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Strategies & Opportunities to<br />Lower Your Healthcare Costs in 2012<br />Presented by Randy Gomez, FSA<br />www.nyhart....
Randy Gomez, FSA<br />Senior Healthcare Actuary<br />randy.gomez@nyhart.com| (317) 845-3595<br />Qualifications or certifi...
Agenda<br /><ul><li>Know your plan
Cost Based Strategies
Design Based Strategies</li></li></ul><li>Know Your Plan<br />
What causes higher medical costs?<br />
Best Practices for Ongoing Analytical Services<br /><ul><li>Benchmarking against norms for larger risk pools and the plan’...
Information on cost and clinical outcomes
Action steps</li></li></ul><li>Cost Based Strategies<br /><ul><li>Evaluation of network discounts
Evaluation of administrative expenses
What is your data telling you?
Raise employee contributions</li></li></ul><li>Network Discounts<br />
Administrative Expenses<br />
Prescription Drug Contracting <br />
<ul><li>What do you know about your risk pool?
What happened?
How isyour compliance with preventive screenings and medications?
Key questions</li></ul>What is your data telling you?<br />
Raise employee contributions<br /><ul><li>Benchmark against norms
Incorporate wellness incentives
Surcharges for working spouses
Incremental contributions for multiple options</li></li></ul><li>Incremental contributions for multiple options<br />
What are your experiences?<br />
Utilization Based Strategies<br /><ul><li>Plan design
Eligibility
Preventive approaches</li></li></ul><li>High Deductible Strategies<br />
Value Based Strategies<br />
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Healthcare Benefit Cost Strategies for 2012

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Healthcare Benefit Cost Strategies for 2012

  1. 1. Strategies & Opportunities to<br />Lower Your Healthcare Costs in 2012<br />Presented by Randy Gomez, FSA<br />www.nyhart.com<br />Copyright 2011. All Rights Reserved.<br />
  2. 2. Randy Gomez, FSA<br />Senior Healthcare Actuary<br />randy.gomez@nyhart.com| (317) 845-3595<br />Qualifications or certifications:Enrolled Actuary; Society of Actuaries Fellow; Member of the American Academy of Actuaries.<br /> <br /> <br />
  3. 3. Agenda<br /><ul><li>Know your plan
  4. 4. Cost Based Strategies
  5. 5. Design Based Strategies</li></li></ul><li>Know Your Plan<br />
  6. 6. What causes higher medical costs?<br />
  7. 7. Best Practices for Ongoing Analytical Services<br /><ul><li>Benchmarking against norms for larger risk pools and the plan’s own history
  8. 8. Information on cost and clinical outcomes
  9. 9. Action steps</li></li></ul><li>Cost Based Strategies<br /><ul><li>Evaluation of network discounts
  10. 10. Evaluation of administrative expenses
  11. 11. What is your data telling you?
  12. 12. Raise employee contributions</li></li></ul><li>Network Discounts<br />
  13. 13. Administrative Expenses<br />
  14. 14. Prescription Drug Contracting <br />
  15. 15. <ul><li>What do you know about your risk pool?
  16. 16. What happened?
  17. 17. How isyour compliance with preventive screenings and medications?
  18. 18. Key questions</li></ul>What is your data telling you?<br />
  19. 19. Raise employee contributions<br /><ul><li>Benchmark against norms
  20. 20. Incorporate wellness incentives
  21. 21. Surcharges for working spouses
  22. 22. Incremental contributions for multiple options</li></li></ul><li>Incremental contributions for multiple options<br />
  23. 23. What are your experiences?<br />
  24. 24. Utilization Based Strategies<br /><ul><li>Plan design
  25. 25. Eligibility
  26. 26. Preventive approaches</li></li></ul><li>High Deductible Strategies<br />
  27. 27. Value Based Strategies<br />
  28. 28. Targeted Limitations<br />
  29. 29. Eligibility Strategies<br />“If your spouse has coverage at their job, they are not eligible for our plan.”<br />“Are your dependents really eligible?”<br />
  30. 30. Preventive Approaches<br />
  31. 31. Onsite Clinics<br />
  32. 32. What are your experiences?<br />
  33. 33. ANY QUESTIONS?<br />This concludes our discussion<br />
  34. 34. Randy Gomez, FSA<br />Senior Healthcare Actuary<br />randy.gomez@nyhart.com| (317) 845-3595<br />Qualifications or certifications:Enrolled Actuary; Society of Actuaries Fellow; Member of the American Academy of Actuaries.<br /> <br /> <br />
  35. 35. So Where is the Peak?<br />Sign up for <br />more webinars<br />Register for upcoming educational events on pensions, 401(k), healthcare and other actuarial and employee benefits topics at:<br />www.nyhart.com/events/<br />
  36. 36. ACTUARY &EMPLOYEE BENEFITS<br />Established in 1943, Nyhart is an ESOP with 84 employees and offices in Indianapolis, Chicago, Atlanta and Kansas City. <br />Areas of Expertise Include:<br /><ul><li> Cash Balance Plan
  37. 37. Defined Benefit & Pension
  38. 38. Defined Contribution & 401(k)
  39. 39. Employee Stock Ownership Plan
  40. 40. Flexible Spending, HRA & HSA
  41. 41. Healthcare Actuarial Consulting</li></ul>Learn more at www.nyhart.com<br />
  42. 42. ACTUARY &EMPLOYEE BENEFITS<br />16 Actuaries Consulting In 48 States.<br />Nyhart is one of the nation’s largest independent actuarial and employee benefit firms, consulting to and administering the plans for clients with more than $14 billion in assets. Our team of benefit advisers deliver personalized analysis and recommendations, translating complex calculations and issues into common language that enables corporations, associations, churches and governments to effectively manage their retirement and health care benefits.<br />

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