Strategies

“No one spends someone else’s money as carefully as they spend their own”   –Milton Friedman

Consumer Directed Health (High Deductible Health Plan)

By shifting 15-20% of the medical budget from the high premiums paid for low-deductible PPO plans, into employee-owned tax-advantaged Medical Expense Accounts (HRA, HSA, or HRA/VEBA), the employees gain the ability to stockpile tax-free dollars for future or post-retirement medical expenses.

A properly designed CDH plan is potentially richer than the old-style PPO. Data shows that approximately 80% of the population will have a growing balance, and $0 out-of-pocket costs.

Capping the out-of-pocket maximum for every member means there is little or no increased exposure for the small percentage of the population that have a rare high claim.

The importance of the CDH plan is that it properly aligns the incentive so that employees who benefit from achieved efficiency now care as much as management does about medical waste and overpricing.

Personal Concierge Medical Referral Resources

Employees feel overwhelmed with the complexity of the medical system. But given easy access to real time quality outcome and price information will almost always make the best decision to get better care at less cost.

A powerful mobile app called Ben-IQ™ empowers members with instant access to outcome and cost data for every procedure or test at every local facility. The same MRI may vary between $650 and $5,000 in the same locality. Ben-IQ then accesses telephonic counselors to answer questions and assist in scheduling needed services. Employees protect their HSA or VEBA balances every time they use this service.

Ben-IQ Screens-01 - moon project

Near-site Employer-sponsored Clinic

On-site or near-site clinics have been around for years, mainly to mitigate workers compensation costs in very large manufacturing environments. Most recently, there has been an explosion of interest in employer-sponsored clinics as a way to improve care and reduce costs. An on-site clinic bends the curve in the following ways:

  • Paying wholesale vs. retail costs
  • Primacy of primary care
  • Prevention and wellness
  • Referral management
  • Workers compensation mitigation
  • Employee morale and retention