The document introduces HLU Consultants, an independent consulting firm that offers an alternative to traditional health plans through an open-platform, self-funded model. This model provides employers more control over their health plans, lower costs through reduced claim costs and a focus on wellness, and simplified administration. The model analyzes claims data to identify overcharges and strategizes ongoing cost control. In contrast to traditional brokers, HLU acts independently without incentives to select the best solutions for each client.
The cost of claims drives the cost of employer health plans. See a sample proposal on of a specialized, self-funded health plan that lowers claim costs and makes health care work for employees and employers.
In an article for Healthcare Executive, Don Seymour, Kevin Talbot, and Chad Stutelberg share their insight on developing compensation strategies that link executive and physician compensation models to acute care outcome-based payment methodologies.
The many ways in which healthcare reform affects the healthcare industry are still playing out. Undoubtedly, a question for physicians and the hospitals that employ many of them is “how will physician compensation be affected?”
PYA Principal Carol Carden recently spoke at the 2013 AICPA Healthcare Industry Conference, where she addressed this question with her presentation, “Current Reform Initiatives and Their Impact on Physician Compensation.”
The Top Three Healthcare Financial Trends in 2017: Payment Transitions, Disru...Health Catalyst
Influential healthcare financial trends in 2017 emerged in three areas:
Transitions in payment.
Disruption from familiar players and newcomers.
Emerging data skillsets.
Uncertainty has been a common theme for 2017. Organizations continue waiting for clarity on the future of the Affordable Care Act (ACA), while working to implement value-based care. Changes from established healthcare organizations as well as the arrival of prominent newcomers (e.g., Amazon) add to the unsettled outlook, as do emerging data skillsets. Amid the uncertainty, however, healthcare is clearly continuing on the path to patient-centered care. Organizations best positioned for 2018 will understand their performance in 2017’s top three healthcare financial trends as they evaluate their preparedness for the coming year.
PYA Speaks the New Language of HealthcarePYA, P.C.
PYA Principal David McMillan addressed the 2013 Florida Institute of Certified Public Accountants Health Care Industry Conference and offered a consultant-turned-linguist perspective on “Learning the New Language of Healthcare.”
Medicine the way it used to be.
Ttelemedicine subscription plans allow you to have access to a doctor 24/7 by phone or secure video conference call.
These plans are complimentary to your regular health care plan meaning having a telemedicine plan allows you to speak with a doctor when your regular doctor is not available or it is an emergency and you need to talk to a physician right away.
Think of it as concierge medicine -- access to a doctor when you want for routine health care questions.
The doctors are located in your state and are all board certified.
Telemedicine plans are available for you and your family for $19.95 per month. There is no deductible and no coinsurance.
Telemedicine subscriptions are available to companies. The fee is $10.00 per employee if paid by the company. The plan is portable and you may take the plan with you if you leave the company.
Secure web portals allow you to keep your personal medical information where you may easily find it. It is available in emergency situations or to show your personal doctor.
Prescriptions cards are part of the plan to receive discounts.
I guarantee that you will find this to be a plan of value to help you when you feel most vulnerable, you are not well and you want to speak to a doctor within minutes and not hours or days.
The webcast focuses on what Executives need to know as the Open Payments Program is fully implemented focusing on the broader implications of how to prepare for healthcare professional transparency.
The cost of claims drives the cost of employer health plans. See a sample proposal on of a specialized, self-funded health plan that lowers claim costs and makes health care work for employees and employers.
In an article for Healthcare Executive, Don Seymour, Kevin Talbot, and Chad Stutelberg share their insight on developing compensation strategies that link executive and physician compensation models to acute care outcome-based payment methodologies.
The many ways in which healthcare reform affects the healthcare industry are still playing out. Undoubtedly, a question for physicians and the hospitals that employ many of them is “how will physician compensation be affected?”
PYA Principal Carol Carden recently spoke at the 2013 AICPA Healthcare Industry Conference, where she addressed this question with her presentation, “Current Reform Initiatives and Their Impact on Physician Compensation.”
The Top Three Healthcare Financial Trends in 2017: Payment Transitions, Disru...Health Catalyst
Influential healthcare financial trends in 2017 emerged in three areas:
Transitions in payment.
