SlideShare a Scribd company logo
Strategies & Opportunities to Lower Your Healthcare Costs in 2012 Presented by Randy Gomez, FSA www.nyhart.com Copyright 2011. All Rights Reserved.
Randy Gomez, FSA Senior Healthcare Actuary randy.gomez@nyhart.com| (317) 845-3595 Qualifications or certifications:Enrolled Actuary; Society of Actuaries Fellow; Member of the American Academy of Actuaries.    
Agenda ,[object Object]
Cost Based Strategies
Design Based Strategies,[object Object]
What causes higher medical costs?
Best Practices for Ongoing Analytical Services ,[object Object]
Information on cost and clinical outcomes
Action steps,[object Object]
Evaluation of administrative expenses
What is your data telling you?
Raise employee contributions,[object Object]
Administrative Expenses
Prescription Drug Contracting
[object Object]
What happened?
How isyour compliance with preventive screenings and medications?
Key questionsWhat is your data telling you?
Raise employee contributions ,[object Object]
Incorporate wellness incentives
Surcharges for working spouses
Incremental contributions for multiple options,[object Object]
What are your experiences?
Utilization Based Strategies ,[object Object]
Eligibility
Preventive approaches,[object Object]
Value Based Strategies

More Related Content

What's hot

Prolifics Cognitive Subrogation Solution
Prolifics Cognitive Subrogation SolutionProlifics Cognitive Subrogation Solution
Prolifics Cognitive Subrogation Solution
Shobhit Bagga (1000+)
 
Introducing catalyst.ai and MACRA Measures & Insights
Introducing catalyst.ai and MACRA Measures & InsightsIntroducing catalyst.ai and MACRA Measures & Insights
Introducing catalyst.ai and MACRA Measures & Insights
Health Catalyst
 
Predictive Health Population Analytics
Predictive Health Population AnalyticsPredictive Health Population Analytics
Predictive Health Population Analytics
Apollo Hospitals Group and ATNF
 
6 Essential Data Analyst Skills for Your Healthcare Organization
6 Essential Data Analyst Skills for Your Healthcare Organization6 Essential Data Analyst Skills for Your Healthcare Organization
6 Essential Data Analyst Skills for Your Healthcare Organization
Health Catalyst
 
Central Region DHBs CIO Report
Central Region DHBs CIO ReportCentral Region DHBs CIO Report
Central Region DHBs CIO Report
Health Informatics New Zealand
 
Post-Election: What are the Impacts? Ellen Feeney, Vice President, Legal Cou...
Post-Election: What are the Impacts?  Ellen Feeney, Vice President, Legal Cou...Post-Election: What are the Impacts?  Ellen Feeney, Vice President, Legal Cou...
Post-Election: What are the Impacts? Ellen Feeney, Vice President, Legal Cou...
ADP, LLC
 
New Ways for Predictive Analytics and Machine Learning to Advance Population ...
New Ways for Predictive Analytics and Machine Learning to Advance Population ...New Ways for Predictive Analytics and Machine Learning to Advance Population ...
New Ways for Predictive Analytics and Machine Learning to Advance Population ...
Edifecs Inc
 
Locum Medical Presentation 2009
Locum Medical Presentation 2009Locum Medical Presentation 2009
Locum Medical Presentation 2009
TSchildh
 
The Role of Data Lakes in Healthcare
The Role of Data Lakes in HealthcareThe Role of Data Lakes in Healthcare
The Role of Data Lakes in Healthcare
Perficient, Inc.
 
