{"id":41612,"date":"2022-10-12T08:30:13","date_gmt":"2022-10-12T12:30:13","guid":{"rendered":"https:\/\/roundstoneinsurance.com\/?p=41612"},"modified":"2023-05-15T16:07:08","modified_gmt":"2023-05-15T20:07:08","slug":"cost-effective-healthcare","status":"publish","type":"post","link":"https:\/\/roundstoneinsurance.com\/excelsior\/blog\/cost-effective-healthcare\/","title":{"rendered":"Building Cost-Effective Healthcare From the Bottom Up with a Self-Insured Plan"},"content":{"rendered":"<p><strong>Highlights\u00a0\u00a0<\/strong><\/p>\n<ul>\n<li>Small to midsize companies looking for cost-effective healthcare must make changes from the bottom up.<\/li>\n<\/ul>\n<ul>\n<li>Bottom-up changes include switching to self-funded group captive insurance and incentivizing low-cost, high-quality care.<\/li>\n<\/ul>\n<ul>\n<li>With Roundstone&#8217;s self-insurance solution, you can build your self-funded plan to meet the healthcare needs of your employees and save money year over year.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<hr \/>\n<p>&nbsp;<\/p>\n<p>In the face of rising healthcare prices, it&#8217;s vital for small to midsize businesses to implement cost-savings measures for cost-effective healthcare in 2022 and beyond. By joining a self-funded group captive plan, these employers can provide high-quality health insurance for employees while saving money.<\/p>\n<p>&nbsp;<\/p>\n<h2><strong>Current State of Employer-Sponsored Healthcare (and its Shortcomings)<\/strong><\/h2>\n<p>&nbsp;<\/p>\n<p>The current state of employer-sponsored healthcare resembles the classic cartoon <em>Ralph Wolf and Sam Sheepdog<\/em>. In the cartoon, the main characters clock in for a day of work, run around chasing each other, and leave a helpless pack of sheep paralyzed in their midst.<\/p>\n<p>&nbsp;<\/p>\n<p>In this analogy, healthcare consumers, particularly <span style=\"text-decoration: underline;\"><a href=\"https:\/\/roundstoneinsurance.com\/excelsior\/\">small to midsize employers and their employees<\/a><\/span>, are the helpless sheep. They are caught up in the run-around between healthcare providers and big-name insurance companies, unable to move and experience freedom from the rising cost of health insurance.<\/p>\n<p>&nbsp;<\/p>\n<p>The following issues and measures have done very little to move the needle on ensuring that members are able to access and afford the care they need:<\/p>\n<p>&nbsp;<\/p>\n<h3><strong>Lack of Quality Control<\/strong><\/h3>\n<p>Healthcare lacks quality control. Patients move from small, independent providers to large hospital systems, receiving differing quality of care. Most mainstream healthcare is like a giant assembly line with no quality control oversight to standardize and track care.<\/p>\n<p>&nbsp;<\/p>\n<h3><strong>Open-Priced Contracts<\/strong><\/h3>\n<p>Traditionally in healthcare, if a cost isn\u2019t provided up front, an open-priced contract is created, which is supposed to be a fair market price for the service. However, hospitals often charge exorbitant fees for services, leaving <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.debt.com\/research\/medical-debt-survey\/\">nearly 50% of Americans<\/a><\/span> with medical debt they can\u2019t pay.<\/p>\n<p>&nbsp;<\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"aligncenter wp-image-41618 size-full\" src=\"https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/10\/stethoscope-on-top-of-paper-money.jpeg\" alt=\"Self-funded-insurance-plans-deliver-considerable-savings-to-the-employer\" width=\"778\" height=\"517\" srcset=\"https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/10\/stethoscope-on-top-of-paper-money.jpeg 778w, https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/10\/stethoscope-on-top-of-paper-money-300x199.jpeg 300w, https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/10\/stethoscope-on-top-of-paper-money-768x510.jpeg 768w\" sizes=\"(max-width: 778px) 100vw, 778px\" \/><\/p>\n<p>&nbsp;<\/p>\n<h3><strong>Price Increases Across the Board<\/strong><\/h3>\n<p>Due to the COVID-19 pandemic and the resulting nursing and hospital staff shortages, hospitals and providers are increasing prices across the board. For example, Medicare\u2019s price projections through 2030 anticipate a <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.cms.gov\/newsroom\/press-releases\/cms-office-actuary-releases-2021-2030-projections-national-health-expenditures\">7.2% annual spending increase<\/a><\/span>, with private insurance spending to increase by 5.7% in the same period.