The Status Quo Is Not An Option

Now that the pandemic is winding down (hopefully) more and more employers are exploring how to lower their ever increasing health insurance costs. Last year it seemed that businesses were focused on financial survival, employment, and other business related issues. Additionally, many businesses saw medical claims decrease as the result of postponement of services.

The postponed of services and procedures have actually resumed, and hospital and provider prices increasing dramatically. 2022 it’s not going to be a very pleasant experience when it comes to health insurance renewals. Increased utilization (occurrences) plus increased prices = BIG renewal increases.

As insurance companies pass increases along, doing nothing is not an acceptable way to conduct business. Putting out a Request For Proposals (RFP) can be a massive and needless undertaking. I have read and replied to many RFPs over the years and quite frankly, many of them miss the mark when it comes to asking the right questions.

In order to better evaluate options without a lot of work and rustling up the marketplace, an easier way to understand if an alternative is possible is to have your medical and pharmacy claims re-priced. With the proper medical and pharmacy claims data, you can determine whether or not it makes sense to even consider a change, if the savings aren’t compelling enough. We provide a FREE Financial Audit which is which takes your actual claims data and runs it through our proprietary repricing methodology to see how much money you could have saved. It’s a useful tool to examine where financial opportunities exist.

We can gather the data for you (with your permission of course) or we can provide you with the “Laundry List” of information needed. Once we have the data, it’s a very straightforward exercise. The 3 claims areas we examine that create the largest savings are:

  • Medical Claims
  • Pharmacy Claims
  • Specialty Drugs

Doing the same things in the future that you’ve done in the past is not going to work for the next year and beyond. It’s like Einstein’s definition of Insanity. Things like raising deductibles and copays, changing to an HSA, implementing wellness, increasing employee contributions, etc. is just kicking the can down the road – a short term solution to a long term problem.

Don’t waste your time with a RFP or talking to brokers or consultants. Take me up on our offer to the FREE Financial Audit of your claims and there  is NO obligation. I really believe that you will find tremendous value in it. Email me at [email protected] or call me at 970-349-7707 to talk about next steps.

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Strategic Healthplan Consulting LLC

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