Healthcare Analytics Adoption Model
Healthcare Analytics Adoption ModelHealthcare Analytics Adoption Model
Healthcare Analytics Adoption Model
Health Catalyst
 
3 Perspectives to Better Apply Predictive & Prescriptive Models in Healthcare
3 Perspectives to Better Apply Predictive & Prescriptive Models in Healthcare3 Perspectives to Better Apply Predictive & Prescriptive Models in Healthcare
3 Perspectives to Better Apply Predictive & Prescriptive Models in Healthcare
Health Catalyst
 
Optimum-Data-Analytics
Optimum-Data-AnalyticsOptimum-Data-Analytics
Optimum-Data-Analytics
Irfan Chaudhry
 
Greenway Health Amicus Case Study
Greenway Health Amicus Case StudyGreenway Health Amicus Case Study
Greenway Health Amicus Case Study
Ideba
 
Healthcare Integration | Opening the Doors to Communication
Healthcare Integration | Opening the Doors to CommunicationHealthcare Integration | Opening the Doors to Communication
Healthcare Integration | Opening the Doors to Communication
BizTalk360
 
Choosing an Analytics Solution in Healthcare
Choosing an Analytics Solution in HealthcareChoosing an Analytics Solution in Healthcare
Choosing an Analytics Solution in Healthcare
Dale Sanders
 
Current Status of Healthcare Analytics
Current Status of Healthcare AnalyticsCurrent Status of Healthcare Analytics
Current Status of Healthcare Analytics
James Young
 
Demystifying Healthcare Data Governance
Demystifying Healthcare Data GovernanceDemystifying Healthcare Data Governance
Demystifying Healthcare Data Governance
Health Catalyst
 
The Healthcare Revenue Cycle: How to Optimize Performance
The Healthcare Revenue Cycle: How to Optimize PerformanceThe Healthcare Revenue Cycle: How to Optimize Performance
The Healthcare Revenue Cycle: How to Optimize Performance
Health Catalyst
 
Managing Participants Beyond Termination of Employment - Robert Malczyk
Managing Participants Beyond Termination of Employment - Robert MalczykManaging Participants Beyond Termination of Employment - Robert Malczyk
Managing Participants Beyond Termination of Employment - Robert Malczyk
BPAS
 
What the ONC's Proposed Rule on Information Blocking Means for Your Work
What the ONC's Proposed Rule on Information Blocking Means for Your WorkWhat the ONC's Proposed Rule on Information Blocking Means for Your Work
What the ONC's Proposed Rule on Information Blocking Means for Your Work
Health Catalyst
 

What's hot (20)

Prolifics Cognitive Subrogation Solution
Prolifics Cognitive Subrogation SolutionProlifics Cognitive Subrogation Solution
Prolifics Cognitive Subrogation Solution
 
Introducing catalyst.ai and MACRA Measures & Insights
Introducing catalyst.ai and MACRA Measures & InsightsIntroducing catalyst.ai and MACRA Measures & Insights
Introducing catalyst.ai and MACRA Measures & Insights
 
Predictive Health Population Analytics
Predictive Health Population AnalyticsPredictive Health Population Analytics
Predictive Health Population Analytics
 
6 Essential Data Analyst Skills for Your Healthcare Organization
6 Essential Data Analyst Skills for Your Healthcare Organization6 Essential Data Analyst Skills for Your Healthcare Organization
6 Essential Data Analyst Skills for Your Healthcare Organization
 
Central Region DHBs CIO Report
Central Region DHBs CIO ReportCentral Region DHBs CIO Report
Central Region DHBs CIO Report
 
Post-Election: What are the Impacts? Ellen Feeney, Vice President, Legal Cou...
Post-Election: What are the Impacts?  Ellen Feeney, Vice President, Legal Cou...Post-Election: What are the Impacts?  Ellen Feeney, Vice President, Legal Cou...
Post-Election: What are the Impacts? Ellen Feeney, Vice President, Legal Cou...
 
New Ways for Predictive Analytics and Machine Learning to Advance Population ...
New Ways for Predictive Analytics and Machine Learning to Advance Population ...New Ways for Predictive Analytics and Machine Learning to Advance Population ...
New Ways for Predictive Analytics and Machine Learning to Advance Population ...
 