Disruption from familiar players and newcomers.
Emerging data skillsets.
Uncertainty has been a common theme for 2017. Organizations continue waiting for clarity on the future of the Affordable Care Act (ACA), while working to implement value-based care. Changes from established healthcare organizations as well as the arrival of prominent newcomers (e.g., Amazon) add to the unsettled outlook, as do emerging data skillsets. Amid the uncertainty, however, healthcare is clearly continuing on the path to patient-centered care. Organizations best positioned for 2018 will understand their performance in 2017’s top three healthcare financial trends as they evaluate their preparedness for the coming year.
PYA Speaks the New Language of HealthcarePYA, P.C.
PYA Principal David McMillan addressed the 2013 Florida Institute of Certified Public Accountants Health Care Industry Conference and offered a consultant-turned-linguist perspective on “Learning the New Language of Healthcare.”
Medicine the way it used to be.
Ttelemedicine subscription plans allow you to have access to a doctor 24/7 by phone or secure video conference call.
These plans are complimentary to your regular health care plan meaning having a telemedicine plan allows you to speak with a doctor when your regular doctor is not available or it is an emergency and you need to talk to a physician right away.
Think of it as concierge medicine -- access to a doctor when you want for routine health care questions.
The doctors are located in your state and are all board certified.
Telemedicine plans are available for you and your family for $19.95 per month. There is no deductible and no coinsurance.
Telemedicine subscriptions are available to companies. The fee is $10.00 per employee if paid by the company. The plan is portable and you may take the plan with you if you leave the company.
Secure web portals allow you to keep your personal medical information where you may easily find it. It is available in emergency situations or to show your personal doctor.
Prescriptions cards are part of the plan to receive discounts.
I guarantee that you will find this to be a plan of value to help you when you feel most vulnerable, you are not well and you want to speak to a doctor within minutes and not hours or days.
The webcast focuses on what Executives need to know as the Open Payments Program is fully implemented focusing on the broader implications of how to prepare for healthcare professional transparency.
Revenue Cycle Management in healthcare encompasses the entire administrative process involved in getting paid for the services you provide to your patients. The process begins when a patient first calls to schedule an appointment and ends when all fees have been collected and verified.
Medical billing is becoming increasingly more complex. It is only going to get more difficult as new codes are added and more detailed patient information is required to be submitted with the claim. Add to that, physicians and other service providers are required by various insurers to provide details not previously necessary.
One small error can result in the claim not being paid promptly, completely or possibly even being denied.
Ten Tips For a More Profitable Veterinary Practice in 2011McGaunnSchwadronCPA
This powerpoint presentation by Mark J. McGaunn, CPA (of McGaunn & Schwadron, CPA’s, LLC) addresses how to best manage a Veterinary Practice to maximize profitability in 2011. Specifically covers best financial and management strategies and ten tips to follow for a successful vet practice.
Using Advanced Analytics for Value-based Healthcare DeliveryMichael Joseph
Promoting Value-based Healthcare Delivery
The fundamental principles of the Affordable Care Act recognize that the volume-based, fee-for-service payment model is unsustainable and that a value-based healthcare delivery system is essential. With the emergence of Accountable Care Organizations (ACOs), providers are incentivized to implement payment reforms and participate in shared savings programs that seek to balance quality of care, access to care and cost of care.
Our healthcare analytics payment model uses predictive analytics to assist ACOs in patient attribution, budget development, bench-marking and performance monitoring to maximize incentives through shared savings and quality improvements.
Hospital / Technology / Revenue / Business
This is the approach for success in terms of workflow, revenue, and technology effeciency in HIT (Healthcare Information Technology).
Learn more about our simple, smart, fast, and reliable behavioral health solutions. We’ll help you enhance care quality, better coordinate care, streamline workflows, and grow your bottom line.
What decisions should you make for your business related to ObamaCare and HealthCare Reform?
The Roadmap & Decision Tree (pages 9 & 10) help to simplify and help you zero in on what you need to do.
If you have 49 or fewer employees...
If you have 50 or more employees...
This will help make your path clear.