<\/p>\n<p>&nbsp;<\/p>\n<p>This spending increase is contributing to insurance premium <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.healthinsurance.org\/blog\/why-your-aca-premium-might-be-going-up-for-2022\/\">increases of 3.5% or more<\/a><\/span> each year.<\/p>\n<p>&nbsp;<\/p>\n<h2><strong>Coming Changes That Affect Cost-Effective Healthcare<\/strong><\/h2>\n<p>&nbsp;<\/p>\n<p>Post-COVID-19, there have been several changes to the healthcare industry that may change the landscape for the better.<\/p>\n<p>&nbsp;<\/p>\n<p>The <span style=\"text-decoration: underline;\"><a href=\"https:\/\/roundstoneinsurance.com\/excelsior\/blog\/behavioral-and-mental-health-trends\/\">32-fold increase in telehealth<\/a><\/span> in 2021 has given patients a more accessible way to receive healthcare services. This move from inpatient to outpatient services is more convenient for patients and costs less than in-person visits for employers.<\/p>\n<p>&nbsp;<\/p>\n<p>On January 1, 2022, the <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.cms.gov\/nosurprises\/Ending-Surprise-Medical-Bills\">No Surprises Act<\/a><\/span> went into effect. This bill requires all healthcare providers to publish their prices and give patients an easy-to-understand summary of charges they must consent to before receiving out-of-network care.<\/p>\n<p>&nbsp;<\/p>\n<p>Finally, some patients see a lower cash price for services that offer an alternative to costly procedures covered by insurance. For example, those covered by insurance are sometimes charged thousands of dollars for a procedure like a colonoscopy, while the cash price may be as low as $700. Centers of excellence can also help reduce costs on routine and scheduled procedures like colonoscopies.<\/p>\n<p>&nbsp;<\/p>\n<p>New tools like the <span style=\"text-decoration: underline;\"><a href=\"https:\/\/healthcostlabs.com\/\">Health Cost Labs website<\/a><\/span> offer consumers a way to see hospital prices so they can compare and find the best option.<\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2021\/09\/Is-Your-Company-a-Good-Candidate-for-Group-Captive-Insurance-Checklist.pdf?__mscta=3146_92678_13181\"><img decoding=\"async\" class=\"aligncenter wp-image-28872 size-full\" src=\"https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/03\/20220117-Can-Captive-Insurance-Help-Your-Company-Save-Money_1800x-1.jpeg\" alt=\"20220117-Can-Captive-Insurance-Help-Your-Company-Save-Money_Building Cost-Effective Healthcare From the Bottom Up_Roundstone Insurance\" width=\"1800\" height=\"514\" srcset=\"https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/03\/20220117-Can-Captive-Insurance-Help-Your-Company-Save-Money_1800x-1.jpeg 1800w, https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/03\/20220117-Can-Captive-Insurance-Help-Your-Company-Save-Money_1800x-1-300x86.jpeg 300w, https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/03\/20220117-Can-Captive-Insurance-Help-Your-Company-Save-Money_1800x-1-1024x292.jpeg 1024w, https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/03\/20220117-Can-Captive-Insurance-Help-Your-Company-Save-Money_1800x-1-768x219.jpeg 768w, https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/03\/20220117-Can-Captive-Insurance-Help-Your-Company-Save-Money_1800x-1-1536x439.jpeg 1536w\" sizes=\"(max-width: 1800px) 100vw, 1800px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<h2><strong>Changing Employee Health Insurance From the Bottom Up Through a Self-Funded Insurance Plan<\/strong><\/h2>\n<p>&nbsp;<\/p>\n<p>Amid positive shifts in the healthcare landscape, employers must continue to push for change from the bottom up \u2014 by providing their employees with quality care that makes sense while educating them on how to get the most from their healthcare benefits.