Prime Advantage Blog

U.S. Healthcare: Where Do We Go from Here?

Mike McDonald on Mar 29, 2017 2:45:00 PM

Skyline-Washington-DC.jpg“You have to address behavior or you cannot reduce costs.” That was the overarching sentiment at the inaugural Prime Advantage Healthcare Summit, held in Washington, D.C. The Summit brought together healthcare legislation architects and experts, members of previous presidential administrations and transition teams, as well as business leaders in manufacturing, all for an inside look into healthcare policy and solutions to subjugate rising costs.

The “behavior” needing to be addressed surrounds taking a more proactive approach to controlling healthcare spending. This comes in the form making decisions that lead to necessitating healthcare less, and making preemptive choices that enable coverage to dovetail with the healthcare that is needed. Recent news suggests that the Affordable Care Act will be the law of the land for the foreseeable future, or at least, for the immediate future. (It’s clear policymakers don’t even know at this point.) Despite the continued uncertainty, the need for a proactive approach holds true no matter what healthcare legislation is enacted or sustained.

It’s estimated that 98% of the healthcare costs come from the two percent of the time one actually sees a medical professional, yet the care one requires is dictated by choices made throughout. Premiums are projected to increase by 25% this year nationwide. Young and healthy people are not enrolling into the exchanges at the rate first hoped, so rising premiums are not an issue likely to get solved anytime soon. Price controls on prescription drugs in other countries like Japan and in Europe creates an environment where most new drugs are developed in the U.S., shifting the immense costs of R&D to Americans.

The escalating cost of healthcare in this country is a dire situation. But one we can overcome. It’s up to companies and individuals to take the reins and control their healthcare spending. One of the leading ways to do so is the Prime Advantage Healthcare Program. This program offers major medical insurance, supplemental insurance, a wellbeing package, and an online platform to seamlessly manage it all from any smart device or computer. The program leverages tools in the marketplace (that many people are simply not aware of) to help make coverage much more health and cost efficient. For employers, it helps control the costs associated with the vast risk that they bear. For employees, it reduces unnecessary coverage, increases wellbeing, and finds a more suitable deductible and copay structure.

The significant tax savings affords companies access to one of the program’s best features, its world-class wellbeing package. And this is not your typical wellness program. It provides the opportunity to modify behaviors, which in turn saves money by needing healthcare services less. Confidential one-on-one sessions with a personal coach create an environment that helps employees open up more to discover the appropriate wellness formula specific to their individual needs. It allows them to connect with coverage providers on a personal level and to ask questions that they might not ask their employers, nor would be logistically feasible at larger companies. Touch points create trust. The program has shown that the more engagement you have from employees, the more satisfied they are, and the more they feel taken care of. The wellbeing program promotes accountability and engagement, producing results with a quantifiable ROI to the point a CFO will see a noticeable difference in the price tag at renewal time due to the reduced claims.

The program also boasts top-notch major medical and supplemental insurance providers so that individuals and companies can be rest assured they are receiving some of the best coverage in the industry. The supplemental package even covers chronic conditions, and provides piece of mind as a check is already on its way as soon as an event occurs. The government estimates that 87% of worker’s comp claims are the result of an injury that was not acquired on the job. This supplemental program covers injuries not incurred while working, saving businesses at least 40% on worker’s comp claims as employees have no incentive to deceive employers by saying the incident happened while on the clock.

The Prime Advantage Healthcare program gets individuals more engaged and a better understanding of their healthcare benefits. Each piece of this comprehensive package is voluntary and is meant to supplement and strengthen coverage. It’s completely customizable to each individual’s situation and circumstances, which is much more effective than taking a blanketed approach to healthcare coverage. Healthcare costs are likely to remain high and someone will have to pay for them. It’s just a matter of not being the only one left at the table when the bill arrives. And an employee not worried about the financial burdens of healthcare, is a productive employee.

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Topics: Buying Groups and Group Purchasing Organizations, Healthcare

Mike McDonald

Posted by Mike McDonald

Mike is the Executive Vice President of Business Development for Prime Advantage, a Chicago based Group Purchasing Organization for mid-market manufacturers. Responsibilities include managing business development, marketing, and the GPO's Healthcare Cost Containment program. He’s been a featured speaker, published author, and recognized award winner within the supply chain community.

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