Below in the BOX is a list of resources that you can use to understand what “EHB” or Essential Health Benefits are and how they work, who is respondible for providing them and who is exempt.
Posts Tagged Wellness
Below you will find an interview with John and Keesha McCue and the story of their Daughter as they experienced dealing with a Significant Health issue that dramatically changed their family forever.
VIDEO INTERVIEW of KETA JO, JOHN, and KEESHA.
There are no silver bullets or quick fixes but there is a recipe and it tastes good and is healthy. Even if the feds take over insurance there is a role for leaders to lead.
If you would like to see some eye popping data on the value of work-site clinics, just contact BILL CRIMMINS (see below)
The root problem in health care costs defined is lifestyle: thinking and actions by membership. It’s the same old stuff…think right, eat right, exercise, don’t do certain behaviors, sleep enough. All the things your mom told you. Your heart told you.
Any solution will incorporate a system and people that can influence membership to the extent that they take responsibility for their own life and health and do the right things. It may have simplistic characteristics but in reality it will be a well orchestrated effort and balance of simplistic tools synced with timing tools like a finely tuned engine or orchestra.
The most significant tool available today that creates an environment for change and potentially creates a win/win situation for all involved if managed by the most appropriate team without conflict of interest…Work Site-Clinics. It’s not the be all by itself but it may be the Keystone that can be a dynamic and central part of the solution.
It appears from all the data that by itself even if not carefully managed that the work-site clinic model saves money significantly. Like many strong foundational tool’s it has the potential to significantly impact all the players positively. However if not carefully laid (managed) it can become another reproduction of the current system and may prove to be a passing phase.
So…how can you help make your work-site clinic pay off for the long term? Really make a difference?
Make sure it’s managed by people who have a mission and vision to positively influence change in membership and the provider community. They must want to play a role in creating a win/win for all involved.
Make sure they have no conflict of interest beyond being a reasonably profitable business with staying power.
Make sure they charge you enough to do the job correctly. You really do get what you pay for. Don’t be penny wise and pound-foolish. The work-site clinic can be done within your clients current benefit budget but the base pricing may not be enough to really orchestrate the kind of strategy needed to take advantage of the possibilities.
Some examples of tools that will compliment work-site clinic efforts include but are not limited to: A powerful and cooperative benefit administrator, a willing and cooperative provider community partner(s), a reasonably discounted network, a reporting engine that captures clinical and financial data that becomes actionable, a wellness and disease management firm that syncs and is integrated into the medical practices of the provider community and work-site clinic and coaches members visiting the clinic and even those not visiting the clinic, an independent data base that helps members distinguish the highest quality providers within your network of providers, a communications company that reaches out to your membership in their homes not only telephonically but via mail and email so that members are reached where they live out the behaviors we need them to embrace.
Make sure they have reporting tools that will hold you, your membership and all the players accountable.
Don’t be afraid to pay for these services. I can assure you, even if you pay’s the full retail price for these services you will be paying less than every company not using these services.
All these tools independently have impact but synchronized and integrated will powerfully influence members to do the right things. This will have long-term productivity and cultural dividends for employers who want to win over the long haul.
Let me know how I may assist.
Bill Crimmins - Ambassador (Ofc: 765-720-0392)
Bill Crimmins is an experienced consultant serving national markets with a wide array of wholesaling services, he works with brokers, consultants, vendors, TPA’s and Employers to facilitate the changes needed for cost reductions for employers and employees by helping create happy, healthy cultures espcially as it relates to integrating wellness programs with insurance benefits.