Navigating Health Care

Created 8 years 274 days ago
by Rita Palmisano

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Categories: Management
Views: 3746

by Holley Maher

The U.S. health care system is complex. While insurance is an important tool to limit exposure, it adds a layer of confusion. Below are a few tips and tricks to controlling benefits spending:

• Transparency tools: These web-based tools help consumers understand pricing differentials associated with various treatments and facilities.

• Telemedicine: Offers 24/7 access to doctors who can virtually prescribe/treat more than 70% of conditions. The cost is typically significantly lower than an urgent care or ER visit, perhaps even free! Since many telemedicine programs don’t hit the claims, these programs may result in more competitive renewals.

• Account-based health plans: Tax-favored vehicles like health savings accounts, flexible spending accounts and health reimbursement arrangements can save consumers 30%; plus, good consumers may find they can roll money over to the next year. 

• Wellness: Some plans provide a monetary incentive to employees who complete a health risk assessment.   

• Narrow networks: With this strategy, the insurance company contracts with a smaller pool of medical providers who agree to deeper discounts on pricing.    

• Individual plans: The family rate for many employer plans assumes an average of 2.5 children. Individual plans can save significant money because the insured may select a higher deductible or narrow network or pay for one to two children instead of 2.5.

• Defined contribution (DC):  With a DC model, employers control cost while providing employees with cost (and benefit) options. DC gives both parties the greatest amount of control and flexibility. Private exchange technology makes it easy for employers to offer transparency tools, telemedicine, account-based health plans, wellness, network variations, and decision support tools designed to help individuals make informed decisions. n