Saul Marquez, Host at Outcomes Rocket Podcast

Transforming Employer-Sponsored Health Plans

Wednesday July 1st 2020

Transforming Employer-Sponsored Health Plans

Transforming employer sponsored health plans


As customers, we want to know exactly how much an item or service is worth before purchasing it. In fact, we spend hours on the Internet reading reviews on the products or services we intend to buy. We even compare prices from other retailers to make sure we find the most affordable price for the best quality.


So why is it that when it comes to healthcare costs, we do not shop for it the way we normally do? 


If you have a fully insured health plan, you will not even know how much a specialist consultation costs. Yes, the bill reflects the total billed amount and the payment savings, but it will not show the list of services and the amount it cost, except for those under a Medicare advantage program. 


With healthcare being so expensive, don’t you think it is about time that we know exactly how much we are paying for what services?


An Alternative Solution to Reduce Cost 


If you are a payer seeking to lower your company’s health cost, Next Impact presents an alternative solution. 


Next Impact is a full-service employee benefits and human resource marketing and consulting company committed to helping other companies grow and add value to their clients. It was founded by Lester Morales, a true consultant in the Human Capital and Employee Benefits Arena. 


I had the pleasure of interviewing Lester at the Outcomes Rocket Podcast and he shared how Next Impact is helping companies reduce their healthcare expenses. 


“It all came from being able to see what the difference is when you talk about reimbursement for services that are being provided. If you are an employer, you sponsor a plan. You provide health care coverage for your employees. How do you know how much that knee surgery costs?”


“And I became fixated on that question after having my knee surgery. How does one not tell you how much it costs? And you start to understand how rates are set and the differences between what a hospital takes from Medicare versus what they are billing at. And it is four, five, six, seven, eight, nine hundred percent difference. And you become flabbergasted.”


“So I learned about the structuring and the building of health plans not using traditional insurance companies, so stepping outside of the PPO contracts and using direct contracting, using bundled and cast payments, using reference-based pricing, using some transparent model of reimbursing for services so that we can do the one keyword that is completely missing in this very opaque industry, which is transparency,” Lester explained.


Transparency is a huge issue in U.S. healthcare. 


Just three days ago, The New York Times reported that a federal judge agreed with the government’s decision to require hospitals and health insurers to publish their negotiated price for health services. 


The list of things to publish includes the list prices, negotiated rates with insurers, cash discount prices, and minimum and maximum negotiated charges for 300 “shoppable” services. 


The policy was designed to improve transparency in health care, which would lead to lower and more predictable prices.


The AHA, of course, was undoubtedly disappointed by the decision and said that it will appeal to the care, so let us wait and see what is going to happen. 


Innovative Ideas for Lower-Cost Healthcare


Next Impact is disrupting the traditional health insurance system. It provides steps your business can take to make healthcare a controllable cost. By following those steps, you can take control of your health insurance expenses. You will know exactly where every penny goes.


Whether you are the CEO of a large company or the manager of a small startup, if you provide healthcare insurance for your employees, you should look at what Next Impact offers. 


Click here to listen to my stimulating interview with Lester Morales : https://outcomesrocket.health/nextimpact/2020/06/.


Written By

Saul Marquez

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