Lean Strategies in Healthcare Revenue Cycle ManagementInvensis
Did you know? Revenue cycle inefficiencies accounted for 15% of 2.7 trillion spent on healthcare, or about $400 billion. Join Dr. Steven M Wagner to understand how to align continuous quality improvement through lean method for staff and management to overcome income obstacles in healthcare and help them to learn and experiment with strategies to address them.
A 360° view of value-based healthcare: how to position your facility for successSourceMed
The shift from volume to value-based healthcare is underway and many outpatient providers are already participating. How are you preparing for this transition?
This presentation will explore the move to value-based care, and share ways for your facility to adapt what it is doing today to thrive under collaborative service delivery models, including: revenue cycle management, data analytics, patient engagement and system interoperability.
Process Improvement: A Consultant's View of your Healthcare Revenue Cycle | A...Meduit
Get a look at how well your revenue cycle processes are functioning and learn how to identify the initiatives your healthcare facility can take to reduce days in A/R and boost revenue! Download the live event recording here: https://lab.meduitrcm.com/process-improvement-innovationlab-webinar/
Compensation Toolbox: Guidelines for Building an Effective Compensation PlanPYA, P.C.
PYA Consultant Allison Wilson recently presented "Compensation Toolbox: Guidelines for Building an Effective Compensation Plan" at the Medical Group Management Association (MGMA) 2015 Financial Management and Payer Contracting Conference, March 1-3, in Phoenix, Arizona.
Software para la Inteligencia Tecnológica de Patentesminiera
Este informe estudia la oferta y la demanda de los programas que tienen por finalidad la explotación de los sistemas de patentes. Como hemos podido apreciar en la revisión bibliográfica anterior, no parece existir según trabajo que tenga una base empírica de estudio obteniendo información de los usuarios de las patentes. En este trabajo la evaluación se ha realizado cruzando dos estudios independientes que utilizan la misma estructura de base.
Las razones que nos han motivado a realizar este estudio pionero pueden ser resumidas en los siguientes puntos:
- Inexistencia de estudios exhaustivos que comparen las aplicaciones informáticas de análisis de patentes.
- La falta de estudios acerca de la demanda de los programas para el análisis de las patentes. Es decir, que no se conoce el uso y el valor que se asocia a las características ofrecidas por los productores de esta clase de aplicaciones informáticas.
- Inexistencia de una comparación de las aplicaciones con la necesidad demostrada por los usuarios de dichos productos.
- Obtener una valoración de la magnitud y el crecimiento de la oferta. Hemos contabilizado en el mercado más de 21 aplicaciones.5 Este número representa, en nuestra opinión, una oferta amplia en este campo especializado. Otra tendencia que destaca es que existe un crecimiento, aunque modesto, de la oferta de este tipo de aplicaciones.
- Nos encontramos con una alta variedad de la oferta de aplicaciones informáticas para la ICT. Una aplicación puede llegar a tener un número muy alto de características. Sin embargo, las aplicaciones existentes en la actualidad en el mercado incluyen diferentes grupos de características y por tanto es difícil llevar a cabo una comparación parcial de las mismas. Por tanto creemos que es necesaria una normalización o un enfoque uniforme en el estudio de estas aplicaciones para que la comparación sea válida.
Revenue Cycle Management in healthcare encompasses the entire administrative process involved in getting paid for the services you provide to your patients. The process begins when a patient first calls to schedule an appointment and ends when all fees have been collected and verified.
Medical billing is becoming increasingly more complex. It is only going to get more difficult as new codes are added and more detailed patient information is required to be submitted with the claim. Add to that, physicians and other service providers are required by various insurers to provide details not previously necessary.
One small error can result in the claim not being paid promptly, completely or possibly even being denied.
Ten Tips For a More Profitable Veterinary Practice in 2011McGaunnSchwadronCPA
This powerpoint presentation by Mark J. McGaunn, CPA (of McGaunn & Schwadron, CPA’s, LLC) addresses how to best manage a Veterinary Practice to maximize profitability in 2011. Specifically covers best financial and management strategies and ten tips to follow for a successful vet practice.
