Reducing Claim Spend
Physician costs can be mitigated. With providers feeling the squeeze on Medicare and Medicaid reimbursements it is imperative to minimize any cost shifting to employer-sponsored plans. Combined with the coding review platforms (ARM™ and ARMOR™) to protect the plan from being overcharged, we help plan sponsors identify ways to:
- Make accessing care easy and cost effective to both the member and the plan.
- Potentially capture 75% of primary care expenses as a fixed cost, paying providers and staff hourly.
- Engage employee in decision of specialty selection by providing usable information that is specifically based on his/her direct costs (considering their deductible, coinsurance and out of pocket), as well as the outcomes of each provider being considered.
- Integrate and manage a comprehensive wellness program; claim costs can be reduced over $1,500 per employee per year with a well managed campaign.
- Improve compliance – making sure member takes prescriptions and receives appropriate care.