"Let's face it, no healthcare provider ever wants to advertise themselves as the "low price leader", explains the company's CEO, Maria K Todd, MHA PhD, who was recently ranked in the top 5 key opinion leaders in healthcare cost containment by the online expert referral engine, Zintro, with more than 40,000 ranked experts. She is the author of 9 professional books dealing with healthcare integration and alignment, managed care, and medical tourism and a frequent international speaker on healthcare cost containment and U.S. healthcare reform.
"Upon the callers' request, we discreetly identify these more affordable providers to plan members so they can maximize the network access discounts that their employers already negotiated. At the same time, plan members realize lower copayments and coinsurance. Better yet, they earn a cash reward simply for being a savvy shopper, while plan sponsors benefit from lower healthcare spend."
Models such as these have been popping up in local markets and gaining in popularity with self-funded health plan sponsors and fully-insured companies in New Hampshire.
Currently Both Harvard-Pilgrim and Anthem in New Hampshire offer local versions of these engagement tools to client employers and employees absolutely love them. But a broader program like MyHealthSavingsUSA™
"With the domestic health travel option integrated into the service, we were able to offer a caller the option to drive 90 minutes away to save $80,000 on a lumbar fusion surgery, says Todd. How would the plan member have otherwise known that such huge savings were only an hour and a half drive down the road?"
The program is 100% voluntary, 100% free for employees, and doesn't require callers to change doctors, hospitals or pharmacies. If the caller selects the lower cost provider, they earn a financial incentive for getting the care they need. Care Navigators™ assist callers with referral and authorization changes, medical records transfers, and to reschedule or use their professional judgment to expedite appointments when there's an indication to do so.
Employers set the reward schedule, determine which expenses are eligible, and determine how the rewards are paid, (either in cash which is taxable, or added to a health savings account or other flexible benefit account, or they can allow plan members to choose at the time of service). Rewards are funded by the employers, who also pay a modest monthly, per employee fee to MHIBG to provide the toll free lines, maintain nursing staff, manage the program, prepare reports, and process reward payments. Employer and union groups of all sizes are welcome. There is no need to change their current insurer or PPO to benefit from the program.
To maintain privacy, all consultations with case managers, nurses, and Care Navigators™ are completely confidential. MHI Benefits Group handles the program management for employers end-to-end, including payment of the reward checks and savings and activity reports at the end of each month, keeping with HIPAA "minimum necessary" privacy rules. Information about specific claims and calls is not shared with employers.
For more information on the MyHealthSavingsUSA™
MHI Benefits Group is no stranger to disruptive innovation in healthcare. In 1997, the company's founder partnered with a local general surgeon to design and launch a workers' compensation pilot program offering predictable, combined case rates for workers' comp outpatient surgeries that bundled local facility and surgeon fees, pre-operative consultations and 90 days' follow up care. The bundled price surgery program is paired with a complete injury management and TTD reduction program option, staffed by registered nurse case managers. It has enjoyed tremendous success in the last 15 years with fewer than three inaccurate or late paid claims per client in 15 years and tight control of TTD costs.
In 2003, the company launched its Corporate Registry™ program to manage executive checkups through a concierge service that is combined with a health travel option for busy executives that are always on the road. The program handles about 800 cases per year, the majority of which are scheduled stateside, but now exotic destinations such as Singapore, Kuala Lumpur, Bangkok, Barcelona, the Costa del Sol, South Africa and other destinations are available for executive checkups combined with golf, relaxation, a quick spa retreat, or corporate meetings nearby. Most companies now allow spouses to tag along and receive preventive health exams for an extra fee at the contracted rates.
Since 2008, it has coordinated corporate health travel management for companies who have have launched pilot programs featuring domestic and expatriate medical travel options. Experienced nurses and Care Navigators™ provide end-to-end management of the complicated health travel logistics, continuity of care coordination, and handle outcomes measurements and reporting. Travel agents handle specialized medical travel planning according to company protocols and Care Navigators™ instructions, and benefit advisers familiar with ERISA plan regulations help prepare plan documents for filings required by regulation. The company also provides third-
MHIBG also has an affiliate program to reward employees who would like to share the MyHealthSavingsUSA™
BROKER AFFILIATIONS ARE INVITED.
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MHI Benefits Group (MHIBG) is a subsidiary of the Mercury Healthcare Companies.
Employers and unions benefit from MHIBG's innovative and affordable solutions that immediately lower healthcare spend for routine health services representing 30% of employers' total claims spend.
MHIBG manages the national program end-to-end for employers that fund the $10, $25, $50, or $75 cash rewards based on the amount of healthcare savings. It's free for employees and 100% voluntary!