Finding Cost-Saving Opportunities
The Alliance negotiates lower costs as a percentage of Medicare, but costs for a specific procedure can still vary greatly between providers. The first step of steering is to identify high-dollar claims based on your health plan costs; examine what claims you spend on most frequently and where you spend it.
For example, the cost of surgery to place ear tubes in young children (myringotomy) is just one procedure that greatly varies in cost depending on where treatment occurs. Fortunately, some providers do a high volume of these surgeries – an indicator of quality care – and those providers are also likely to have better contracted rates because of it.
If you’re interested in finding cost-saving opportunities, see how we can help.
Incentives are a Win-Win
Once you identify where you can achieve significant savings, the next step is getting employee “buy-in.” Financial incentives that reward employees for choosing high-value care are crucial. To put it simply: you must share the savings with employees so you both reap the benefits from choosing a high-value provider – a well-designed incentive means everyone saves.
Communication is Key
Unless employees know about your new incentives, they simply won’t use them, so communicating incentives are a crucial component of steering. Employers need to share information across the company in many forms and on a consistent basis so employees remember the offer when making health care decisions.
Smarter HealthSM Analysis
Our proprietary Smarter Health analysis offers deep insights into where your employees are seeking high-cost care — and where you can save — without compromising health care quality. Smarter Health is completely custom to each employer and helps you gain transparent access into your claims data. This is a foundational piece towards creating a successful employee steering program. Smarter Health is only available to employer-members of The Alliance.
Smarter Care AdvisorSM
Our new patient tool, Smarter Care Advisor, helps employees understand where to find a procedure and how much it might cost. They can search for services within a 100-mile range of their location and get contact information for a provider along with a cost estimate! Smarter Care Advisor helps educate and empower employees to make better health care decisions, which is the first step to a successful steering program!
Steering Works for All Sizes of Employers
Steerage programs aren’t just for small-to-midsize businesses. Companies like Wal-Mart, Lowe’s, The Boeing Company, Pepsi, and Safeway have all implemented changes that steered employees to higher value care that saved money.
- Wisconsin alone could save $394 million per year if employers steered their patients to high-value, low-cost providers. Contact Account Management to find out how much you could save.
- The creation of benefit designs that explicitly encourage consumers to act on price and quality information, including reference pricing, tiered networks, centers of excellence contracting and V-BID, is a step toward a system that provides and rewards high-value care, while simultaneously driving waste from the health care system.
Featured Insights on Benefit Design & Analytics
The Alliance: Driving High-Value Healthcare for Employers and Their Employees
Driving employees to high-value healthcare can improve quality of care while reducing costs for employees and their self-funded employers. It’s no secret that we are facing some complex challenges in healthcare today. Over 70% of employers expect moderate to...
Three Alternative Payment Models Reducing Cost and Improving Care
Traditionally, healthcare has been paid with a fee-for-service model where providers are paid separately for each service provided. This model can make it difficult for patients and healthcare payers to estimate the total cost prior to seeking care. But alternative...
Value-Based Insurance Design is Driving Change in Healthcare
As healthcare costs continue to rise, payers are turning to innovative strategies, like value-based insurance design (VBID), to improve quality, maximize healthcare dollars for care that is most needed by plan participants, and improve costs in the long run. VBID...