With this revolutionary tool from MHI Benefits Group, when health care consumers are sent for routine medical tests, instead of going wherever the doctor recommends, they are paid to compare prices and seek lower-cost, high-quality care elsewhere.
MyHealthSavings USA - Employees Love It!
PRLog (Press Release) - Mar 08, 2012 -
While consumers are often unaware of the costs of tests and procedures because their insurers are billed, soaring premiums have forced many employers to redesign policies with higher deductibles and co-pays, meaning individuals are paying more on their own.
Now, with this revolutionary new tool offered by MHI Benefits Group, when employees of employer self-funded health plans are told they need a routine medical test, such as a MRI, CT Scan, minor surgical procedure and biopsy, a stress test, colonoscopy or a mammogram, instead of going wherever the doctor sends them, they will be paid to make a single phone call to compare local, in-network prices and possibly seek care elsewhere in their community.
MHI Benefits Group has introduced MyHealthSavingsUSA, a national rewards program through which client employers can offer their employees a money-saving tool to maximize out of pocket savings. All employees have to do is call a “Care Navigator’’ who that will direct them to hospitals or medical facilities that charge less for the same tests. The service is intended to help employees make smarter health care choices, and to rein in the runaway prices of imaging tests and other procedures that have contributed to steadily rising premiums.
Works with existing PPO provider networks
The providers are already in the employees' PPO network, so the quality, credentials and licensure have already been reviewed and verified by an external reviewer. MHI will be the first to offer this tool nationwide to over 210,000 self-funded employer plans. It maximizes the value of what the brokers already worked out with the employers.
In return for making a quick telephone call, they will receive a reward check processed by MHI funded by their employer, which typically ranges from $10 to $75, but we encourage each employer to set up their shared savings reward incentive as they wish. MHI administers the program and provides the Care Navigators and nurses to provide this concierge level of service to employees.
By removing the entire process out of HR, employee privacy and confidentiality are maintained. The employer receives a general report of the savings each month and an end of the year recap so they can reconcile bonus reward payments for W2 processing. They won't receive specifics about who had which tests. MHI also handles all bonus check processing for the shared savings.
“It’s the kind of decision patients aren’t making today because they don’t have the access to confidential pricing information,’’ said Maria Todd, chief executive of The Mercury Healthcare Companies, the parent company of MHI Benefits Group. “Doctors are still referring patients for diagnostics as they’ve always done it, without any concern for the cost. When we asked the doctors if they had any idea that the price variation in any given community most were amazed that the variance was as much as 250% for the same service.’’ For instance, potential savings on a colonoscopy can total $1,700 per procedure, MRIs can also vary between $1750 and $495, while the price variation for mammograms is sometimes as much as $285.
It's all about consumers choosing to save on healthcare
"The patients are the buyer, the program is 100% voluntary, and if the patient wants to spend more to go to their doctor's favorite MRI provider, we won't stop them. If the doctor wishes to sell the patient on their reasons to pass up savings to use the doctor's favorite vendor, that's between them and their patient; not us."
If a fully-insured employer wants this program for their employees, 100% of the savings benefits the health plan, and not the employer. MHI has other similar program designs tweaked to accommodate insurers and employer groups offering employees high-deductible health plans.
"We're buzzing with calls from agents and producers wanting to introduce this tool to their employer clients. Employers have been complaining that they need to get employees more engaged in making their own health care decisions. Up until now, there’s been no incentive and no tool for an employee to shop around. The tool pays for itself. Early pilot programs are returning 1.5 to 2x savings, after factoring the payouts from shared savings rewards and program fees.
Educating workers about this benefit will be key to the adoption of MyHealthSavingsUSA because employers typically pay the largest portion of health expenses for employees and their dependents. As part of the program, MHI supplies employers with a private web-page to be hosted on the employers' benefits intranet, as well as provide them with materials to be used as paycheck inserts, newsletter articles and come to the work site and offer an informational session or a video that can be used for new hires during standard orientation sessions. But the concierge service interaction to shop prices is conducted by a Care Navigator familiar with each company's benefits, plan limitations and exclusions and network providers. Calls generally take no more than about 4 minutes start to finish. If there are medical questions about tests, preps, and so forth, a registered nurse adviser is available to review fasting or other requirements.
Several U.S. markets with university-affiliated teaching hospitals and facilities with geographic monopolies have been among the highest paid. PPOs have attempted to reign them in with tough negotiations but in some markets, the provider leverage prevails. This program will spotlight highly competitive providers who support more openness on pricing to enable the market to appreciate their lower pricing and high quality. The tool contributes to transparency and with a quick and simple toll-free, voluntary phone call, helps consumers to make rational health care purchase decisions.
Todd expects that brokers and agents will be able to sell this tool and rapidly grow market share while driving down health care costs, one consumer at a time. "This becomes a conversation in the break room - ‘I just got a check for $75!’ ’’ she said.
MHI Benefits Group is a subsidiary of the Mercury Healthcare Companies.
Self-funded employers and unions benefit from tools we offer through brokers and agents that immediately lower healthcare spend for routine health services representing 30% of employers' total claims spend.