Locum Medical Presentation 2009
Locum Medical Presentation 2009Locum Medical Presentation 2009
Locum Medical Presentation 2009
 
The Role of Data Lakes in Healthcare
The Role of Data Lakes in HealthcareThe Role of Data Lakes in Healthcare
The Role of Data Lakes in Healthcare
 
Healthcare Analytics Adoption Model
Healthcare Analytics Adoption ModelHealthcare Analytics Adoption Model
Healthcare Analytics Adoption Model
 
3 Perspectives to Better Apply Predictive & Prescriptive Models in Healthcare
3 Perspectives to Better Apply Predictive & Prescriptive Models in Healthcare3 Perspectives to Better Apply Predictive & Prescriptive Models in Healthcare
3 Perspectives to Better Apply Predictive & Prescriptive Models in Healthcare
 
Optimum-Data-Analytics
Optimum-Data-AnalyticsOptimum-Data-Analytics
Optimum-Data-Analytics
 
Greenway Health Amicus Case Study
Greenway Health Amicus Case StudyGreenway Health Amicus Case Study
Greenway Health Amicus Case Study
 
Healthcare Integration | Opening the Doors to Communication
Healthcare Integration | Opening the Doors to CommunicationHealthcare Integration | Opening the Doors to Communication
Healthcare Integration | Opening the Doors to Communication
 
Choosing an Analytics Solution in Healthcare
Choosing an Analytics Solution in HealthcareChoosing an Analytics Solution in Healthcare
Choosing an Analytics Solution in Healthcare
 
Current Status of Healthcare Analytics
Current Status of Healthcare AnalyticsCurrent Status of Healthcare Analytics
Current Status of Healthcare Analytics
 
Demystifying Healthcare Data Governance
Demystifying Healthcare Data GovernanceDemystifying Healthcare Data Governance
Demystifying Healthcare Data Governance
 
The Healthcare Revenue Cycle: How to Optimize Performance
The Healthcare Revenue Cycle: How to Optimize PerformanceThe Healthcare Revenue Cycle: How to Optimize Performance
The Healthcare Revenue Cycle: How to Optimize Performance
 
Managing Participants Beyond Termination of Employment - Robert Malczyk
Managing Participants Beyond Termination of Employment - Robert MalczykManaging Participants Beyond Termination of Employment - Robert Malczyk
Managing Participants Beyond Termination of Employment - Robert Malczyk
 
What the ONC's Proposed Rule on Information Blocking Means for Your Work
What the ONC's Proposed Rule on Information Blocking Means for Your WorkWhat the ONC's Proposed Rule on Information Blocking Means for Your Work
What the ONC's Proposed Rule on Information Blocking Means for Your Work
 

Similar to Healthcare Benefit Cost Strategies for 2012

Comparing Healthcare Benefits in Indiana
Comparing Healthcare Benefits in IndianaComparing Healthcare Benefits in Indiana
Comparing Healthcare Benefits in Indiana
Nyhart Actuary & Employee Benefit Consultancy
 
Ibs Power Point Group Benefit Presentation 2010
Ibs Power Point Group Benefit Presentation 2010Ibs Power Point Group Benefit Presentation 2010
Ibs Power Point Group Benefit Presentation 2010
jwalker56
 
IBS Power Point Group Benefit Presentation 2010
IBS Power Point Group Benefit Presentation 2010IBS Power Point Group Benefit Presentation 2010
IBS Power Point Group Benefit Presentation 2010
jwalker56
 
Bbi statement of qualifications
Bbi statement of qualificationsBbi statement of qualifications
Bbi statement of qualifications
Ron Bechtol
 
Employer toolkit: Eight Steps to Building a Successful Wellness Program
Employer toolkit: Eight Steps to Building a Successful Wellness ProgramEmployer toolkit: Eight Steps to Building a Successful Wellness Program
Employer toolkit: Eight Steps to Building a Successful Wellness Program
Nicole Edwards
 
About QuestOps - 2000 to 2006
About QuestOps - 2000 to 2006About QuestOps - 2000 to 2006
About QuestOps - 2000 to 2006
hsbezanson
 