<\/p>\n<p>&nbsp;<\/p>\n<p>Here\u2019s how.<\/p>\n<p>&nbsp;<\/p>\n<h3><strong>Move to a Self-Funded Insurance Plan<\/strong><\/h3>\n<p>Joining a <span style=\"text-decoration: underline;\"><a href=\"https:\/\/roundstoneinsurance.com\/excelsior\/blog\/group-captives-offer-freedom-of-choice\/\">self-funded group captive insurance plan<\/a><\/span> instead of a fully insured plan with a mega carrier can offer you information, control, and savings.\u00a0 With a self-insured plan, you can control plan design and see a return of your unused premiums. Roundstone recently <span style=\"text-decoration: underline;\"><a href=\"https:\/\/roundstoneinsurance.com\/excelsior\/blog\/roundstone-distributes-10-5-million-of-savings-back-to-its-captive-participants\/\">distributed $10.5 million in savings<\/a><\/span> back to its captive participant clients, highlighting just one benefit of moving to self-funded health insurance.<\/p>\n<p>&nbsp;<\/p>\n<h3><strong>Partner With Trusted Advisors in a Self-Funded Insurance Plan<\/strong><\/h3>\n<p>Insurance brokers often steer companies toward an insurer because they earn a commission on the contract. Instead, partner with a trusted advisor who will help you discover solutions that are in your best interest rather than theirs.<\/p>\n<p>&nbsp;<\/p>\n<p>Roundstone advisors work with our Cost Savings Investigator (CSI) team to find solutions to your healthcare needs. They can help you tailor your self-insured plan design and find innovative cost containment strategies that will help you provide the best care possible at a reasonable price.<\/p>\n<p>&nbsp;<\/p>\n<h3><strong>Work Together With Your Employees<\/strong><\/h3>\n<p>Adopt a \u201cwe\u2019re in this together\u201d strategy with your employees by educating them about their healthcare options and how to make choices that get them the care they need at a reasonable cost for the company.<\/p>\n<p>&nbsp;<\/p>\n<p>For instance, by helping them understand the differences in cost among telehealth, urgent care, and ER services and steering them toward the low-cost option, you can lower overall costs, which ultimately lowers costs for them, too.<\/p>\n<p>&nbsp;<\/p>\n<h3><strong>Implement Cost Containment Strategies in Your Self-Funded Insurance Plan<\/strong><\/h3>\n<p>Implementing cost containment strategies to save on healthcare costs for your company. Consider starting a <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.dpcare.org\/\">Direct Primary Care<\/a><\/span> program, concierge care system, or <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5516836\/\">Centers of Excellence<\/a><\/span> strategy. These options get your employees better care upfront at a better price, lowering costs and preventing high-dollar claims in the future.<\/p>\n<p>&nbsp;<\/p>\n<h3><strong>Build Incentives Into Your Self-Funded Insurance Plan<\/strong><\/h3>\n<p>You can build incentives into your self-insured group captive plan to reduce costs. Try incentives like waiving cost-sharing responsibilities, reducing co-pays, or increasing co-pays and deductibles for higher-cost services like urgent care and ER.<\/p>\n<p>&nbsp;<\/p>\n<h3><strong>Choose Vendors Wisely<\/strong><\/h3>\n<p>Work with cost-effective vendors for auxiliary services. Explore independent imaging centers and labs for diagnostics and testing.<\/p>\n<p>&nbsp;<\/p>\n<h3><strong>Use Out-of-the-Box Services in Your Self-Funded Insurance Plan<\/strong><\/h3>\n<p>Use new healthcare services from out-of-the-box sources like Walmart and Amazon. <span style=\"text-decoration: underline;\"><a href=\"https:\/\/amazon.care\/\">Amazon Care<\/a><\/span> can help you with low-cost healthcare like vaccines and offers healthcare teams to guide patients through their experiences.