Using Advanced Analytics for Value-based Healthcare DeliveryMichael Joseph
Promoting Value-based Healthcare Delivery
The fundamental principles of the Affordable Care Act recognize that the volume-based, fee-for-service payment model is unsustainable and that a value-based healthcare delivery system is essential. With the emergence of Accountable Care Organizations (ACOs), providers are incentivized to implement payment reforms and participate in shared savings programs that seek to balance quality of care, access to care and cost of care.
Our healthcare analytics payment model uses predictive analytics to assist ACOs in patient attribution, budget development, bench-marking and performance monitoring to maximize incentives through shared savings and quality improvements.
Hospital / Technology / Revenue / Business
This is the approach for success in terms of workflow, revenue, and technology effeciency in HIT (Healthcare Information Technology).
Learn more about our simple, smart, fast, and reliable behavioral health solutions. We’ll help you enhance care quality, better coordinate care, streamline workflows, and grow your bottom line.
What decisions should you make for your business related to ObamaCare and HealthCare Reform?
The Roadmap & Decision Tree (pages 9 & 10) help to simplify and help you zero in on what you need to do.
If you have 49 or fewer employees...
If you have 50 or more employees...
This will help make your path clear.
Lean Strategies in Healthcare Revenue Cycle ManagementInvensis
Did you know? Revenue cycle inefficiencies accounted for 15% of 2.7 trillion spent on healthcare, or about $400 billion. Join Dr. Steven M Wagner to understand how to align continuous quality improvement through lean method for staff and management to overcome income obstacles in healthcare and help them to learn and experiment with strategies to address them.
A 360° view of value-based healthcare: how to position your facility for successSourceMed
The shift from volume to value-based healthcare is underway and many outpatient providers are already participating. How are you preparing for this transition?
This presentation will explore the move to value-based care, and share ways for your facility to adapt what it is doing today to thrive under collaborative service delivery models, including: revenue cycle management, data analytics, patient engagement and system interoperability.
Process Improvement: A Consultant's View of your Healthcare Revenue Cycle | A...Meduit
Get a look at how well your revenue cycle processes are functioning and learn how to identify the initiatives your healthcare facility can take to reduce days in A/R and boost revenue! Download the live event recording here: https://lab.meduitrcm.com/process-improvement-innovationlab-webinar/
Compensation Toolbox: Guidelines for Building an Effective Compensation PlanPYA, P.C.
PYA Consultant Allison Wilson recently presented "Compensation Toolbox: Guidelines for Building an Effective Compensation Plan" at the Medical Group Management Association (MGMA) 2015 Financial Management and Payer Contracting Conference, March 1-3, in Phoenix, Arizona.
Software para la Inteligencia Tecnológica de Patentesminiera
Este informe estudia la oferta y la demanda de los programas que tienen por finalidad la explotación de los sistemas de patentes. Como hemos podido apreciar en la revisión bibliográfica anterior, no parece existir según trabajo que tenga una base empírica de estudio obteniendo información de los usuarios de las patentes. En este trabajo la evaluación se ha realizado cruzando dos estudios independientes que utilizan la misma estructura de base.
Las razones que nos han motivado a realizar este estudio pionero pueden ser resumidas en los siguientes puntos:
- Inexistencia de estudios exhaustivos que comparen las aplicaciones informáticas de análisis de patentes.
- La falta de estudios acerca de la demanda de los programas para el análisis de las patentes. Es decir, que no se conoce el uso y el valor que se asocia a las características ofrecidas por los productores de esta clase de aplicaciones informáticas.
- Inexistencia de una comparación de las aplicaciones con la necesidad demostrada por los usuarios de dichos productos.
- Obtener una valoración de la magnitud y el crecimiento de la oferta. Hemos contabilizado en el mercado más de 21 aplicaciones.5 Este número representa, en nuestra opinión, una oferta amplia en este campo especializado. Otra tendencia que destaca es que existe un crecimiento, aunque modesto, de la oferta de este tipo de aplicaciones.
- Nos encontramos con una alta variedad de la oferta de aplicaciones informáticas para la ICT. Una aplicación puede llegar a tener un número muy alto de características. Sin embargo, las aplicaciones existentes en la actualidad en el mercado incluyen diferentes grupos de características y por tanto es difícil llevar a cabo una comparación parcial de las mismas. Por tanto creemos que es necesaria una normalización o un enfoque uniforme en el estudio de estas aplicaciones para que la comparación sea válida.
