Reduce Your Health Insurance Costs


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  • WebMD disclaims - WebMD does not provide medical advice, diagnosis or treatment. SOOO once a consumer accesses health information based on symptoms using their symptom checker they are left to Dr. Google to self – diagnose. Alternatively, with CADR, member can actually TALK to a doctor about their symptoms 24/7 with 1-click.
  • Reduce Your Health Insurance Costs

    1. 1.  Over UtilizationAverage Cost of a PCP Visit is $153Average Cost of a Urgent Care Center Visit is $350Average Cost of a Emergency Room Visit is $1029Doctors are Paid for Service.As we get older we tend to need more healthcare.Employees don’t understand the cost of service.Doctors practice “Defensive Medicine”.Most doctors’ offices closed over 75% of hours/week.Avg. time to make an appointment, 3 weeks.Avg. time spent in waiting room, 23 minutes.Over 66% of ER visits are for non emergent reasons.
    2. 2.  Cost Prohibitive 25% of people have skipped a recommended medical test due to cost. 24% of people do not fill prescriptions. 16% cut pills in half or skip doses. Untreated Stress 75 - 90% of visits originate from stress factors. 25 million Americans will have an episode of depression. Employees do not know where to turn when they are stressed. No/Limited resources available. Uneducated about resources that are available. Employees do not seek treatment for stress or depression. There is a stigma to receiving help to improve mental health.
    3. 3.  Increase in claims. Skyrocketing insurance premiums. Insured employees do not behave like consumers. Individuals visit Immediate Care Clinics & E.R.s insteadof their PCP. Individuals who wait to receive treatment seek carewhen their illnesses becomes more severe. Employees are distracted and less productive at work. Employees miss more work. Employees incur more costs
    4. 4. A Consumer DrivenHealth Insurance Plan with an Effective“First Alternative”A First Alternative is a low cost, high impact resourceemployees & their families can access before seeking a moreexpensive healthcare solution.
    5. 5. Telemedicine means using information andcommunications technologies for the delivery ofhealthcare Telemedicine
    6. 6. By 2015 Industry experts realistically foresee100 million individuals/yearaccessing virtual care services like telemedicine.This level of growth mirrors the development of thepopular MinuteClinic model, which had less than100,000 visits in 2006and in late 2011 grew to more than10 million visits/year
    7. 7. 100+ Carriers across 26 statesreimburse for telemedicine:States with legislative mandates:California ColoradoGeorgia HawaiiKentucky LouisianaMaine New HampshireOklahoma OregonTexas VirginiaMaryland VermontMichigan And Growing…PREDICTION- ALL MAJOR PLANS 50 STATES – 36 MONTHSWidely reimbursable and becoming fullyintegrated into the delivery systems andbenefit offerings of major health plans andself-funded groups.
    8. 8. Resource for LivingTelemedicine
    9. 9. Multiple Ways to ConsultTechnology and service platform whichallows patients to consult with physiciansvia Telephone, Mobile APP, Video, On-line,Email & Text, on an immediate basis,24/7/365 AND receive a refill or prescriptionfor their illness…ready when they are!Give them a call and you will be connected within 90 seconds!
    10. 10. National TelemedicinePhysician Network Enterprise Platform PLUS CADR’s NationalNetwork of Primary Care Physicians 50 State PCP Provider Network U.S.-based, Board Certified/Eligible Credentialed to NCQA Standards 170 Languages Supported On-Demand (24/7) Via Secure Phone,Web (Video/Email) or Mobile App Additional Specialties Now Online: Pediatrics, Cardiology, OB/GYN Mental Health, Endocrinology
    11. 11. Patients triaged to alternativelevel of care when necessary. Cold/Flu Sinus infections Upper RespiratoryInfections Allergies Headaches Urinary TractInfections (UTI) Zithromax Z-Pak Amoxicillin Albuterol Augmentin Tessalon Perles Azithromycin Keflex Bactrim Macrobid Pyridium Biaxin Allegra Bactrim Ibuprofen 800 Nasonex Lipitor* NO DEA CONTROLLED SUBSTANCESLess prescribing than officesettings Doctor less pressured More convenient More accessible Less effort/ aggravation for patient~40% Cipro Lisinopril Tamiflu Prednisone Metformin Flonase Diflucan HCTZ LevaquinTop 25 diagnosisTop 50 diagnosis Bronchitis Stomach Ache/Diarrhea Eye infections Ear Infections Rash/Skin Irritation Yeast Infection Other GYNE complaintsConditions treated with Telemedicine73%Common Medications PrescribedCommon Conditions82%
    12. 12. Symptom CheckerInteractive questionnaires designed tonarrow down condition or illnessHealth Risk AssessmentInteractive health tools identify healthrisks and promote wellness.Wellness Tool & Lab OrderingPromote prevention with discountwellness tests for at risk population.ePrescribing to Choice PharmacySafer and faster way to get RXmedication when necessary.Interactive Health ToolsPrograms to help stop smoking, learnabout diet, nutrition & moreHealth LibraryThe latest articles sorted by topics,most popular or key words