AonHealthSolutionsforPE Firms
AonHealthSolutionsforPE FirmsAonHealthSolutionsforPE Firms
AonHealthSolutionsforPE Firms
Robb DeGraw
 
1015 hess and sasso
1015 hess and sasso1015 hess and sasso
1015 hess and sasso
hfmadixie
 
CMS Bidding From Process to Strategy-August 24-25 2015-Paradise Point Resort ...
CMS Bidding From Process to Strategy-August 24-25 2015-Paradise Point Resort ...CMS Bidding From Process to Strategy-August 24-25 2015-Paradise Point Resort ...
CMS Bidding From Process to Strategy-August 24-25 2015-Paradise Point Resort ...
Kyle Raeder
 
Our Services
Our ServicesOur Services
Our Services
PATHS LLC
 
Tidewater Story Sept2010 Rev
Tidewater Story Sept2010 RevTidewater Story Sept2010 Rev
Tidewater Story Sept2010 Rev
Sean Ballance
 
Compliance
ComplianceCompliance
Compliance
Lexi DeBrock
 
Regis_Resume
Regis_ResumeRegis_Resume
Regis_Resume
Michael Regis
 
Tiffany L Beaver Resume 4.11.12
Tiffany L Beaver Resume 4.11.12Tiffany L Beaver Resume 4.11.12
Tiffany L Beaver Resume 4.11.12
oceanomadr
 
2468 process innovation & enterprise architecture -(foundation for operation...
2468  process innovation & enterprise architecture -(foundation for operation...2468  process innovation & enterprise architecture -(foundation for operation...
2468 process innovation & enterprise architecture -(foundation for operation...
Ravi Sarkar
 
CSOHIMSS - OSU HIMS Students 20100920
CSOHIMSS - OSU HIMS Students 20100920CSOHIMSS - OSU HIMS Students 20100920
CSOHIMSS - OSU HIMS Students 20100920
Richard Moore
 
CATS Presentation
CATS PresentationCATS Presentation
CATS Presentation
RedChip Companies, Inc.
 
Catasys Presentation
Catasys Presentation Catasys Presentation
Catasys Presentation
RedChip Companies, Inc.
 
Marketplace Plans What to Expect in 2017 and Beyond
Marketplace Plans What to Expect in 2017 and BeyondMarketplace Plans What to Expect in 2017 and Beyond
Marketplace Plans What to Expect in 2017 and Beyond
Enroll America
 
Presentation Health Span Pro Forma
Presentation Health Span Pro FormaPresentation Health Span Pro Forma
Presentation Health Span Pro Forma
HealthSpan
 

Similar to Healthcare Benefit Cost Strategies for 2012 (20)

Comparing Healthcare Benefits in Indiana
Comparing Healthcare Benefits in IndianaComparing Healthcare Benefits in Indiana
Comparing Healthcare Benefits in Indiana
 
Ibs Power Point Group Benefit Presentation 2010
Ibs Power Point Group Benefit Presentation 2010Ibs Power Point Group Benefit Presentation 2010
Ibs Power Point Group Benefit Presentation 2010
 
IBS Power Point Group Benefit Presentation 2010
IBS Power Point Group Benefit Presentation 2010IBS Power Point Group Benefit Presentation 2010
IBS Power Point Group Benefit Presentation 2010
 
Bbi statement of qualifications
Bbi statement of qualificationsBbi statement of qualifications
Bbi statement of qualifications
 
Employer toolkit: Eight Steps to Building a Successful Wellness Program
Employer toolkit: Eight Steps to Building a Successful Wellness ProgramEmployer toolkit: Eight Steps to Building a Successful Wellness Program
Employer toolkit: Eight Steps to Building a Successful Wellness Program
 
About QuestOps - 2000 to 2006
About QuestOps - 2000 to 2006About QuestOps - 2000 to 2006
About QuestOps - 2000 to 2006
 
AonHealthSolutionsforPE Firms
AonHealthSolutionsforPE FirmsAonHealthSolutionsforPE Firms
AonHealthSolutionsforPE Firms
 
1015 hess and sasso
1015 hess and sasso1015 hess and sasso
1015 hess and sasso
 
CMS Bidding From Process to Strategy-August 24-25 2015-Paradise Point Resort ...
CMS Bidding From Process to Strategy-August 24-25 2015-Paradise Point Resort ...CMS Bidding From Process to Strategy-August 24-25 2015-Paradise Point Resort ...
CMS Bidding From Process to Strategy-August 24-25 2015-Paradise Point Resort ...
 
