EBMS Case Study: Value Based Health Strategy
by lhenderson2232 on Jan 18, 2010
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EBMS’ value-based benefit strategy takes a holistic approach toward employee benefits. This strategy is focused first on the patient/employee, and second on how that impacts the overall financial ...
EBMS’ value-based benefit strategy takes a holistic approach toward employee benefits. This strategy is focused first on the patient/employee, and second on how that impacts the overall financial health of your organization. The approach accomplishes the following:
1. Wraps a benefit design that supports prevention and wellness, with the ability to support the patient in the event of an unplanned or unexpected illness or injury. This is done through the wellness benefit available at first dollar, inclusion of a Health Reimbursement Account that can be carried over from year to year, reasonable out-of-pocket maximums, and generous in-network co-insurance.
2. Engages the employee through incentives, completion of an annual Health Risk Assessment (HRA), and additional funding by the employer into a Health Reimbursement Account or other qualified consumer directed account.
3. Empowers the employee through Disease Management and Wellness initiatives geared toward their personal needs, with targeted interventions from health coaches to educate and encourage compliance.
4. Provides greater access to care through an onsite-clinic. This model connects the provider with the pharmacist and care management team to close the loop between the benefit plan management and the services the patient is actually receiving.
5. Educates the members on the specific health concerns unique to your population. For example, following the completion of an HRA campaign, the group aggregate report might disclose your population to be at high risk for obesity and lung cancer. Through the addition of a smoking cessation program and wellness initiatives, your organization can see an immediate positive impact, with a reduction in your exposure to the illnesses tied to both of those behavior issues, and an increased productivity as members become more active and concerned with achieving good health.
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