    13. 13.  Mobile Phone: First Aid Medications Medical Tests / Labs Wellness Chronic Condition Management Challenges Rewards Support Groups
    14. 14. Features / BenefitsElectronic prescribing Less errors SureScripts RX history Med2Medinteraction Decision support Evidence basedPharmacy of choice By home, work,hotel, school Less wait Formularies InsuranceDocumented in EMRReported to PCP/PlanePrescriptions
    15. 15. Follow Up/Referral Post Consult Benefits Follow up careinstructions Telemedicineconsultations In-person referrals Patient education Scheduledmessages/reminders Diagnostic labs Health tracking tools Health risk assessments Coding CPT ICD-9
    16. 16. Presented byWaveFront Brokerage Services• Low-PEPM of $2 - $5 (Physicianconsult = $38/consult; Wellnessconsult = $27/consult)• 2 - 12% utilization ratenationally (lowest in nation)• Avg. Physician response time:up to 3 hrs.• Consultations available bytelephone only after goingonline prior.• No recording of consultations• SureScripts Access – No.• Secure Email Consultations –No.• Very modest physiciannetwork (reason physicianresponse time slowest)• Employee + Family $30/month(Unlimited usage; no fees)• 18 % utilization rate• Average Physician responsetime: 24 minutes• Consultations available bytelephone, internet and video.• Record consultations and postto personal health record.• SureScripts Access – No.• Secure Email Consultations –No.• 2,000 GP Physician network (notenough physicians to handle currentrate of enrollments)• Employee + Family $10/month(Unlimited usage; no fees)• 26+% utilization rate• Avg. Physician response time:90 seconds.• Consultations available bytelephone, internet, video,smart phone app, secure email,chat, and text msg.• Record consultations and postto personal health record.• SureScripts Access – Yes.• SecureEmail Consultations –Yes.• Nation’s largest physiciannetwork; includes specialists(ONLY Physician Network equipped tohandle current rate of enrollments).
    17. 17. Resources for LivingAetna Resources For Living provides the resources youneed to help you handle life’s challenges, whether thatbe emotional, financial or legal. They’re your partner inachieving resiliency.
    18. 18. THE STRESS EFFECT Over 1/2 of Americans self-report that they are “struggling” withlife today and 1/3 state their average stress level as “extreme”. 75 – 90% of doctor visit are considered to be stress-related. Stress is linked to all of the leading causes of death includingheart disease, cancer, accidents and suicide. The World Health Organization estimates that the equivalent of7.1 productive days are lost per employee each year due tostress-related factors. 25 million Americans will have an episode of major depressionthis year alone.
    19. 19. WHAT IS AETNA RESOURCES FOR LIVING? A no cost, confidential telephone consultation and referral service foremployees and their household members. 24/7 online access to targetedresources. Members can speak with a counselor any time — 365 days per year — fromthe comfort and privacy of home or anywhere else they choose. Members engage instantly with a clinician — with no limit on the time it takesto help resolve their issues. Legal/Financial , ID Theft, Crisis counseling Patient Advocacy Personalized assistance with child care, elder care, pet care and everydayneeds Coaching or counseling to help members achieve worklife balance Access to the online Discount Center, your one stop resource for every daysavings on electronics, travel, movie tickets and more.
    20. 20. Resources For LivingHow it Works: Give it a TRY!Phone Number1-877-856-1788Websitewww.mylifevalues.comLogin: CADRPdemoPassword: demo
    21. 21. The lowest cost, highest impact soluction to many ofthe issues plaguing the healthcare system today.Simply put…The lowest cost, highest impact solution to many ofthe issues plaguing all Employers, Employees and thehealthcare system.
    22. 22. Benefits ofReduces health insurance claims.Reduces premium costs and premium increases.Reduces costs for employers & employees.Reduces the need for employees to take off work.Reduces distractions at work.Increases productivity.Turnkey Implementation.
    23. 23. Families &IndividualsUnlimited, 24/7 AccessIndividual EnrollmentCredit Card or Bank PaymentUp to 6 Family Members$19.95/monthGroupVoluntaryUnlimited, 24/7 AccessMultiple GroupsOpt-In Enrollment/Payroll DeductUp to 6 Family Members$14.95/monthGroupSponsoredUnlimited, 24/7 AccessMultiple GroupsWhole Group EnrollmentUp to 6 Family Members$10/monthNO Underwriting, ALL Qualify – Pre-existingConditions IncludedPick Your Plan
    24. 24. You’re in Good Company
    25. 25. The lowest cost, highest impact soluction to many ofthe issues plaguing the healthcare system today.Partner: Pepsi Bottling VenturesCovers 26 locations in 7 States•- ROI: 413% based on actual usage•- 99% satisfaction rate•- 16 minute average response time•- 80% of people who used the platform would• have gone to a higher cost setting•- 48% would have taken time off work, but didn’tCase Study…
    26. 26. Presented byWaveFront Brokerage ServicesThank you for viewing this presentation!Presented by:Mike