Strategies that lower costs for limited benefit medical plans

March 17, 2022
Josie Livengood

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It’s a common struggle among most payers to ensure members receive great healthcare while controlling operating costs. Limited benefit medical plans are no exception. It’s often a balancing act trying to provide great benefits, maintain member satisfaction, help members to stay within their cost limits, and not exceed your own organization’s budget. In this blog, we’re going to share strategies that lower healthcare costs for you and your members without hurting member satisfaction or retention.

Enable members to shop for care.

Just about every type of health plan can reap the benefits of price transparency, but limited benefit medical plans are especially well suited for this cost-containment strategy. After all, lower medical bills lead to lower claims costs. And although you’ll never pay more than your set amount, you can use price transparency to help members avoid getting large out-of-pocket medical bills. When members are aware of pricing upfront, they’ll:

  • Be more likely to actually receive care.
  • Will have higher satisfaction with your plan because they’ll know their out-of-pocket cost, if any.

A cost-effective way to offer usable price transparency to members is to use a third-party patient advocacy app. This allows users to search and compare thousands of healthcare services, facilities, providers, etc.

Focus on member retention and satisfaction.

Not so fun fact: it costs five times as much to attract a new member than to retain a current one. If you have a goal to lower healthcare costs, one of the best tips you can follow is to focus hard on retention rather than acquisition. Whether you do that through retraining your member support teams or hiring a vendor, now is not the time to get lazy with member satisfaction. Increasing member satisfaction is an almost foolproof way to keep retention high. 

But therein lies the next question: how do you keep member satisfaction high on a tight budget? For starters, customization will be your best friend. And it can be totally free depending on how you do it. Create consistent communication with members and offer helpful resources that are specific to their needs. For example, you can create an email campaign with tips on how to manage a specific condition that goes out to members who actually have that condition. Showing you care about members as individuals and offering them free, helpful resources is a cost-effective way to improve member satisfaction and retention.

Reduce your service team’s workload.

Outsourcing certain member needs will shift workloads off your internal teams, which can help you save money. For example, the PointHealthTech app is a front door to healthcare that gives members the power to make informed healthcare decisions without submitting any help requests to your team. For more complex healthcare situations, patient advocates step in to guide your members to the right care. This frees up your member support team to:

  • Focus on other requests,
  • Increase response time,
  • And improve member satisfaction.

Bill negotiation.

We’ve gone over solutions that help lower healthcare costs before a medical event happens, but what about after? That’s where bill negotiation comes in. A third-party patient advocacy company will take expensive medical bills and use multiple avenues to reduce the final bill. Our own patient advocates have an average bill reduction amount of 44% and have negotiated over $384 million dollars in savings since 2007

Final thoughts.

The strategies in this blog can help you reach your cost containment goals while increasing member satisfaction and actually improving benefit offerings. A third-party patient advocacy company can provide most of the strategies mentioned in this blog, which provides a great ROI for you since you can rely on one service to provide multiple solutions.

Reach out if we can ever be helpful on your search to implement cost containment strategies that don’t take away from members’ benefits and that actually save money.

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Download Your Guide to 2022's Healthcare Policy Changes

Discover the major changes happening that affect you, how to prepare, and even how to make the new rules work in your favor.

Download The Limited Benefit Plans’ Guide to Competing On More Than Price

Discover how to stand out based on unique offerings and high member satisfaction, and how to implement these strategies.

Download The Complete Guide to Implementing Price Transparency

Discover how to bring price transparency into your benefit offerings to increase member satisfaction, lower overall costs, stand out from competitors, and improve member retention.

Download Your Roadmap to Creating Engaged Healthcare Consumers

Discover the roadmap unique to your health plan type and start seeing higher member satisfaction, lower overall costs, and healthier members.

Download How to Leverage Ambulatory Surgical Centers for Lower Costs and Higher Satisfaction

Discover how TPAs, health cost sharing groups, and limited benefit medical plans can benefit from the use of ASCs.

Download the Patient Advocacy 2.0 White Paper

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download the Complete Guide to Retaining Health Plan Members.

Learn the best strategies and tips for retaining your members while keeping costs low.

Download the Complete Guide to Growing Your Health Plan Membership

Learn the best strategies and tips for growing your members while keeping costs low.

Download the Complete Guide to Lowering Member Costs

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download Healthcare Consumerism 101: A Playbook for Health Plans

Learn the best strategies and tips for retaining your members while keeping costs low.

Download Your Guide to the Transparency in Coverage Rule

Discover how the the new rule will affect TPAs and health plans and how you can start your journey to compliance.

Download Your Guide to Unique Benefit Offerings that Don't Break the Bank

Discover how to add value to your health offerings that delight clients and members but don’t cost a fortune.

Download the Complete Sedera Case Study

Discover what health plan members had to say about the value of patient advocacy in our survey.

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