New Broker's Sales PresentationPresentation Transcript
Wellness Health Solutions Market Opportunities The State of Healthcare Suite of Benefits Pricing & Commission Structure How We Support You
Wellness Health Solutions• Built a program to support brokers with a one- stop business model• Offers a suite of benefit plans to help employers control healthcare cost• Brokers are supported 24/7 and compensated above industry standards
The Market Opportunity• Healthcare costs has more than doubled the past decade• Employers are reducing benefits• Employees are being hit with first dollar exposures• Cost sharing of health premiums increasing
Milliman (MMI) Index
MMI: Cost By Source of Payment
MMI: Components of Spending
Healthcare Reform: What It Means• Government regulation and mandates• Commission reduced or eliminated altogether• Brokers forced to expand their offerings into other product lines to protect revenue• 30+ million more consumers into an already overburdened system
Healthcare Reform Issues• Shortage of physicians• Longer delays• Increased absenteeism• Decreased productivity• Ignored symptoms will result in more expensive care which will increase premiums
Employer Problems• Healthcare out-pacing inflation 2:1• Premiums increasing without any control• Claim filings increasing causing higher premiums• Employee benefits being cut• Healthcare reform limiting benefits
There is a Solution• We help control costs and premiums by focusing on the two key healthcare cost drivers: – Doctor/Urgent Care/ER visits – Prescription drugs• By utilizing Telemedicine and our Pharmacy Savings Card we can help control costs
The Game Changer: TelemedicineMembers have access to a board certified U.S. based physician 24/7/365 who can diagnose and treat non-emergency, routine medical conditions. Physicians can prescribe medication and access the service via phone, email, or bi-directional video.
The Benefits of Telemedicine• Controls claim loss• Reduces absenteeism• Increases productivity• Benefit options to employers• More benefits to employees• Controls premiums
Telemedicine Facts• Experienced in Primary Care, Internal Medicine or Emergency Room Practices• Fully Credentialed by the NCQA• 80% of doctor visits are for non-emergency conditions• 15% of emergency room visits are for non-emergency conditions Common Conditions treated: Cold/flu Sore Throat Sinus and Respiratory Fever Telemedicine can significantly reduce non-emergency visits resulting in huge savings!
Doctor Visit: Current SituationSet up appointmentMiss two days of workWait at doctor’s office with other sick Missed multiple days of workpeople Spent time in doctor’s officeSee doctor for five minutes Co-paysPrescribes medication Claim against insurancePay co-pay (claim against insurance) or$120 bill if you don’t have insurancePick up medicationMiss additional day of workReturn for follow-up visit
Telemedicine: The Alternative• Call Consult A Doctor • Miss one day of work• Medication prescribed • No exposure to sick• Pick up medication people• Miss one day of work • No cost for visit • No insurance claim to file
Consult a Doctor ROINUMBER OF EMPLOYEES 100 UTILIZATION 25% 33% 50% 75% REDUCED OFFICE VISITS 118 156 236 354MONTHLY INVESTMENT REDUCED ER VISITS 4 5 7 11 $1,000 OFFICE VISIT SAVINGS $11,789 $15,561 $23,578 $35,366 ER VISIT SAVINGS $3,645 $4,811 $7,290 $10,935 PRODUCTIVITY SAVINGS $5,013 $6,617 $10,026 $15,040ANNUAL INVESTMENT TOTAL SAVINGS $20,447 $26,990 $40,894 $61,341 $12,000 TOTAL RETURN ON INVESTMENT $8,447 $14,990 $28,894 $49,341
Consult a Doctor ROI
Pharmacy Facts• In the U.S. in 2008 spending for prescription drugs was more that doubled what was spent in 1999• Over the last decade the percentage of Americans who took at least one prescription drug in the past month increased by 10%• The use of multiple prescription drugs increase by 20% and the use of five or more drugs increased by 70%• One out of every five children used at least one or more prescription drugs compared with nine of every 10 adults aged 60 and over.• More than 30 million individuals in the US do not have access to PBM wholesale pricing• The trend in the healthcare industry shows fewer drugs being covered by insurance and more individuals required to pay a high deductibles
dataRx: Our Pharmacy Partner• Founded in 1998• Owned by independent pharmacists• Processes more than three million prescriptions a month• Available for use in all 50 states, Guam, and Puerto Rico• More than 25 million pharmacy savings cards in circulation The Pharmacy Savings Card is not Insurance.
Comparison of Rx Cards The Pharmacy Savings Card is not Insurance.
Our Pharmacy Card• Covers all prescriptions except controlled substances• Offers an interactive Price Look-up Tool• No claims to file• Only card that pass on the rebates to the consumer• Save 11-75% on prescription drug purchases, with an average saving of 53%• More than 33,000 prescriptions under $7• Accepted at more than 65,000 pharmacies The Pharmacy Savings Card is not Insurance.
Participating Pharmacies The Pharmacy Savings Card is not Insurance.
Price Look-up Tool
Price Control is Our Bottom-line• Promoting consumerism by adding look-up tools to lower prescription cost• Covering all prescriptions• No claims to file against insurance which helps control premiums• Direct rebates to consumer
Controlling Utilization• Implementing a program to control usage of benefits Call First Policy™• Interactive return-on-investment (ROI) calculators for employers• Year-end reports showing annual savings
Call First Policy™• Call First Copy.
Health Savings Promotion
Other Healthcare Benefits• Dental• Vision• Hearing• Lab and X-ray• Galaxy Network• Medical Health Advisor• EAPThese benefits are built into our Benefits Packages to help control preventive care cost.These benefits use best in class networks and promote consumerism. We have included a Provider Look-up Tool on our Website for members to easily locate a doctor in the network.
One Stop Business Solution• Sales Center• Call center with LiveChat• Live training Webinars• On-demand sales collateral printing• Mailing and fulfillment• Website and email marketing support• Back office/workflow integration