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Mercury Healthcare Benefits Group Slashes Costs for ERISA Self Funded Benefit Plans
MHI brings disruptive innovation to group health with silo busting programs that reduce health and wellness costs and plan administrative expenses through bundled national PPO access, wellness, health travel program management, and TPA services.
- local, regional and national PPO access
- wellness communications campaigns, health risk assessments and employee engagement tools
- cost containment, high-cost disease management, predictive modeling,
- dependent eligibility audit, claims audit, TPA and PBM services, and
- medical travel options in the USA and over 90 countries.
Employers and plan participants benefit from access to MHI's high-performance global provider network, reduced plan management costs, and lower costs on targeted surgical procedures for domestic and expatriate workers and company retirees.
When it comes to benefits business decisions, MHBG works with employers and labor union plan administrators to establish or modify a plan, determine the new scope of benefits in the package, and help include certain features such as wellness programs, health travel, IPMI and travel accident supplements for plans operated under ERISA and Taft Hartley regulations.
Through game changing disruptive innovation, MHBG moves plan sponsors towards a new healthcare business model that helps self-funded companies, PEOs and Taft-Hartley plans reduce costs while improving both quality and accessibility. MHBG specialists take them through the benefit design and SPD development process and then implement the programs and help manage programs with end-to-end support. Fiduciaries benefit from MHBG support that helps them achieve significant healthcare cost reduction and reduce plan administration expenses.
Traditional business models for health benefits management are laden with "sacred silos" that add layers of costs which produce little value and actually decentralize accountability for quality, outcomes, and cost savings. Plan managers and corporate executives know that the silos are ineffective but most plan sponsors are not sure what to do or how to change the game other than cost shifting and benefits reductions. MHI's game changing innovations topple traditional healthcare benefit management silos like bowling pins.
Three Step Process
The first step of disruptive innovation involves elimination of many sacred silos that create ineffective administrative cost redundancies. Many previous silo services are bundled into a single per-employee-
In the second step, MHBG helps plan sponsors to shape a new system that provides a continuum of care focused on each individual patient’s needs, supported by healthcare analytics, disease prevention and cost avoidance, instead of focusing on crises. MHBG uses a combination of new technology, innovative new repricing and bundled payment methodologies that long established legacy TPAs can't easily adopt or implement because of hard-coded legacy software systems. Disruptive pay for performance incentives reward wellness and cost avoidance achievements for both plan participants and providers.
In the third step, MHBG supports the disruptive innovation with full service, end-to-end management of new benefit programs such as health travel management. Through corporate travel savings and bundled surgical and diagnostic case rates, MHBG also provides complete health travel management which brings down costs on targeted surgical and diagnostic procedures using a narrow network of employer-selected high-performing providers" says Maria Todd, Mercury's CEO. "Our network offers over 6000 hospitals and 9000 ambulatory surgicenters in more than 90 countries, starting right here in the USA. The list of facilities includes most every Medicare-approved Center of Excellence, Research Institutes, and over 1500 facilities with Joint Commission Disease Specific Certifications (DSCs) in the USA and abroad.
As part of this third step, plan administrators are free to designate some or all of the providers in the network worldwide, and to select from about 100 targeted high-cost cases. A team of MHBG benefits experts and analysts provide a no-cost, no-obligation analysis of actual 2010-11 claims data to create a drip pan analysis of savings that could have been achieved using the MHI providers and contracted rates. The reports also include network provider disruption analyses providing plan administrators with valuable intelligence to make better decisions. The turnaround time for the analysis takes approximately 7-10 days from receipt of HIPAA de-identified claims data.
If plan administrators can supply ICD-9 diagnosis incidence frequency rates across participant age bands, MHBG analysts can project estimated savings costs that can be realized through a domestic or international health travel program using MHBG TPA services, case management, and health travel logistics coordination services.
Plan sponsors can start with a pilot program of only one or two procedures steered to one or two facilities, or design a benefit program that offers a wider array of procedures and more domestic and/or international options right from the start. MHBG uses its expanded network and advanced TPA services to help employers better manage expatriate employees and retiree benefit plans in over 90 countries.
The company's trademarked globally integrated health delivery system® combines features of managed care, consumer directed health and wellness, provider integration, quality management, and patient-centered care with game changing price and quality improvements that turns the employee benefits market on its head.
With the patient's consent, using a virtual electronic patient record and our continuum of care, domestic and multinational employers alike can integrate patient care for all active participants and retirees in a care management system that follows patients wherever they go within the globally integrated system. This enables care providers and plan participants to better co-manage preventive measures and therapies which are most effective. Tests aren’t needlessly duplicated, competing medications aren’t prescribed by different doctors, and everyone knows what therapies a patient has received and how it worked or if it didn't.
If a high-cost disease or illness is detected, the participant is routed to a disease management nurse and through a medical management protocol. Technologies such as care team video conferencing and remote second surgical opinions are also utilized.
When the virtual patient record is combined with our exclusive global implant registry, the system easily tracks clinical outcomes and can assist with manufacturer recalls for any implant, hardware, material or device used in a surgery across over the globally integrated system, worldwide. All this is managed for plan sponsors under a single PEPM administrative fee. If a plan participant separates from employment, upon the patients' written request, the entire data set can be removed from the system and electronically forwarded to the patient or his designee in a matter of seconds.
According to a number of reports published by several benefits consultants, disruptive innovation systems can provide 22-30 percent greater cost efficiency than competing systems. Todd explains, "It's easier to reduce costs when overtreatment incentives disappear and are replaced with patient and provider incentives for managing wellness and avoiding unnecessary costs.
Self-funded health benefit plan administrators and CFOs owe it to their bottom lines to invest 15 minutes chatting with us to learn how quickly a little "silo busting" will benefit their bottom line."
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About Mercury Healthcare Benefits Group:
MHBG helps self-funded health benefit plan sponsors to shape exciting new health benefits options that offer a globally integrated continuum of care. Bundled benefits administration services and disruptive, integrated, state-of-the-
MHBG has been providing health travel logistics coordination for executive health and medical tourism since 2003. The company also makes its globally integrated health delivery system available to foreign employers and physicians to help them coordinate treatment referrals and cost savings, worldwide.
To learn more, or request a detailed claims analysis or savings projection, please call 800.727.4160 or visit http://mercury-