Our Services
Our ServicesOur Services
Our Services
 
Tidewater Story Sept2010 Rev
Tidewater Story Sept2010 RevTidewater Story Sept2010 Rev
Tidewater Story Sept2010 Rev
 
Compliance
ComplianceCompliance
Compliance
 
Regis_Resume
Regis_ResumeRegis_Resume
Regis_Resume
 
Tiffany L Beaver Resume 4.11.12
Tiffany L Beaver Resume 4.11.12Tiffany L Beaver Resume 4.11.12
Tiffany L Beaver Resume 4.11.12
 
2468 process innovation & enterprise architecture -(foundation for operation...
2468  process innovation & enterprise architecture -(foundation for operation...2468  process innovation & enterprise architecture -(foundation for operation...
2468 process innovation & enterprise architecture -(foundation for operation...
 
CSOHIMSS - OSU HIMS Students 20100920
CSOHIMSS - OSU HIMS Students 20100920CSOHIMSS - OSU HIMS Students 20100920
CSOHIMSS - OSU HIMS Students 20100920
 
CATS Presentation
CATS PresentationCATS Presentation
CATS Presentation
 
Catasys Presentation
Catasys Presentation Catasys Presentation
Catasys Presentation
 
Marketplace Plans What to Expect in 2017 and Beyond
Marketplace Plans What to Expect in 2017 and BeyondMarketplace Plans What to Expect in 2017 and Beyond
Marketplace Plans What to Expect in 2017 and Beyond
 
Presentation Health Span Pro Forma
Presentation Health Span Pro FormaPresentation Health Span Pro Forma
Presentation Health Span Pro Forma
 

More from Nyhart Actuary & Employee Benefit Consultancy

The Hidden Costs to Participants of High-Fee Funds In Your Portfolio
The Hidden Costs to Participants of High-Fee Funds In Your PortfolioThe Hidden Costs to Participants of High-Fee Funds In Your Portfolio
The Hidden Costs to Participants of High-Fee Funds In Your Portfolio
Nyhart Actuary & Employee Benefit Consultancy
 
Liability Driven Investing to Achieve Better Pension Returns
Liability Driven Investing to Achieve Better Pension ReturnsLiability Driven Investing to Achieve Better Pension Returns
Liability Driven Investing to Achieve Better Pension Returns
Nyhart Actuary & Employee Benefit Consultancy
 
10 Questions to ask your 401(k) or 403(b) Vendor To Get Fee Transparency
10 Questions to ask your 401(k) or 403(b) Vendor To Get Fee Transparency10 Questions to ask your 401(k) or 403(b) Vendor To Get Fee Transparency
10 Questions to ask your 401(k) or 403(b) Vendor To Get Fee Transparency
Nyhart Actuary & Employee Benefit Consultancy
 
A Financial Advisors Guide to Cash Balance Retirement Plans
A Financial Advisors Guide to Cash Balance Retirement PlansA Financial Advisors Guide to Cash Balance Retirement Plans
A Financial Advisors Guide to Cash Balance Retirement Plans
Nyhart Actuary & Employee Benefit Consultancy
 
The Impact of IRS Regulation 408(b)(2) & Your 401(k)
The Impact of IRS Regulation 408(b)(2) & Your 401(k)The Impact of IRS Regulation 408(b)(2) & Your 401(k)
The Impact of IRS Regulation 408(b)(2) & Your 401(k)
Nyhart Actuary & Employee Benefit Consultancy
 
