If you're any of the following:
- Discount medical plan
- Limited benefits medical plan
- Health share
- Self-insured employer
- Large health plan
Odds are that cost containment is an important goal for you. As a payer, it’s your job to provide great health coverage and benefits while trying your best to not exceed your budget or drastically raise members’ premiums. There are a lot of healthcare cost containment strategies out there, but they’re not all built the same. Some might get the job done of keeping costs down but then hurt your member satisfaction and retention. To assist you in your search, we’re diving into three highly effective strategies to help you contain healthcare costs.
Hear us out! This might sound like it will cost you more money, but ensuring members are getting quality care actually lowers your overall healthcare costs. How? For starters, preventive care is much more affordable than major surgery. Even physical therapy or medications are often more affordable (and less invasive for the member) than a procedure. By placing an emphasis on ensuring members get better care, you save on healthcare costs and improve member satisfaction. Creating member education materials and incentives that make it easy and beneficial for members to receive preventive care will be important for this strategy's success. Consider incorporating direct primary care into your offerings or telemedicine. These two tactics are a way for members to receive convenient and affordable preventive care. When members do need procedures, make sure you’re directing them to providers that can provide the best clinical outcomes for an affordable price. This will ensure your healthcare costs are contained and members are receiving excellent care.
Patient advocacy services such as bill negotiation and healthcare navigation are low-cost solutions that make a big impact on your healthcare cost containment goals. Through bill negotiation, patient advocates will lower members’ medical bills. Through healthcare navigation, patient advocates or a self-service app can guide members to the most affordable option for their care. In addition to saving you money, third-party patient advocacy services can improve member satisfaction and retention. In our own survey, 100% of respondents reported being willing to pay a little more on their monthly premiums to receive patient advocacy services. This is a strategy where paying a little bit of money results in much bigger savings for you and your members.
Administrative work has proven to be one of the most expensive line items for healthcare. An FCA Healthcare Economics paper found that 25% ($760 billion) of administrative costs are unnecessary and wasteful. Not only that, but the U.S. leads in administrative costs for healthcare spending among other high-income countries. There are several reasons why administrative costs are so expensive, so we won’t get into that part. Instead, we’ll look at how you can reduce your administrative work. One strategy is to focus on the data part of admin. Think of administrative data exchange between healthcare entities as a network. In a network, you can assess the different pipelines of data being used to exchange data. Analyzing this network, you could find the slowest and most expensive lines of exchange and then address them. Another solution is to use vendors that promote interoperability. Interoperability makes data exchange faster and easier, saving you time and money.
Containing healthcare costs is an important goal for anyone who offers healthcare coverage. All the types of payers we listed at the beginning of the blog benefit by practicing strategies that keep costs low. If you’re lost or overwhelmed by all the healthcare cost containment strategies out there, let the three pointed out in this blog help you find the most effective strategy for you.
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