<\/p>\n<p>&nbsp;<\/p>\n<p><img decoding=\"async\" class=\"aligncenter wp-image-41619 size-full\" src=\"https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/10\/two-colleagues-having-a-discussion.jpeg\" alt=\"Self-insurance-allow-employers-to-save-considerable-money-on-health-benefits\" width=\"778\" height=\"518\" srcset=\"https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/10\/two-colleagues-having-a-discussion.jpeg 778w, https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/10\/two-colleagues-having-a-discussion-300x200.jpeg 300w, https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/10\/two-colleagues-having-a-discussion-768x511.jpeg 768w\" sizes=\"(max-width: 778px) 100vw, 778px\" \/><\/p>\n<p>&nbsp;<\/p>\n<h2><strong>Get Cost-Effective Healthcare With Roundstone&#8217;s Self-Insurance<\/strong><\/h2>\n<p>&nbsp;<\/p>\n<p>Experience freedom of choice with a group captive plan from Roundstone. Our advisors and Cost Savings Investigators can work with you to design a plan that addresses your company\u2019s employee benefits needs and fits your healthcare budget.<\/p>\n<p>&nbsp;<\/p>\n<p>Contact Roundstone today to learn how you could <span style=\"text-decoration: underline;\"><a href=\"https:\/\/roundstoneinsurance.com\/excelsior\/what-your-fully-insured-insurance-carrier-doesnt-want-you-to-know\/?__mscta=3083_92678_13181\/\">save thousands on your health insurance costs<\/a><\/span> and provide better coverage for your employees through a self-funded health insurance plan.<\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/roundstoneinsurance.com\/excelsior\/what-your-fully-insured-insurance-carrier-doesnt-want-you-to-know\/?__mscta=3083_92678_13181\/\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-28836 size-full\" src=\"https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/03\/The-guide-that-could-save-you-thousands.jpeg\" alt=\"The-guide-that-could-save-you-thousands_Building Cost-Effective Healthcare From the Bottom Up_Roundstone Insurance\" width=\"1800\" height=\"942\" srcset=\"https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/03\/The-guide-that-could-save-you-thousands.jpeg 1800w, https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/03\/The-guide-that-could-save-you-thousands-300x157.jpeg 300w, https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/03\/The-guide-that-could-save-you-thousands-1024x536.jpeg 1024w, https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/03\/The-guide-that-could-save-you-thousands-768x402.jpeg 768w, https:\/\/roundstoneinsurance.com\/excelsior\/wp-content\/uploads\/2022\/03\/The-guide-that-could-save-you-thousands-1536x804.jpeg 1536w\" sizes=\"(max-width: 1800px) 100vw, 1800px\" \/><\/a><\/p>\n<p>Material for this article was drawn from the Medical Captive Forum 2022 webinar <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.youtube.com\/watch?v=Vu-7j9anSf4\">How Employers and Employees Can Beat the High Cost of Health Care Together<\/a><\/span>. Our thanks go to panelists Thomas Campanella, Marshall Allen, and Chas Rhoades.<\/p>\n","protected":false},"excerpt":{"rendered":"<p class=\"excerpt\">Highlights\u00a0\u00a0 Small to midsize companies looking for cost-effective healthcare must make changes from the bottom up. Bottom-up changes include switching to self-funded group captive insurance and incentivizing low-cost, high-quality care. With Roundstone&#8217;s self-insurance solution, you can build your self-funded plan to meet the healthcare needs of your employees and save money year over year. &nbsp; [&hellip;]<\/p>\n","protected":false},"author":27,"featured_media":41616,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1827],"tags":[],"class_list":["post-41612","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-employers"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v22.8 (Yoast SEO v25.6) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Building Cost-Effective Healthcare | Roundstone Insurance<\/title>\n<meta name=\"description\" content=\"Learn smart ways to pay less for better employee healthcare when employers and employees work together to become informed healthcare consumers.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, 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