Managing a Frozen Pension Plan
Managing a Frozen Pension PlanManaging a Frozen Pension Plan
Managing a Frozen Pension Plan
Nyhart Actuary & Employee Benefit Consultancy
 
High Pension Costs: When and Where is the Peak
High Pension Costs: When and Where is the PeakHigh Pension Costs: When and Where is the Peak
High Pension Costs: When and Where is the Peak
Nyhart Actuary & Employee Benefit Consultancy
 

More from Nyhart Actuary & Employee Benefit Consultancy (7)

The Hidden Costs to Participants of High-Fee Funds In Your Portfolio
The Hidden Costs to Participants of High-Fee Funds In Your PortfolioThe Hidden Costs to Participants of High-Fee Funds In Your Portfolio
The Hidden Costs to Participants of High-Fee Funds In Your Portfolio
 
Liability Driven Investing to Achieve Better Pension Returns
Liability Driven Investing to Achieve Better Pension ReturnsLiability Driven Investing to Achieve Better Pension Returns
Liability Driven Investing to Achieve Better Pension Returns
 
10 Questions to ask your 401(k) or 403(b) Vendor To Get Fee Transparency
10 Questions to ask your 401(k) or 403(b) Vendor To Get Fee Transparency10 Questions to ask your 401(k) or 403(b) Vendor To Get Fee Transparency
10 Questions to ask your 401(k) or 403(b) Vendor To Get Fee Transparency
 
A Financial Advisors Guide to Cash Balance Retirement Plans
A Financial Advisors Guide to Cash Balance Retirement PlansA Financial Advisors Guide to Cash Balance Retirement Plans
A Financial Advisors Guide to Cash Balance Retirement Plans
 
The Impact of IRS Regulation 408(b)(2) & Your 401(k)
The Impact of IRS Regulation 408(b)(2) & Your 401(k)The Impact of IRS Regulation 408(b)(2) & Your 401(k)
The Impact of IRS Regulation 408(b)(2) & Your 401(k)
 
Managing a Frozen Pension Plan
Managing a Frozen Pension PlanManaging a Frozen Pension Plan
Managing a Frozen Pension Plan
 
High Pension Costs: When and Where is the Peak
High Pension Costs: When and Where is the PeakHigh Pension Costs: When and Where is the Peak
High Pension Costs: When and Where is the Peak
 

Recently uploaded

TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
Donc Test
 
Histololgy of Female Reproductive System.pptx
Histololgy of Female Reproductive System.pptxHistololgy of Female Reproductive System.pptx
Histololgy of Female Reproductive System.pptx
AyeshaZaid1
 
share - Lions, tigers, AI and health misinformation, oh my!.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptxshare - Lions, tigers, AI and health misinformation, oh my!.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptx
Tina Purnat
 
LOOPS in orthodontics t loop bull loop vertical loop mushroom loop stop loop
LOOPS in orthodontics t loop bull loop vertical loop mushroom loop stop loopLOOPS in orthodontics t loop bull loop vertical loop mushroom loop stop loop
LOOPS in orthodontics t loop bull loop vertical loop mushroom loop stop loop
debosmitaasanyal1
 
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.GawadHemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
NephroTube - Dr.Gawad
 
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptxREGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
LaniyaNasrink
 
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Oleg Kshivets
 
Part II - Body Grief: Losing parts of ourselves and our identity before, duri...
Part II - Body Grief: Losing parts of ourselves and our identity before, duri...Part II - Body Grief: Losing parts of ourselves and our identity before, duri...
Part II - Body Grief: Losing parts of ourselves and our identity before, duri...
bkling
 
Aortic Association CBL Pilot April 19 – 20 Bern
Aortic Association CBL Pilot April 19 – 20 BernAortic Association CBL Pilot April 19 – 20 Bern
Aortic Association CBL Pilot April 19 – 20 Bern
suvadeepdas911
 
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPromoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
PsychoTech Services
 
