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The American Benefits Conundrum: Realigning Healthcare Incentives

  1. PRESENTATION PREPARED FOR:
  2. Modernize Healthcare Eliminate employee’s out-of-pocket expenses while guiding them to the highest quality healthcare
  3. Healthcare costs are rising faster than ever!
  4. MEDICAL LOSS RATIO
  5. ANTHEM UHC CIGNA $63.61 $33.16 $36.77 MARCH 23, 2010 OCT 12, 2022
  6. ANTHEM UHC CIGNA $63.61 $33.16 $36.77 MARCH 23, 2010 $468.83 $501.94 $290.38 OCT 12, 2022
  7. Inpatient DRG 470 (major hip and knee joint replacement) across 5 hospitals in SEATTLE
  8. Inpatient DRG 470 (major hip and knee joint replacement) across 5 hospitals in SEATTLE
  9. Facilities, Hospitals, AND Individual Doctors
  10. GBS STRATEGIC PROCESS
  11. TAKE BACK CONTROL - CASE STUDY How it started... ➔ Fully insured Bronze plan with a $6000 deductible ➔ No guidance for employees for accessing highest quality care ➔ Using manual processes for HR functions ➔ Open Enrollment was done via group meetings and paper ➔ EE only rate of $614 per month How it’s going... ➔ Level funded plan with $0 deductible ➔ Medical Advocacy team provides guidance to highest quality care options ➔ Integrated technology solution for HR (reducing administrative burden) ➔ Open Enrollment done via self-service portal with call center support available ➔ EE only rate of $532 per month (15% savings at renewal) Employee testimonial about the program!
  12. MEDIA
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