Self-funded Employers: Improving Healthcare for their Businesses and their Employees

MADISON, WI. (March 13, 2023) – A major challenge in healthcare today is the high price of medical services. Inflation, workforce shortages, and provider consolidations are causing healthcare prices to increase to an unaffordable level. Healthcare prices are so high that medical debt is the leading cause of personal bankruptcy, even among those with health insurance. Workforce shortages are likely to persist in the coming years, affecting both healthcare and other industries.

Self-Funding to Manage Rising Prices

Employers need to manage healthcare costs but aren’t willing to do so at the expense of their employees. Self-funding continues to be a popular option for employers to manage their healthcare spend while maintaining, or improving, benefits for their employees. More employers are pursuing self-funding, even in Dane County, where the use of Health Maintenance Organizations (HMOs) is common. Cheryl DeMars, CEO of The Alliance, said, “this is because employers want greater control and more flexibility to design their benefit plans. And with an increased emphasis on fiduciary responsibility, it is important that employers have access to their data.”   

Healthcare Delivery is Changing

The way healthcare is being delivered is rapidly changing, with new, convenient, and affordable options emerging. Telemedicine and home-based care are creating meaningful options for consumers to get the care they need when and where they need it. DeMars said, “I’m encouraged by the innovation I see in healthcare. There aren’t many upsides to the pandemic, but the increase in new and more convenient modes of healthcare delivery is one of them and is reason for hope.” Telehealth and virtual care are powerful tools for increasing accessibility and giving patients the opportunity to take a proactive role in their health. Employers can benefit from offering high-value virtual care options because healthier employees lead to higher productivity and increased workforce retention.

The Alliance is focusing on facilitating and promoting high-value healthcare in their Smarter Networks^SM. They use innovative models of care, including advanced primary care to improve health outcomes and lower costs for self-funded employers and their employees. Advanced primary care is a model that focuses on comprehensive, patient-centered care, often with behavioral healthcare as an integrated component. This model would not be possible without primary care physicians who work hard to improve access to high-quality care at an affordable price. So, The Alliance prioritizes building relationships and contracting with, high-value comprehensive primary care providers. They work to make it easier for employers to encourage their employees to seek care from doctors and hospitals that deliver quality care and at lower costs.

Employers are Moving Healthcare Forward

The Alliance is made up of over 340 employer-members working to together improve healthcare. DeMars said, “I’m proud of our employer-members who are taking action to manage their healthcare spend without reducing benefits for their employees. Almost 100% of our employer-members with 100 employees or more are using cost-saving programs that encourage their employees to use doctors and hospitals that deliver good care at lower prices. I’m looking forward to continuing to grow The Alliance, adding employer-members who want to be part of the solution. When employers buy healthcare based on value, we create market forces that make a positive impact. That’s the free market in action!”

About The Alliance

The Alliance serves as the voice for self-funded employers who want more control over their health care costs. Using Smarter Networks℠ and sophisticated data mining and analysis, they provide transparent, creative approaches to network and benefit plan design to unlock savings where others can’t – or won’t. The Alliance remains a trusted, objective partner for its 340+ employers and their brokers who seek improved access to high-quality health care by contracting with a network of 38,000 health care providers and doctors across the Midwest.