CHEMOTHERAPY_RDP_CHAPTER 4_ANTI VIRAL DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 4_ANTI VIRAL DRUGS.pdfCHEMOTHERAPY_RDP_CHAPTER 4_ANTI VIRAL DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 4_ANTI VIRAL DRUGS.pdf
rishi2789
 
Cell Therapy Expansion and Challenges in Autoimmune Disease
Cell Therapy Expansion and Challenges in Autoimmune DiseaseCell Therapy Expansion and Challenges in Autoimmune Disease
Cell Therapy Expansion and Challenges in Autoimmune Disease
Health Advances
 
TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd...
TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd...TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd...
TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd...
Donc Test
 
Identifying Major Symptoms of Slip Disc.
 Identifying Major Symptoms of Slip Disc. Identifying Major Symptoms of Slip Disc.
Identifying Major Symptoms of Slip Disc.
Gokuldas Hospital
 
Efficacy of Avartana Sneha in Ayurveda
Efficacy of Avartana Sneha in AyurvedaEfficacy of Avartana Sneha in Ayurveda
Efficacy of Avartana Sneha in Ayurveda
Dr. Jyothirmai Paindla
 
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptxEar and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
Holistified Wellness
 
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachIntegrating Ayurveda into Parkinson’s Management: A Holistic Approach
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Ayurveda ForAll
 
Complementary feeding in infant IAP PROTOCOLS
Complementary feeding in infant IAP PROTOCOLSComplementary feeding in infant IAP PROTOCOLS
Complementary feeding in infant IAP PROTOCOLS
chiranthgowda16
 
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
19various
 

Recently uploaded (20)

TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
 
Histololgy of Female Reproductive System.pptx
Histololgy of Female Reproductive System.pptxHistololgy of Female Reproductive System.pptx
Histololgy of Female Reproductive System.pptx
 
share - Lions, tigers, AI and health misinformation, oh my!.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptxshare - Lions, tigers, AI and health misinformation, oh my!.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptx
 
LOOPS in orthodontics t loop bull loop vertical loop mushroom loop stop loop
LOOPS in orthodontics t loop bull loop vertical loop mushroom loop stop loopLOOPS in orthodontics t loop bull loop vertical loop mushroom loop stop loop
LOOPS in orthodontics t loop bull loop vertical loop mushroom loop stop loop
 
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.GawadHemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
 
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptxREGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
 
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
 
Part II - Body Grief: Losing parts of ourselves and our identity before, duri...
Part II - Body Grief: Losing parts of ourselves and our identity before, duri...Part II - Body Grief: Losing parts of ourselves and our identity before, duri...
Part II - Body Grief: Losing parts of ourselves and our identity before, duri...
 
Aortic Association CBL Pilot April 19 – 20 Bern
Aortic Association CBL Pilot April 19 – 20 BernAortic Association CBL Pilot April 19 – 20 Bern
Aortic Association CBL Pilot April 19 – 20 Bern
 
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPromoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
 
CHEMOTHERAPY_RDP_CHAPTER 4_ANTI VIRAL DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 4_ANTI VIRAL DRUGS.pdfCHEMOTHERAPY_RDP_CHAPTER 4_ANTI VIRAL DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 4_ANTI VIRAL DRUGS.pdf
 
Cell Therapy Expansion and Challenges in Autoimmune Disease
Cell Therapy Expansion and Challenges in Autoimmune DiseaseCell Therapy Expansion and Challenges in Autoimmune Disease
Cell Therapy Expansion and Challenges in Autoimmune Disease
 
TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd...
TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd...TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd...
TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd...
 
Identifying Major Symptoms of Slip Disc.
 Identifying Major Symptoms of Slip Disc. Identifying Major Symptoms of Slip Disc.
Identifying Major Symptoms of Slip Disc.
 
