Tom's Take Blog
June 27, 2019
How can benefit plans gain some control over the high cost drivers in health care?
Tom’s Take: This is an age-old question that we’ll probably be asking for years – decades even – to come. But before we tackle the how, I think we have to first consider the what … as in “what’s driving costs so high?”
A recent report from Milliman sheds some light on this as it lists the following as the four primary drivers of care costs:
- Hospital Care, 31%
- Physician Services, 29%
- Outpatient Surgery, 19%
- Prescription Drugs, 17%
So how does a benefit plan go about lowering the amount spent on things like hospital care and physician services … costs that may seem somewhat difficult to influence?
This is where all those cost containment solutions I’m often talking about come in!
Think about it for a minute. How can spending be affected if your health plan offers a telemedicine option or focuses on benefits education? A lot! Having a member call in for a consult with a physician instead of going straight in for treatment can be more cost-effective than a trip to urgent care or the ER. And when member outreach/engagement services are emphasized? A little education can mean the difference between a member settling for a high-cost, name-brand drug and inquiring about a more economical generic option.
As overwhelming as it can seem to try and rein in care costs, there are so many ways benefit plans can be proactive in the effort to lower them. Have you taken a good look at what you’re doing to manage costs lately? Now is a great time to do so!
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