From an employee point of view, the idea of having to travel to a "Center of Excellence," unless it is local, is batshit crazy. Boeing (in Seattle) was - maybe still is, I don't know as I'm ten years retired - touting the Cleveland Clinic as a "Center of Excellence" for certain procedures. What? Employees in Seattle, likely with families, are supposed to go TWO THOUSAND MILES away for something that is available in multiple hospitals within a ten mile radius? And be without any personal support unless they can somehow manage to bring another person or two along with them? Whatever this is, it is NOT a sane method of providing needed health care. Please, try again.
Great post. We have been using RBP for hospitals for years. It saves a lot of money for the plan and our members and families. We have explored direct contracting but we have lots of small groups scattered over broad areas and many hospitals/providers want a minimum guarantee. We have recently implemented second bill review and are finding substantial reductions on hospital bills in particular. We are about to implement a national bundle for most surgeries and for imaging which we hope will provide considerable opportunities for our members to save money with us. But I will attest that it takes a lot of time and energy to defend RBP and occasionally litigate when certain hospitals/health systems. But our incentive is to pay 100% if done via a bundle and 90% if they use our preferred network and to cover all travel related costs if member will go to a center of excellence in our bundle or otherwise save the Plan a lot of money. All of these things have allowed to keep our costs well below other commercial plans, whether fully insured or self insured. But self insured gives us the ability to do all of the things I have noted.
Susan, regular readers of our Health Care Uncovered newsletter are often warned about Medicare Advantage plans under Part C like the one you mentioned because of the same tactics Big Insurance follow in the commercial market, which involves preauthorization and claim denials -- tactics used to deny care. Traditional Medicare doesn't play those games.
Patrick, much like Lester you are part of a quiet revolution that is making high-quality health care more accessible and affordable. Glad to know you've made some nice progress implementing these approaches.
My intention was twofold: focus on the novel solutions that Lester employs in his client work (something not enough employee benefit advisers do) and cast a light on his revealing back story, which explains why he decided to pursue this line of work. Lester's realization that he was part of the problem earlier in his career and wanted to instead become part of the solution is inspiring and newsworthy. There's nothing promotional about that.
From an employee point of view, the idea of having to travel to a "Center of Excellence," unless it is local, is batshit crazy. Boeing (in Seattle) was - maybe still is, I don't know as I'm ten years retired - touting the Cleveland Clinic as a "Center of Excellence" for certain procedures. What? Employees in Seattle, likely with families, are supposed to go TWO THOUSAND MILES away for something that is available in multiple hospitals within a ten mile radius? And be without any personal support unless they can somehow manage to bring another person or two along with them? Whatever this is, it is NOT a sane method of providing needed health care. Please, try again.
Great post. We have been using RBP for hospitals for years. It saves a lot of money for the plan and our members and families. We have explored direct contracting but we have lots of small groups scattered over broad areas and many hospitals/providers want a minimum guarantee. We have recently implemented second bill review and are finding substantial reductions on hospital bills in particular. We are about to implement a national bundle for most surgeries and for imaging which we hope will provide considerable opportunities for our members to save money with us. But I will attest that it takes a lot of time and energy to defend RBP and occasionally litigate when certain hospitals/health systems. But our incentive is to pay 100% if done via a bundle and 90% if they use our preferred network and to cover all travel related costs if member will go to a center of excellence in our bundle or otherwise save the Plan a lot of money. All of these things have allowed to keep our costs well below other commercial plans, whether fully insured or self insured. But self insured gives us the ability to do all of the things I have noted.
What about people on Medicare? My Arizona State Retirement System is in with UnitedHealth group and part C.
Susan, regular readers of our Health Care Uncovered newsletter are often warned about Medicare Advantage plans under Part C like the one you mentioned because of the same tactics Big Insurance follow in the commercial market, which involves preauthorization and claim denials -- tactics used to deny care. Traditional Medicare doesn't play those games.
Patrick, much like Lester you are part of a quiet revolution that is making high-quality health care more accessible and affordable. Glad to know you've made some nice progress implementing these approaches.
I'm sure it was not intentional, but this reads like an paid ad for this particular broker.
My intention was twofold: focus on the novel solutions that Lester employs in his client work (something not enough employee benefit advisers do) and cast a light on his revealing back story, which explains why he decided to pursue this line of work. Lester's realization that he was part of the problem earlier in his career and wanted to instead become part of the solution is inspiring and newsworthy. There's nothing promotional about that.