Efficacy of Avartana Sneha in Ayurveda
Efficacy of Avartana Sneha in AyurvedaEfficacy of Avartana Sneha in Ayurveda
Efficacy of Avartana Sneha in Ayurveda
 
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptxEar and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
 
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
 
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachIntegrating Ayurveda into Parkinson’s Management: A Holistic Approach
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
 
Complementary feeding in infant IAP PROTOCOLS
Complementary feeding in infant IAP PROTOCOLSComplementary feeding in infant IAP PROTOCOLS
Complementary feeding in infant IAP PROTOCOLS
 
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
 

Healthcare Benefit Cost Strategies for 2012

Editor's Notes

  1. High claim years are going to happenShow chart and stats
  2. Network discounts Goal is to compare the cost for the same service at the same facility by the same providerNeed a fair representation of servicesInpatient facilityPrimary care and specialist services (surgeons, anesthesiologist, radiology, oncology)Many problems with vendor responsesProvide average cost within areaProvided lowest cost of all providers in areaMay not reflect severity of illnessConfidential informationIndependent audit to verify accuracy
  3. Network discounts Goal is to compare the cost for the same service at the same facility by the same providerNeed a fair representation of servicesInpatient facilityPrimary care and specialist services (surgeons, anesthesiologist, radiology, oncology)Many problems with vendor responsesProvide average cost within areaProvided lowest cost of all providers in areaMay not reflect severity of illnessConfidential informationIndependent audit to verify accuracy
  4. Newer contracts are less generous to PBMMore transparency
  5. What do you know about your risk pool?High risk: diabetes, high blood pressure, obese, smokersIndustry and age implicationsWhat happened?Heart attack Knee replacementHow is compliance with preventive screenings and medications?
  6. Plan designHigh deductible plansValue based designsTargeted limitationsEligibilitySpousal carve-outs for working spousesDependent auditsPreventive approachesIdentify potential problemsOnsite clinic
  7. Very common Shift benefit cost to employeesChart on how many are affectedDecisions to makeComplete replacement of existing option or new optionIncentives to elect high deductible optionLower employee contributionsEmployer contribution for HSA or HRAStatistical data is starting to show behavior modificationsDesign attracts all types of employees
  8. Ok to use higher or lower benefits to steer utilization towards low cost providersExamples: MRIs and X-rays, dialysis, oncology servicesKeep generic Rx copayments low while increasing brand copayments
  9. Visit limits are ok and dollar limits are notMore flexibility for benefits not part of “essential benefits” definitionExamples Limit of 15 chiropractic visits$10,000 limit for sleep disorders (if not part of essential benefits)Definition of appropriate emergency room usage and higher copayments for ER visits.
  10. Spousal carve-outs for working spousesConsiderationsIs the other coverage comparable Is the other coverage affordableHow do you enforce it?Dependent auditsEasy financial decision when the expected savings is more than the cost of auditOne employer defaulted to a “not covered decision” if the employee did not respond to the request for data.
  11. Identify potential problemsFlag problems before they become larger onesFlag noncompliance in medication usage for chronically sick.Methods includesHealth screeningsAllow spouses to participate as wellCompliance with age-appropriate guidelinesData mining Rx usage Q for Gomez – what do you once you identify the sick person?
  12. Conceptually good idea if goals can be meetLower cost of services compared to using existing network of providers (hard dollars)Improvement in clinical measures because of easy access (soft dollars)Reduced out of office time (soft dollars)Other considerationsMore face time with doctorsAbility to add wellness coachingAbility to monitor health of chronically sick membersNot cost efficient for smaller employers
  13. Because rates are averaged over two years, it will take a couple of years for costs to declinePlans will likely see high requirements drop quickly to zero within a few years of rates increasing
  14. Areas of Expertise Include: Cash Balance Plan Defined Benefit & Pension Defined Contribution & 401(k) Employee Stock Ownership Plan (ESOP) Flexible Spending, HRA & HSA Healthcare Actuarial ConsultingLearn more at www.nyhart.com
  15. Areas of Expertise Include: Cash Balance Plan Defined Benefit & Pension Defined Contribution & 401(k) Employee Stock Ownership Plan (ESOP) Flexible Spending, HRA & HSA Healthcare Actuarial ConsultingLearn more at www.nyhart.com