This is a level 200 - 300 presentation.
It assumes:
Good understanding of vCenter 4, ESX 4, ESXi 4.
Preferably hands-on
We will only cover the delta between 4.1 and 4.0
Overview understanding of related products like VUM, Data Recovery, SRM, View, Nexus, Chargeback, CapacityIQ, vShieldZones, etc
Good understanding of related storage, server, network technology
Target audience
VMware Specialist: SE + Delivery from partners
Presentación de la ponencia "Productividad colectiva" dentro de las jornadas técnicas tituladas "Más productividad, menos estrés" organizadas por Grupo Euroformac. Junio 2015
Great Articles, news and expertise from leadership, HR and People development experts around the world. Come and see our great new e.MILE Magazine here: http://www.peopledevelopmentmagazine.com
2013 10 utilizing member engagement to improve cahps scoresimagine.GO
The Accountable Care Act means more access to healthcare for more people. But to pay for that access it also means margins for healthcare companies are going to be squeezed. But this does not necessarily imply doom for healthcare companies. The law actually encourages healthcare businesses to build better business models – and is willing to pay for it. By retooling your market approach, and the operations that run your business, you can actually improve your margins and your customer’s happiness at the same time you are helping to create a better and more efficient healthcare ecosystem.
Streamlining Your Medical Practice for Profitability and SuccessConventus
Conventus webinar video providing key success strategies and tactics for improving productivity, profitability, and patient care. The one-hour video features host Susan Lieberman of Conventus and Stevie Davidson of Health Informatics Consulting.
Workplace productivity is an estimate of how efficiently organizations utilize their resources to accomplish business objectives. Improving productivity is important because increasing it can increase revenue using the same or fewer resources.
POV Healthcare Payer Medical Informatics and AnalyticsFrank Wang
Health Insurance / Payer Analytics
Medical Informatics
Fraud Detection
Care Management
Utilization Management
Business Performance Management
Clinical Outcome Measures
Financial Strategies for Healthcare Providers Budco Financial
Managing the cost of healthcare continues to be a top concern for consumers and healthcare providers alike. Here are three strategies providers should use to improve self-pay receivables and increase patient satisfaction
The 100-Percent Solution to Improving Healthcare’s Operating MarginsHealth Catalyst
Healthcare organizations face unparalleled pressure to increase operating margins as they adapt to the revenue compression from COVID-19 and growing competition from insurers and digital disrupters. Yet, many health systems rely on outdated, revenue-centric cost accounting solutions that are ill equipped for strategic financial decision making. As a methodology for today’s complex healthcare environment, activity-based costing (ABC) can capture healthcare resource use at a granular level. With this service-level insight into clinical cost, ABC provides actionable intelligence to help organizations improve profitability and make strategic cost-reduction decisions. These comprehensive costing solutions give health systems a full understanding of cost across the care continuum—the only level of insight that will enable strategic cost transformation in the industry’s new normal.
Clinical Co-Management Arrangements: Trends, Issues and FMV ConsiderationsCBIZ, Inc.
Healthcare providers are under scrutiny and feel pressure from patients, employers, insurance and the federal and state governments to provide higher quality care at lower costs and higher efficiency.
As a healthcare provider, it is difficult to manage a successful medical practice without practice management challenges. Physicians face some practice challenges. Let us discuss briefly.
Three Keys to a Successful Margin: Charges, Costs, and LaborHealth Catalyst
How can cost management and complete charge capture protect and enhance the margin?
In this webinar, we will look at 2024 margin pressures likely to impact your organization’s financial resiliency. This presentation will also share how organizations can move from Fee-for-Service to Value; bringing Cost to the forefront.
Rethink Healthcare webinar brochure for companies involved in or ready to maximize employee participation and satisfaction in Consumer Directed Health Plans
1. It’s here. It’s time.
Re-Thinking the Traditional Health Plan
with YOUR BUSINESS in Mind
2. Imagine a health plan that offers. . .
Introducing: HLU Consultants
SCALABLE
SOLUTIONS
DESIGNED BY YOU
NO MORE generic,
cookie cutter plans that
consist of identical benefits
and a limited network
of partners
ALL OF THESE
THINGS AND MORE
add up to
significant annual SAVINGS
year after year!
