Risk Management of Health Care Benefits is Crucial
Healthcare pricing is typically one of the most opaque structures that consumers face. They often purchase a product or service without knowing the costs in advance, comparable pricing, or even the quality. With risk management strategies in place, CIP ensures that your employees receive the Right Care, at the Right Place, at Right Time, for the Right Price. If any of those four “Right” criteria are not being met, it is just plain wrong.
Actively manage healthcare risk & costs throughout the year by:
Working with an advisor who knows how to draw up the right plan.
Align compensations to benefit your company and employees.
Right Care, Right Time, Right Price
There is no reasonable price for poor health care – how do you know who is substandard? Medical management examines hospital safety and quality, preventing misdiagnosis and inappropriate care, and investigates physician quality.
Not only are outcomes widely divergent among hospitals, but prices for procedures can also be too – sometimes within the same city or even a single healthcare system! Our medical management team will ensure that your employees are armed with information to make the best healthcare choices for the right price. We do this by:
Guidance to top-quality doctors & facilities correlates to a lower cost. We share national quality scores of providers ranked on a 0-100 basis.
Pre-determined, “bundled” pricing is agreed upon before the procedure.
Offering free healthcare to employees motivates them to utilize quality solutions.
Stop Spread Pricing & Understand the Impact of Rebates
We will supply you with transparent PBMs instead of the traditional ones that increase medication costs for your employees. Our PBMs know that while a name-brand specialty drug may be a lower cost or even free for the patient, it can sometimes cost your company hundreds of thousands of dollars! We steer them to choices to enable better, balanced outcomes to everyone’s benefit.
Traditional PBMs mark up a drug’s cost, then keep the difference (spread pricing).
Manufacturers’ coupons do not eliminate any portion of the drug’s cost from the plan but motivate employees to choose the most expensive option, with the employer picking up the total amount.
This strategy incentivizes PBMs to push higher-cost drugs for a more significant profit – at your expense.
Second Opinions are a First Line of Defense
When you are sick, nothing is more critical to your recovery than an accurate and timely diagnosis. A correct and effective treatment begins with the proper diagnosis, and prompt care is often a factor too. However, 1 in 20 adults (about 12 million patients) is misdiagnosed every year. Of those misdiagnoses, 50% could potentially be harmful. In fact, 400,000 Americans annually die from preventable medical errors! Who is making sure your employees are diagnosed properly and receiving suitable care?
Know the Price Before You Buy
Under bundled, pre-arranged, or direct contract pricing, your company (supported by a third-party administrator [TPA] or other vendors) has greater transparency with pricing negotiations than traditional opaque, pre-determined, and often overpriced network contracts. The result can be double-digit savings. Our team can explore this and provide you with options to enact it within your organization.