||A Strategic Direction To Define, Improve And Manage Employers' Medical Risk Profiles
Rising health care costs and the associated increases in health insurance premiums have become major issues for our economy as a whole, and a serious challenge for employers of all sizes. Employers are finding that the rising cost of health benefits is taking a toll on other offered benefits, salaries, training, hiring, and investments in technology.
Many employers find the spiraling cost of health care has pushed the cost of providing health care to where it is now the second or third highest overhead item in their operating budget. If health care costs are not brought under control many employers may be forced to erode—perhaps even eliminate—the vitally important health insurance protection they offer. Can this area be better managed? In a word, “ YES ”.
Even though health costs have sharply increased over a significant period of time, much of today's marketplace is still being led to believe that a new insurance-related direction will help solve its health insurance cost woes. Most employers are being advised that their primary options in mitigating health care insurance increases are limited to reducing benefits, changing their benefit concept (e.g., through the implementation of an Health Savings Account, Health Reimbursement Arrangement, etc.), and / or passing a higher share of premium costs to employees.
Many employers have been advised for years that these types of changes represent the only ways they have to fight increasing health insurance costs. The fact is that employers desiring to wage a successful, long-term war against rising health care costs will not find success by simply engaging health insurance strategies, alone. Long term success in harnessing health care cost increases can only be found in building comprehensive health care and health insurance strategies.
Some employers have incorporated a variety of wellness programs, some of which are limited only by one's imagination. The upside to a wellness program is that something proactive is being implemented to fight rising health care costs; however, the downside is that all-too-often only those individuals that are currently healthy actually benefit from such programs, which leave them well short of being able to accomplish positive, long-term results.
It is the chronically ill—and those falling into an “unhealthy well” category—that we must reach, if we are to prove successful in effectively managing health care costs over the long-term. Simply put, wellness-related pursuits alone will not mitigate the drivers causing your rising health costs.
Statistics prove that 75-85% of the overall cost of health insurance is driven by claims costs [ i.e., not fixed costs]. The past success of managed care and negotiated discounts from providers have largely run their course. If your organization is going to find success in providing competitive and affordable health insurance for the long-term, then you will want to engage AscendUSA to work on your behalf.
What We Can Accomplish Working Together…
We will define, improve and manage the medical risk profile of your covered population to ultimately reduce both your current and future claims risk. In doing so, we will minimize your paid medical claims thereby reducing your overall health care / health insurance costs over the long-term.
Executing Our Model…
- An in-depth analysis of the current benefit program and historical claim trends.
- Providing a broad spectrum Health Risk Assessment (HRA) for the covered employee population as well as spouses.
- Analysis of the HRA data to identify undiagnosed conditions that could result in chronic or acute diseases, and psychological issues which impact claims costs as well as productivity.
- Enlisting a high percentage of employees with identified risk to participate in a personal coaching or clinical management program on a proactive rather than reactive basis.
- Tracking the improved risk profile and using predictive modeling to design a benefit plan design and contribution schedule reflective of the changes in risk profile.
- Working with insurers or Third Party Administrators that data warehouse and enable us to effectively data mine to ensure that we have actionable report data on claim costs, diagnoses, and overall risk management with which we can (1) provide a report set to our employer clients' reflecting any current and future claim challenges that exist, and, (2), build effective health care and health insurance strategies that will take direct aim at any existing challenges.
- Providing data that will result in reduced health insurance costs and more strategic alternatives from which the employer can select.
- If applicable, introducing a risk transfer insurance program to allow plan design alternatives for improved plan costs while the process of risk profile improvement evolves.
Our Results-Driven, Leadership Direction…
AscendUSA has recognized the need for a “better mousetrap”, and has dedicated an enormous amount of time and effort to create a multi-faceted program to address the problem of how to minimize and potentially eliminate future health claims. Our philosophy and approach focuses on anticipating, controlling, reducing, and in many cases eliminating the risk elements which, left unchecked, will result in ever-higher health care / health insurance costs for your covered employees and your organization.
Scientific studies on modifiable health risks have proven that specific risk factors such as diabetes, obesity, high cholesterol, high blood pressure, etc. can cost an employer as much as $300 to $500 per year per risk factor. Thus, each risk that can be identified and eliminated would result in a direct savings to the plan via lower claim costs; or, in the case of a fully insured plan help to secure and maintain the lowest available, required premium levels. Of course, there will be additional savings that will result from better self-management of their high risk factor(s) by covered participants [wherein there are risk factor(s) that cannot be totally eliminated]. In addition, through our recommended initiatives, your organization will be in check; realizing positive peripheral benefits including, but not limited to, the following:
- Reduced Absenteeism;
- Increased Presenteeism ( Increased Productivity );
- Improved Morale; and,
- Reduced Number of Workers' Compensation Claims
AscendUSA's well-rounded philosophical direction and comprehensive health management approach will provide many positive results for your organization and your highly valued employees, in addition to securing your best opportunity to stem rising health care costs.
Please contact us for additional details on how we can build a strategic plan specifically tailored to address the needs of your organization.