FLEXIBLE,
MODERN-DAY
BENEFITS
NO MORE same-old
thinking based on the
idea of “this is how
we’ve always done it”
STRATEGIES FOR
MANAGING
OUT-OF-CONTROL
COSTS
NO MORE questionable,
error-filled claims
slipping through
3. HLU CONSULTANTS | Reclaim Control of Your Health Plan
For far too long, choosing
a health plan has gone
something like this:
Renewal time is coming so your broker schedules a visit
The same basic year-end spreadsheets are presented and the
dreaded news is relayed: rates are going up AGAIN
Your broker assures you this plan is still the most cost-effective
option (besides, switching now would be a huge headache,
wouldn’t it?)
You renew, shake hands and hope for the best
1.
2.
3.
4.
4. HLU CONSULTANTS | Reclaim Control of Your Health Plan
It’s here. It’s time.
But what if there was an
ENTIRELY DIFFERENT SOLUTION
out there for your business that
would mean a change for the better?
The WAY better?
A plan that would help contain costs
from day one and especially focus on
the key item that is so consistently
overlooked: out-of-control claim
costs? And what if that plan included
predictive modeling once it was in
place so you could actually see the
future impact of your out-of-pocket
cost savings?
5. HLU CONSULTANTS | Reclaim Control of Your Health Plan
HLU Puts Plan Control and
Cost Savings Back in your Hands
Control of Health Plan Employer Insurance company Insurance company
Provider Network Access
Data Analysis & Forecasting
Large Claim Case Management Analysis
Utilize Independent, Best-In-Class
Vendors to Reduce Claim Costs
Pricing Transparency for
Employee Medical Services
Customizable Summary
Plan Description (SPD)
Claim Review Procedure
Compliance & Employee Onboarding
HLU Open-Platform Health Plan
with Healthcare Intelligence
Hybrid Plan Platform
ASO, Insurance Company, Self-Funded,
Level-Funded, Balance Funded Plans
Closed Platform
Humana, Anthem, UHC, MMOH,
Aetna, etc.
Traditional PPO Networks, National Access
and Customizable Networks
Typically 1 or 2 PPO options
(One size fits all)
Typically 1 or 2 PPO options
(One size fits all)
YES - actionable data Basic claims and expense overview only
Data is not actionable
No data provided
YES - actionable data No No
YES No No
YES No or limited No or limited
No or limited
YES Yes - with limitations No
Claims are itemized and reviewed for
overcharges and billing errors
Full Service, Hands-Free Suite: FMLA, COBRA,
5500, ERISA, ACA, FTE Record-Keeper and filings
Claims are passed through and paid
by a summarized invoice
Limited
Usually reference materials only
Claims are passed through and paid
by a summarized invoice
6. HLU CONSULTANTS | Reclaim Control of Your Health Plan
We offer a smarter approach.
It’s an open-platform health plan that provides
the highest quality benefits at the lowest costs
with better employee health outcomes.
An exciting change for the better, this efficient and
cost-effective self-funded plan allows employees
and employers to reclaim ownership of their
healthcare benefits and costs.
It provides data you can act on and use to tailor
your plan for the greatest value . . . it’s structured
around a long-term strategy to continually control
plan design effectiveness and costs . . . and, it
simplifies administration and compliance
along the way.
For the employee, it’s empowering. HLU’s
Open-Platform Health Plan provides employees
with educational resources to help them make
informed decisions to select the best available
healthcare plans and options for their needs. The
result . . . better employee health and lower
plan costs.
7. HLU CONSULTANTS | Reclaim Control of Your Health Plan
The Consultant vs. The Broker
HLU serves as an independent consultant, not a broker. What does this mean?
Operating on our own, we take a totally objective approach to match your
plan with the best benefits and partners.
We’re not limited to working with a small ecosystem of defined partners or
big-name vendors, but rather, we’re connected to a wide-ranging network
of systems, resources and solutions to match accordingly with clients.
We don’t tack on costly brand-name fees and our business
isn’t driven by extra incentives or sales commissions.
Your account is handled by the same consultant,
not handed off from rep to rep.
