your employees.
Prefer to self-serve? We give you the tools to create a system that works best for you through our employer portal and voice services.
The combination of our high-performance provider networks and strategically aligned Healthcare Highways Health Plan delivers employers of 100 employees or more choice, affordability, improved health outcomes, and lower total cost of care by:
Providing you a single point of contact your designated account manager--for detailed implementation, supported member enrollment, and renewal support, backed by our customer service call center and self-service portal for members and employers.
Guiding members to appropriate in-network providers through our PCP attribution models, care navigation, and care team guided member engagement, as well as your benefit designs;
Providing value-based care medical management of large cases or chronic diseases;
Identifying high-risk cases through intensive, customizable precertification and utilization review led by evidence-based clinical guidelines and bolstered by care-pathway tables, integrated medical evidence, and automated quality flags with preset triggers throughout our system; and offering concurrent reviews and discharge planning to ensure your plan lowers costs while providing excellent care;
Confirming billing appropriateness before claims are processed through our robust claims protocols ensuring timely and accurate payment processing;
Handling claims through the entire process of entire adjustment, auditing, and appeals to administer services like underwriting and premium billing:
Protecting employers that self-fund their employee benefit health plans from assuming 100% of loss liability with stop-loss services, and sharing the risk with you through our partner arrangements. Healthcare Highways Health Plan is rated by an A.M. Best A+ Superior rated stop-loss company.
Our networks are the foundation of our client’s success in reducing costs and providing high-quality care. Choose from our broad and high-performance health plan networks designed with the quality, alignment, and cost transparency needed to put your company in control of benefits and cost management. Your company’s needs are at the center of the health plansdesigned for you because our independent networks of providers allow us to create partnerships that benefit all parties.
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Hospital systems and physician group coverage
Out-of-network coverage with a benefit differential in the primary area - INCLUDED
Out-of-service area coverage - CLIENT SPECIFIC
Network designed to meet cost and quality metrics goals - INCLUDED
Provider incentives for meeting effciency and quality metrics - INCLUDED
Our out-of-network strategies are designed and implemented around access, driven by cost management, and tailored for member satisfaction. We help you craft your optimal benefit solution by aligning the Healthcare Highways Health Plan with the benefits design that meet your company’s strategic needs. This means flexibility and choice in national wrap, reference-based pricing, and exclusive provider organization solutions. Offering a state-wide high-value solution that includes national network partners gives employers health plans that provide effcient, affordable access to quality health care, care coordination, and claims administration at home and throughout the U.S.
It’s your plan so it’s your data. Data is only as good as its accuracy and your company’s access to it. Errors, inconsistencies, limited accessibility, and gaps in data affect your bottom line. Through collaboration and integrated data reporting processes, Healthcare Highways provides you with complete, accurate, clearly explained, and actionable data from your health plan.
Our quarterly health reports and comprehensive data analytics help you determine the cost effectiveness of your plan and identify gaps in care and the patterns of your biggest cost drivers, such as future high claimants and excessive use. Reports are easily accessed through your Employer Portal. Modify or add reports easily to improve your decision-making with your dedicated account managers.
Employers that self-insure its medical plan for their employees often seek outsourced partners who can bear much of the administrative burden, and it is here that expertise and well-equipped resources and facilities can contribute to lowering healthcare costs. Healthcare Highways Health Plan offers the people, platforms, and expertise that are necessary to handle claims through the entire adjustment, auditing, and appeals process and to administer services like underwriting, stop loss, and premium billing.
We’re here to challenge healthcare to do better and assist you in taking back your large business. Enjoy quality, conveniently-located providers, paying only for what your company needs—and nothing more, 24/7 access to your data that you own, positive employee experience and engagement, and lower total cost of care.
Your small business shouldn’t have to accept health insurance that has benefits you can’t use, or don’t need. Ideal for employers with two or more employees who have good health experience and who feel they are paying too much premium for too little benefit, the Healthcare Highways Funding Advantage Plan for Small Businesses empowers your company to choose and pay for only the benefits that make healthcare affordable and high-performing for its unique needs.
We lower the risks of self-funding, lower monthly costs, and provide substantial refunds for healthy employee groups while offering high-quality service providers and fully-covered preventative health services. Coverage always includes preventative health services covered 100 percent, major medical, and pharmacy benefits management. Many plans return money at the end of a healthy plan year. Our solutions are always risk-mitigated and offer low cost, quality care that is:
Affordable Contributions are cost-effective for employers and employees.
Flexible Benefits align with budget constraints, diverse workforces, and grow with your workforce.
Predictable Costs are pre-determined and level. Individual medical underwriting clearly forecasts claim activity when plan costs are set. Established claims are processed with clear accountability (saving peace of mind as well as money).
Simple Monthly reporting, easy access portal, customer support, self-service option, and practical, combined medical and pharmacy benefit management solutions.
Fill out the form below and take back your small business from inflexible, costly healthcare plans