Category Archives: Cost Saving Ideas

The Impact of Medicare’s Ability to Negotiate with Pharma

We’ve probably all experienced sticker shock at the pharmacy counter. How can employers with self-funded plans continue to provide high-quality health benefits when so many of their healthcare dollars are going to prescription drug costs? A piece of legislation that would allow Medicare to negotiate some drug prices could possibly provide some relief, for both Medicare members and self-insured employers alike. Continue Reading >

Smiling female pharmacist holding up a red medicine capsule that could be covered by medicare.

Pros and Cons of Reference Based Pricing for Self-insured

As self-insured employers look for ways to control healthcare costs, they have to evaluate every strategy that might help them accomplish that goal. Reference based pricing is a pricing strategy that eliminates rate negotiation between employers and healthcare providers, and may result in employers spending less on their employees’ medical claims. Continue Reading >

Reference based pricing allows employers to better predict medical budgets. A medical plan administrator working on billing while eating an apple.

Why Municipalities Should Seek Competitive Quotes for Stop-Loss Insurance Each Year

Providing benefits for your employees requires you to balance cost control with the needs and wants of your workforce. As decision makers, you have to scrutinize every expense that crosses your desk. That’s especially true when you’re making financial decisions on behalf of a municipality. Controlling your stop-loss costs is just one way to stretch your healthcare dollars without sacrificing employee benefits. Having the right level of stop-loss coverage allows a municipality to cap its financial risk while it provides a high-quality self-funded plan to its employees. But the stop-loss decisions you made last year may not reflect your current needs. That’s why we urge you to seek competitive quotes every year, even if you’re already working with a healthcare consultant. Continue Reading >

A municipal administrator in a red skirt stands on a staircase. Benefit administrators like her should seek out competitive quotes for stop-loss insurance each year.

Supporting Employee Health and Wellness While Continuing Remote Work

When your employees are unwell, your business is unwell. Supporting employee health is good for morale, good for productivity and really good for your budget. Having a largely healthy workforce is a key element of controlling health care costs, especially for self-insured employers that cover their own medical claims.  Continue Reading >

Woman works from home on a laptop with a red coffee mug. Employee health.

Preventive Medicine is the Best Medicine

It’s preferable to stop a fire from starting than it is to stop the flames from spreading, or to undo the damage that they cause. Prevention is naturally a primary goal for healthcare providers, who strive to keep patients from becoming sick and/or getting sicker. But self-insured employers benefit from this branch of  healthcare too. Though it’s hard to say definitely if preventive medicine will help you dramatically slash costs, embracing prevention has lasting benefits for all involved. Continue Reading >

preventive medicine

Health Apps: They’re Everywhere, And They Could Help Self-Funded Employers Control Healthcare Spending

When was the last time you scrolled through the health and fitness apps available on your favorite device? Maybe you’ll check them all out the next time you have, oh, five or six free days in a row. That’s probably about how long it would take you to review the full range of health apps available in your device’s app store. Continue Reading >

health apps

Tips for Businesses with Self-Funded Insurance to Improve Overall Healthcare Spending

Saving money is the primary reason that many employers decide to provide self-funded insurance. Balancing that objective and the healthcare needs of employees can be an ongoing struggle. Trimming benefits would help you cut spending, but not without sacrificing employee health and morale. Instead, think about making some strategic shifts to your plan. For some employers, it only takes a few small changes to dramatically slash healthcare spending. Continue Reading >

Self-funded insurance


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    In 2011, the top 5 most expensive medical conditions treated in US hospitals were: Septicemia, Osteoarthritis, Complication of device, implant or graft, Liveborn, and Acute myocardial infarction

    From 2010 to 2013, the number of claims that were individually $1 million or above rose by 1,000%

    In 2017 approximately 18% of the American public will purchase insurance through exchanges, radically transforming the health insurance landscape.

    In 2014, 98% of large firms (= 200 Workers) offer 1+ wellness programs to their employees.

    The most costly 1% of patients account for 20% of national health expenditures – accruing average annual expenses of nearly $90,000 per person.

    6% of firms offering fully-insured plans report they intend to self-insure because of Obamacare.

    In 2014, PPO plans remained the most common plan type, enrolling 58% of covered workers.

    In 2012, 93% of businesses with 5,000+ employees and 80% of companies with 1,000-4,999 employees were self-funded

    Massachusetts has the third-highest prevalence of self-funded insurance in the small-group market (Fewer than 50 employees).

    In 2013, the average deductible was $2,906 for individuals selecting plans from marketplaces. This compares with average deductibles of $1,135 for an individual with employer coverage.

    In 2013, the average annual premiums for employer-sponsored health insurance are $5,884 for single coverage and $16,351 for family coverage, up 5% and 4% respectively from 2012.

    From 2010 – 2013, cancer followed by chronic/end stage renal disease and leukemia accounted for the top 3 costliest illnesses.