Highlights
- Healthcare costs are increasing, making it vital for employees to know how to shop wisely for healthcare services.
- Employees can learn how to save money on healthcare in a self-funded insurance plan by being smarter consumers, using online resources, and being empowered to ask questions.
- Companies using self-funded insurance can encourage employees to make cost-effective healthcare choices with education, communication, and flexible benefit plans.
Healthcare costs are steadily increasing yearly, with the average family insurance premium rising by 20% since 2017 and by 43% since 2012.
Many companies have turned to self-funded group captives to offer flexibility in spending and healthcare coverage options. As an employer offering self-funded insurance, you can teach employees how to save money on healthcare and strategize pricing so they can continue to receive quality care at a fair rate.
Comparison Shop for Healthcare to Save Money on Health Benefits
As of March 2020, employers spent 8.2% of their total compensation budget on healthcare, making it one of the most expensive benefits in a company’s budget. From 2015 to 2019, commercial U.S. health spending increased by 21.8%. Two-thirds of the increase came from the rise in service prices, while 18.3% was attributed to drug, professional, and in- and outpatient care price increases.
Yet the cost of healthcare may be unfamiliar to employees in terms of how much they and their employers pay. A 2017 study revealed that only 13% of respondents with out-of-pocket expenses at their last healthcare visit knew what they would spend before receiving care, and only 3% compared costs across providers.
Additionally, 75% of respondents did not know of a resource to help them compare prices and budget expenses. Many people need help saving money on healthcare but don’t know where to turn.
According to a recent study, younger workers are more likely to research healthcare costs when getting healthcare. Additionally, high-deductible plan members are more likely to check prices than those with relatively low deductibles.
Educating your employees about better healthcare consumption can help them reduce costs and ease their financial burden. They should know where to find affordable pricing for out-of-pocket healthcare costs and how to communicate with providers for fair, affordable pricing on necessary services.
How to Save Money on Healthcare: A Guide for Employers and Employees
Employees become better healthcare consumers when they learn to take advantage of cost-saving opportunities for better health benefits. When they know how to shop for healthcare, they are more likely to get the necessary treatments and save money on expenses.
Members of a self-funded insurance plan can take the following actions to price-shop for their healthcare and save money on their medical bills.
View Hospital Pricing Sheets
The Price Transparency Rule (PTR) requires all hospitals to post a list of standard prices for 300 shoppable services in machine-readable and user-friendly formats as of 2021. The regulation says these lists must include negotiated rates with insurance companies, past payments and charges for out-of-network providers, and their best healthcare prices for patients.
To price-compare healthcare services among hospitals, members can search for their local hospital’s pricing lists on their website. The lists should show the healthcare services and the associated billing codes.
Check with Your Insurance Carrier
A health insurer’s website provides detailed pricing information for medical services. Employees can log into your company’s self-insured insurance carrier website and look for a link to your plan’s network, providers, and doctor search tool. Members can look up providers to ensure the doctor they want to see is in your company’s insurance plan network.
However, it is possible that the site does not list all the costs for services and providers and will give a specific service price range. The insurer’s service representative can inform members whether the insurance covers a doctor, prescription, or service.
Research State Databases
Several states provide pricing information based on insurance claims databases called all-payer claims databases (APCDs). There are medical claims, pharmacy claims, dental claims, and provider files in these databases from both private and public insurers. For instance, Maine’s database provides information about charges and payments, categorized by insurance plan and procedure.
To find out if your state offers an APCD, members can look online using the terms “price transparency website” or “price transparency law” with their state’s name.
Use Online Pricing Websites
Several websites can help you find out what healthcare services cost near you. Here are a few examples:
- Healthcare Bluebook shows the fair prices for medical services that medical providers accept from health insurers.
- FAIR Health Consumer provides out-of-pocket and in-network medical expenses based on your area.
- New Choice Health’s Free Quote Request platform lets you request a quote directly from medical facilities and have them contact you.
- The Turquoise Health search engine allows you to determine costs based on the hospital’s pricing sheets.
Get Quotes from Providers
Members can get an estimate for procedures and treatments from medical centers, groups, and providers directly. Some facilities offer online patient estimator tools that use information from your insurance policy to calculate the price.
They can contact the facility’s billing department to determine how much a particular service will cost. These centers and providers should present members with the prices for the procedure and inform them if they need to pay out of pocket for it.
Look for Medication Discounts
Plan members can check your insurer’s list of covered drugs on their website to see if they cover a particular prescription drug. Some plans have calculator tools to help employees find the best healthcare prices for their prescriptions. This is a great way for those on a self-funded plan to save money on healthcare.
Discount medication sites and apps can help members find affordable prices on prescription drugs at local and mail-order pharmacies. Employees can browse them to see if they list necessary medications and find the lowest prices.
Use a Concierge or Care Navigation Service
Healthcare concierge services are an affordable add-on service for self-funded healthcare plans that help employees navigate their employer health benefits. For example, if an employee needs a new primary care provider, the concierge service can direct them to a high-quality, in-network option.
Healthcare concierge services are sometimes called “member navigation services” or “healthcare navigation services.” They help plan members become better healthcare consumers and make informed health decisions. High-quality concierge services have multiple touchpoints so that plan members can access their healthcare concierge team in whatever mode is most convenient to that particular member. Modes include the concierge service’s app, website, email, and phone.
Your healthcare concierge service should help guide plan members to make good healthcare decisions. They can simplify the whole experience for the member and optimize plan utilization for the employer.
How Employers Can Educate Their Employees to Save Money on Healthcare
Employees can benefit from employers fostering an open, transparent culture around healthcare. As an employer, you can help them learn how to advocate for their healthcare choices and make the best decisions for their care.
Encourage Self-Advocacy
Employers can educate employees about the company’s insurance coverage and how to ask questions of their providers. Empowering your employees to make the right choices for their health can improve their health and your organization’s bottom line.
Provide Transparent Data
You can use transparency and digital claims tools provided by your health insurer to create reports of your insurance costs compared to the national average. Seeing this data can help employees choose the appropriate insurance plans during open enrollment.
Communicate with Members About the Benefits of Saving Money on Healthcare
Employees can learn about their benefits offerings through emails, flyers, and meetings. You can send them email campaigns with helpful healthcare tips, such as visiting retail clinics or urgent care centers if they suffer a minor injury, to save time and money.
Offer Flexible Benefits Plans to Save Money on Healthcare
Your organization can design its self-insurance plan and tailor its benefits to your employees’ needs and demographics. Choosing a self-insurance plan with flexible benefits can result in direct employee savings and empower them to make healthcare choices that benefit the entire group.
Roundstone offers small to medium-sized businesses the opportunity to self-fund health benefits through group captive insurance. With Roundstone, you can build your plan from the ground up, allowing your employees to help you choose the best healthcare for their lifestyles and find affordable care near them.
Contact Roundstone today to find out how to save money on healthcare costs and help your employees actively participate in their healthcare benefits plan.
Want to Learn More About How to Save Money on Healthcare? Come to MCF!
If you’re ready to wake up to the realities of self-funded insurance, you need to attend Roundstone’s Medical Captive Forum (MCF).
Held this May 18 to 19 in Chicago, MCF brings employers and benefits advisors together to learn more about self-funding best practices and trends. It’s designed to be educational. We’ll explore a variety of issues in the current health benefits landscape. Learn how to best save money through self-funded insurance using the Group Medical Captive model and improve care quality for your employees.
If the system isn’t working for you, why aren’t you doing anything about it? Attend MCF, and learn more about the benefits of self-funded insurance using Roundstone’s Group Captive Model.
Secure your spot at Roundstone’s MCF.