8. HLU CONSULTANTS | Reclaim Control of Your Health Plan
Understanding Health Care Hikes
& Hidden Costs
Health care costs are rising faster than inflation and wages. Another problem on top of that?
The traditional health plan is bloated with waste and inefficiency and offers very minimal control.
20-40%+
Rate Increases
9.3%
Employee Health
Plan Costs Increase
10x
Amount Overcharged
by Some Hospitals
80%
Family Premiums
Increase
There was a 9.3% increase
in employee health plan
costs from 2011-2012 (Kaiser)
Over the last 10 years,
family premiums have
gone up an average of
80% (Kaiser)
In 2012, the 50 hospitals
with the highest prices were
found to be charging 10 times
more than what’s allowed by
Medicare (The New York Times)
Health insurance companies
around the country are
seeking rate increases of 20
percent to 40 percent or
more for 2016
(2015, The New York Times)
9. HLU CONSULTANTS | Reclaim Control of Your Health Plan
How can your
business possibly
keep up with such
unpredictable hikes?
10. HLU CONSULTANTS | Reclaim Control of Your Health Plan
Here’s the thing –
But things
can change . . .
Most companies have no idea how much their
health claims are costing them or that the issue
of excess, unnecessary charges has become so
incredibly routine.
All too often, claims get processed and paid
without a thorough review to catch errors and
inconsistencies.
Common issues like overcharging, miscoding and
duplicate charges are slipping through the cracks
resulting in ridiculously high payments that are eating
away at your bottom line.
11. HLU CONSULTANTS | Reclaim Control of Your Health Plan
HLU’s Winning Formula
LOWER
CLAIM COSTS
EMPOWERED
EMPLOYEES
IMPROVED
QUALITY OF CARE &
BETTER OUTCOMES
AN AVERAGE
OF
27%
TO REDUCE OVER-UTILIZATION
AND IMPROVE CARE
12. HLU CONSULTANTS | Reclaim Control of Your Health Plan
Consider
Fixed Costs vs. Flexible
In a traditional plan, you pay a set
amount no matter what your
employees’ collective claims add
up to at year’s end. But what if you
pay more than the care your group
actually receives? That money is lost.
In the open-platform, self-funded
plan, you pay only for the care
that’s administered. Your dollars go
directly toward the cost of claims,
and stop-loss insurance kicks in
to cover the very large claims, as
needed. This approach eliminates a
substantial portion of the overhead
and profits paid to a traditional plan.
13. HLU CONSULTANTS | Reclaim Control of Your Health Plan
On top of sky-high claim
costs, the old, outdated
plan model means:
• A major lack of flexibility
• Less engagement and education among employees, often
resulting in unnecessary and costly care
• Limited or no claim data to use in being proactive and making
informed decisions
• Limited selection among benefit solutions and vendors
• Renewals driven by extra perks like incentives and commissions
• High turnover rates among staff and a lack of experience in
who is managing your account
• More manual compliance management and HR
administration needs
14. HLU CONSULTANTS | Reclaim Control of Your Health Plan
Why HLU Open-Platform Health Plan?
The reasons are plenty. Simplified compliance is a big one.
HLU Open-Platform Health Plan puts YOU back in control through:
Employee onboarding with 360-degree reporting and billing that’s seamless and integrated
FMLA and COBRA compliance that’s hands-free and full-service
ACA compliance and employee notifications for your added convenience
1095-C or 1094-C tracking and reporting
15. HLU CONSULTANTS | Reclaim Control of Your Health Plan
It’s simple. This is a smarter way to manage health benefits … one that works AND saves you money
now and for the long-term. HLU Open-Platform Health Plan puts YOU back in control through:
Meaningful data with the ability to analyze, model and forecast … this significantly reduces the
costs of administration, insurance and claims, and allows you to adapt your plan whenever and
however needed
Better care and improved outcomes because employees are more engaged in their care … this
leads to more effective disease management and reduces excess office visits, lab tests, hospital
admissions, etc.
Thorough claims review to identify overcharges and billing errors and address them before
claims are processed and paid
Best-in-class partnerships without being limited to a minimal number of vendors
A “pay for what you use” approach to care with a plan built from the most appropriate modules
Pricing transparency for medical services is achieved by giving employees the resources they
need to make the best choices and avoid overpaying for provider services
Why HLU Open-Platform Health Plan?
