One-Size Fits All Is Not The Right Size
Customized Plan | April 2016 |
If we lived in a one-size-fits-all world, there would only be one kind of car, one type of music and one flavor of ice cream. Fortunately, we live in a land of options. Companies can choose whether to go with a self-insured health benefits plan or a fully-insured plan.
It’s estimated that nearly 59 percent1 of all health plans in the US are now self-funded and that number continues to grow. Self-funded plans give companies the choices they want, and more and more companies are realizing they can customize a plan to create a perfect fit.
Customizing a plan relies on quality data collection, analysis and extraordinary reporting. For instance, when employee healthcare claims are out of control, an in depth analysis can pinpoint the money pit. Are employees seeing out-of-network providers? Are they taking brand-name meds instead of generic or mismanaging chronic health conditions? Are they heading to the ER instead of urgent care? It’s possible. Nearly 17 percent of all visits to hospital emergency departments across the United States could be treated at an urgent care center – for a significantly reduced cost.2 Our thorough data analysis can tell you which of these money-sucking culprits are driving up healthcare claims.
Analysis Leads To Solutions
Tapping into cost-saving solutions depends on two things: clean, up-to-date data and competent analysis. As a claims payer, we have immediate access to critical data in a HIPAA compliant environment. That data is analyzed by our clinician analysts, who understand risks and potential plan cost drivers. It’s key to structuring a customized plan that addresses rising healthcare costs, while also meeting the needs of all members.
As a leading health benefits administrator, Prairie States knows how to collect, measure, analyze and report data that facilitates results. To help companies reduce costs over time, we analyze:
- Claims and prescription data
- Health risk appraisals and biometrics
- Condition management data
- Wellness programs
- Demographic profiles
- Average tenure and turnover rates
Solutions = Savings
Prairie States’ account managers prepare detailed reports and are always available to explain the deep and relevant data. We can also provide individualized recommendations to improve ROI for healthcare services, meet specific company health goals and ensure effective risk reduction strategies.
1. Employee Benefit Research Institute: “Self-Insured Health Plans: State Variation and Recent Trends by Firm Size”; 2011, Paul Fronstin, Ph.D.
With nearly 30 years in cutting edge health benefits administration, we have the experience to interpret data and help customize a cost-saving healthcare benefits plan that is a perfect fit.
You can give your clients a better, customized, money-saving self funded plan from Prairie States. Talk to us today!
2. Weinick, Robin M.; “Many Emergency Department Visits Could Be Managed at Urgent Care Centers and Retail Clinics”; Health Affairs, vol. 29, no. 9, Sep. 2010, p. 1630-1636.