The healthcare system can be a confusing place for someone who is well, let alone someone who is sick and in need of help. Oftentimes, health plan members do not know their benefits and can seek care in the wrong place; like the ER when the problem is not urgent, or outside their network, which means they may incur an expensive and unexpected bill. This confusion can cause delays in treatment and less than desirable outcomes; as well as an increase of cost to everyone involved--from the patient to the health plan itself.
A great many of things happen in May. The blossoming of trees and plants in the Northern Hemisphere signals the much awaited onset of spring. Even the popular rhyme, “April showers bring May flowers” gains new life as we hear and consciously repeat it with the faith that April rains mean life and color to our settings in May. This rhyme originates from a short poem written in 1557 by Thomas Tusser:
There are many regulatory and alluring incentives that come with self-funding, such as avoiding medical loss ratio requirements or exemption from the health insurance tax mandated by the ACA, but in order to more accurately weigh the risk vs. reward of self-funding, the following questions should first be answered:
Innovation is defined as a new idea, more effective device or process. Healthcare is widely considered one of the least innovative business sectors by the tech industry and yet, according to a recent survey by Ketchum, consumers value innovation in healthcare above innovation in all other industries. Considering that many doctors still fax prescriptions to pharmacies to be filled, it shouldn’t come as a surprise that this group is slow to adopt technological advances. Things are changing though.
According to Partnership for Workplace Mental Health, people with untreated mental illness use non-psychiatric inpatient and outpatient services three times more than those who are treated. However, the high cost of mental illness can be alleviated through proper diagnosis and treatment. Appropriate mental health management in the workplace can reduce the incurred costs of these disorders and can improve the employee’s overall mental health and workplace productivity. Bottom line: When employees get the mental health treatment they need, employers benefit.
Improving the health of your employees and health plan, while positively impacting clinical and financial outcomes, is critical to getting the best benefit. This blog explains how to do it. To ensure cost-effective, quality health care, you need to control and manage your health plan like you do your core business. That means making sure that clinical and wellness initiatives are working as intended, and integrated among the member, insurer, plan and the provider team.
In today’s healthcare world, benefits brokers are primed to gain a competitive edge through harnessing the power of big data analytics. With the right analytics engine, brokers can streamline risk analysis to provide their clients with key insights – at micro and macro levels – that shed light on crucial aspects of their member population and generate actionable results (1 Year $1 Million Saved: CEBG). The next major step in healthcare technology is here and ready to assist in the effort to improve population health.
Congratulations Hill Country Memorial on again being named on Truven’s Top 100 Hospitals in the US (5th year in a row—6th time overall) healthcare organizations that are delivering exceptional healthcare value through outstanding performance on an 11-measure, balanced scorecard.
Data analytics is the current and most effective means to achieving population health management, but let’s face it: To many employers, population health management is merely a health-benefits catchphrase, an empty expression that represents a goal but lacks the means to achieve it. However, in the right hands, data analysis is much more than that. Data analysis gives brokers the edge to fulfill population health management goals by providing common-sense human interactions to take action on the steps identified for plan performance.
The further we venture into our modern healthcare system, it becomes more apparent that the self-insured employer understands their potential to slash healthcare costs by creating and effectively implementing custom population health management programs. This is not so surprising of a trend, considering that health policy architects designed the Affordable Care Act and quality-based reimbursement initiatives to stem rising healthcare costs through population health management, as we reported in our ebook, "The New Broker."