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| Posted on: Tuesday, January 8, 2008 |
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Just when you thought your 2008 New Year’s Resolution list was complete, here is a friendly reminder adding more items to your list. Good news! Your team at Denman will continue to keep you on top of and on track to make thoughtful, intelligent and effective benefit decisions. Here is a brief preview of some of the many items on “our to-do-for-you" list that we’ll be briefing you and your team on throughout the year.
2008 – 2010 Healthcare/Medical Plan Trends
• Medical Tourism – When will purchasing healthcare internationally make
sense for your Plan?
• Emerging Predictive Genetic Testing – Should your plan pay for
screenings for which there is no current illness?
• Pharmaceuticals – typically 12-20% of Plan expenditures
o Orphan/Specialty drugs – Will impact few patients but may cost
$10-$20k/month
o Rx Cost Containment – Step therapy, covering OTCs, pill splitting,
etc. have the potential of reducing drug expenditures by 5-8%
• Mental Health Parity – Likely additional federal laws will expand benefits
and impact costs.
• Surgical implant/devices mark ups can exceed 500% - Ensure that your
Plan negotiates aggressively
• Consumer Directed High Deductible Health Plans – After 4 years, are
HDHPs with HSAs working? How can they be improved for the future?
• Doctor and Hospital Services – Transparency/Web resources for cost and
quality outcome data
• Community Health Plans or Association Plans – Could save 10% or could
cost 20% more depending upon cost shifting between member groups.
• Elder Care Needs – Is Long-term Care Insurance a solution?
• State and/or Federal Health Insurance Mandates – State successes?
Federal Medicare for all? Generational cost shifting? Implicit rationing?
Realistic timeframe for fundamental change?
• Understanding Reinsurance/Pooling and managing risks
o Contract Basis - alignment with Plan’s Claim filing deadline
o Setting your Individual Specific Deductible level / Pooling Point
o Lasers and Aggregating Specific Deductibles
o Selecting your reinsuror
Action Plan - What can an Employer do in 2008 to slow the growth of healthcare costs which have averaged 7%-12% per year for the past decade
• Never stop being a “risk manager” - Denman AWARDS TM
• Change Eligibility and waiting period rules while still meeting
Attract/Retain/Reward business needs
• Narrow Plan Options, such as:
o Add a New Hire Plan – in first year, new hires are only eligible for
Plan with more limited coverage
o Consider a Plan with comprehensive coverage for employees,
but limited benefits for dependents for a one to three year period
• Exclude spouse or adult dependent coverage when other coverage is
available
• Pharmaceuticals (Rx):
o Offer only generic Rx, exclude Brand name Rx
o Mandate drugs that can be filled at retail/mail order are excluded
from Dr. office (lowers cost and avoids office visit cost)
• Mandatory, intensive Wellness Programs – incentives based on achieving
health measures (Bona-fide wellness program)
• Increase incentives or mandate participation in disease management
programs
• Consider higher deductibles for “lifestyle” injuries/illnesses (examples:
obesity surgeries/treatments, hazardous activities, etc.)
• Route high cost care, such as transplants, to the Plan’s selected Center
of Excellence hospital, otherwise coverage is significantly limited
• Pay deduction strategies – Is it affordable to be “family friendly?” Use pay
deductions to encourage participation in the desired Plans. Should pay
deductions be partially based upon pay level?
So, as you can see, nothing is easy! Your team at Denman will keep you on top of and on track to make thoughtful, intelligent and effective benefit decisions.
Should you have any additional employee benefit questions or would like to discuss this material in detail, please don’t hesitate to call the Denman Team. |
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