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Are more employers realizing they are Health Insurers?

According to Dave Chase in Forbes a growing number of employers are making it their business to locate some of the waste in their health benefit spending and to slash it by finding more cost effective care to meet their workforce’s needs. This means benefit departments and their advisors are performing provider contracting and medical utilization policy work they formerly delegated to health plans.

It makes perfect sense. No one cares as much about your bottom line as you do, and health plans haven’t proven to be very effective at controlling costs. So what can employers do?

Almost any employer can introduce lower cost options like telehealth and alternative care networks. In regions where competition for clinic business is strong a large company can often make better deals than a health plan and can create a company-specific “preferred provider network”. In areas with monopoly pricing employers can consider offering “medical tourism” – sending a plan participant out of town with a family member to access better, lower-cost care. By tracking data on their healthcare spend, Companies can directly negotiate for procedures and bundles that most impact their employees.

At Capsci we are working with employers – and multi-employer groups – that have rolled up their sleeves and put programs in place including all the examples above. We are impressed with the creativity and determination they show in working to stabilize their spend without simply shifting the burden to their employees. We are excited to provide tools that make it easy for employees and dependents to access this better-negotiated care.