Innovative Solutions For Healthcare Cost Management

Individuals who sponsor health plans for themselves or for their loved ones are always on the lookout for innovative health design benefits that can help them give more control on the medical spending, which includes prescription cost and specially drug coverage. While there is a higher percentage of employers who are looking for alternative pro health plans for their employees, the recent announcement of the alliance of Berkshire Hathaway, JP Morgan, and Amazon to deal with healthcare costs and quality has encouraged other employers to explore fresh health plan programs. Not only the big players, but also the smaller employers are seeking referenced-based pricing and other techniques that might make easier for them to understand and monitor. Before moving forward, we would like to tell you that the employers, irrespective of their size are required to recognise the constantly evolving compliance issue that these initiatives might bring along with them.



Evolving payment arrangements 

An effective healthcare cost management solution must take into consideration the following aspects: enhanced care for individuals, improved health for populations and low cost models.

Quality-focused payment model promises to improve the quality of care by shifting from fee-for-service to an alternative payment model. With the help of this plan, group health plans can be offered for payments to providers that fulfill the standard quality and spending criteria.

The center of excellence initiative is a simple initiative that involves employers who directly workers with their carrier. This initiative works great for reference-based pricing models for specific conditions or procedures (transplants).

A large fraction of employers have started providing on-site clinics to deliver cheaper and more convenient primary care to employees. This is known as direct primary-care arrangement. With the help of this initiative, an employer contract comes along with a well-defined package of basic health services for a fixed amount of money (fee).

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