Apr 26th 2018

Keeping Up With the Marketplace

​According to the Health Care Cost Institute1, total healthcare spending per person rose 4.6% in just ONE year (2016), heavily influenced by the increased sales in prescription drugs and outpatient services. With a focus on effectively controlling healthcare costs, employers and health plans are turning to evidence-based medical benefits management (MBM) solutions to help protect the health and well-being of their employees and retail members.

Making Decisions

There is no question that several new options for navigating the healthcare system are emerging, including new entrepreneurial endeavors by large brands such as Amazon, Berkshire Hathaway, and JPMorgan. More and more, employers are choosing to think outside the box and search out their own solutions if they decide they're not being served appropriately by health plans. Consequently, cooperative partnerships such as Amazon's are raising the pressure on health plans to deliver value and effectiveness in a more affordable healthcare option.

Delivering Choice is Key

With annual premiums having increased by 55% since 2007 alone2, health plans must deliver differentiated value to employers, providers, and members in order to retain renewals and capture new growth. The success of a health plan is determined by not only the quality of coverage, but also by how affordable it is for the member. Perceptions about "true value" are changing, so MBMs must offer the marketplace a variety of choices and solutions that accurately reflect those perceptions.

Informing and Educating the Member

In today's complex healthcare environment, members trying to access and understand information about the quality and value of their health services need an ally. Facing a maze of healthcare service options, they need a map to help them identify the safest and most affordable options for them and their families. The right patient-engagement tools and services can help them make more informed decisions about health and wellness, offer insights on the comparative quality of MBM solutions, and help them make more informed decisions about their care choices with their provider. In addition, a patient's better understanding of care choices can be key to their chances of complying with and completing treatment.

Providing a Consultative Approach

eviCore believes that an educational and consultative approach is crucial to building a more effective bridge among the islands of the U.S. healthcare system. Many health plans are trying to provide members with clearer choices for care, more cost-effective treatment options, and, of course, a greater familiarity with the decision-making processes they are likely to face. Helping members manage their benefits is a good way for both the plan and the member to start getting a handle on the rising costs of healthcare.

At eviCore, we believe that a consultative approach in supporting the member is essential to reducing the costs of care, increasing adherence to medication and treatment, and strengthening compliance with preventive-care behaviors. Our nationally recognized administrative programs are proven to deliver results to health plans, grow the doctor/patient relationship, and enhance the safety of patients in our care. We are committed to "Connecting Intelligent Care" in order to make a positive impact in the healthcare sphere.

Will you be around at the Summit in Orlando next week? Come see us at booth #927 to talk more about how we equip plan members to navigate the healthcare system to secure better, safer, and more affordable healthcare.

[1] http://www.healthcostinstitute.org/report

[2] https://www.kff.org/report-section/ehbs-2017-summary-of-findings/