3. Educate your client on the options to improve plan performance and claim spend

Clients expect the annual renewal increase, but that doesn't mean they like it. Imagine their reaction if you show them options that reduce spend. Talk to your clients about:

Reference-based pricing (RBP). Most RBP solutions start with the amount Medicare would pay for a service and add a percentage to establish the reference price. In doing so, they guard employers and members against potentially inflated and unpredictable charges for treatments. Use an interactive calculator to run through different savings scenarios with your clients to demonstrate the long-term revenue impacts of an RBP model.
Pharmacy alternatives. Pass-through PBMs, formulary substitutes, and specialty Rx solutions can yield six-figure savings for 200-EE Plans, with little disruption to members.
Direct contracts. Employers can select and negotiate directly with health systems, hospitals and doctors to establish cost-competitive rates and drive members toward high-quality providers. In addition, many providers are tired of the "middle-man" big box insurance carriers and welcome direct relationships with employers within their communities.
On-site or near-site clinics. Convenient access to medical services can improve employee health, control costs and increase productivity. Employers with a concentration of covered members have seen success with on-site and near-site clinics, reducing health care costs by 64%, reducing time lost from employees leaving work for medical appointments by 70%, and lowering emergency room utilization by 63%.
For employers with a more widely distributed or remote workforce (in industries like trucking, for example) telehealth may be a strong option. Nearly 9 out of 10 employers now offer access to remote medical care. Online medical services available today extend beyond primary care to include physical therapy, mental health counseling and even access to ER doctors.

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