16. HLU CONSULTANTS | Reclaim Control of Your Health Plan
A Real Example: Diabetes Management
TRADITIONAL PLAN
An employer needs more coverage
focused on diabetes care, but
the current, not-so-flexible
plan only includes basic disease
management services.
HLU OPEN-PLATFORM HEALTH PLAN
We offer award-winning programs that address disease management and make
employees active participants in their own care. This emphasis on disease
management lowers costs to the plan and to the employee . . . and, it also results
in better employee health through well-coordinated outreach programs.
17. HLU CONSULTANTS | Reclaim Control of Your Health Plan
Why is HLU for You?
Benefits Done Better: Our Roots
• We are fully independent consultants with each employer’s
best interests in mind
• We have 55 years of experience in the industry, backed by a
team of professionals who truly understand what works in a
plan and what doesn’t
• We are a focused and efficient company with national reach
that takes an objective approach to finding the best vendors
18. HLU CONSULTANTS | Reclaim Control of Your Health Plan
Why is HLU for You?
Benefits Done Better: Our Method
• You’ll work in partnership with the same account
representative who is focused on the full relationship,
from sales to implementation and strategy
• You’ll receive one-on-one customer service with a
high-touch, hands-on approach
• You’ll never have to worry about brand-name fees,
incentives or sales driven by commission coming into play
19. HLU CONSULTANTS | Reclaim Control of Your Health Plan
It works for everyone.
While some plans might make sense from the
owner/CFO perspective, they don’t function for
the HR team. And vice versa.
Here’s the good news about the open-platform,
self-funded design: it works for everyone.
The plan saves you for the long-term, not just
the first 365 days.
Plus, the switch is seamless. It doesn’t put a
strain on your HR department or result in any
troublesome compliance gaps.
20. HLU CONSULTANTS | Reclaim Control of Your Health Plan
The Right Solution: CFOs/Owners
The Before: CFOs/owners see that plan costs are rising
sharply and quickly, making it hard to achieve a profit. Any
experience shopping other traditional plans has typically
been limited to some first-year savings, but increased rates
(once again) beyond that.
The After . . .
21. HLU CONSULTANTS | Reclaim Control of Your Health Plan
The After with HLU: Our clients have
experienced an average health plan cost
increase of less than 3% since 2007.
They also benefit from better health plan
intelligence through detailed claim reporting
that allows them to:
• Take action on trends and issues that impact the bottom line
• Analyze what-if-contingencies to predict improvement cost
and effect
• Gain visibility into questionable billing trends
• See ROI on cost control features
• Take an effective wellness approach to lower costs and
improve quality of care
The Right Solution: CFOs/Owners
Average
health plan
cost increase of
since 2007
22. HLU CONSULTANTS | Reclaim Control of Your Health Plan
The Right Solution: HR Team
The Before: For HR groups that have tried other plans
without seeing results, it’s hard to believe a successful
alternative actually exists. Plus, it often feels like there
are too many moving parts with hiring, open enrollment,
changing insurances, etc., to consider. There’s also the fear
that any change in the process could result in mistakes,
compliance issues and added headaches.
The After . . .
23. HLU CONSULTANTS | Reclaim Control of Your Health Plan
The After with HLU: Things are simpler and more streamlined
than ever with our technology-rich solutions. A few ways your
HR team will benefit:
• Employees keep the same benefits for many years, and
there’s no need to tweak deductibles and copays to manage
plan costs
• Universal ID Cards and Employee ID Numbers remain the
same even if you change insurance providers
• The renewal process is streamlined, with advance notice
of rate changes . . . no need for employees to complete new
applications to shop for new providers
• A dedicated customer service team provides personalized
service and is available to handle billing and answer
employee questions
The Right Solution: HR Team
24. It’s here. It’s time.
Learn more about HLU Consultants:
Are You Ready for a Smarter Health Plan
that has YOUR BUSINESS in Mind?
hluconsultants.com
Browse our site or sign up
for a webinar
info@hluconsultants.com513.559.7503