PPO's. Do Employers and Employees Have a Cost-Saving, Quality Alternative?

                                           Yes. RBP --                                         Reference-Based-Pricing is the Compelling Solution                                                                                                                                                     But First: The Failures of the PPO System.

Put simply, the Preferred Provider, Organization healthcare model, representing more than 90% of the providers in most markets, has failed in the two areas it promised to cure:

(1) exclusivity of providers, based on the quality of their care, and 

(2) equitable negotiated cost-for-service.

The PPO model has resulted in extraordinary and opaque cost increases year-after-year; it is a runaway train with no foreseeable end and ever-diminishing healthcare quality.

                                                                              Moving On:                                                 The Compelling Solution: Reference Based Pricing (RBP)

RBP has had a long run—more than 20 years. It has become the most compelling solution to healthcare affordability and quality care. 

How? The transparent RBP model charges buyers—the Employers and Employees— a maximum “reference” price for healthcare services based on 140% to 150% of the Medicare schedule of claim payments. The Employer's TPA determines fair, fixed prices for quality care, not the providers.

The best part? In the first year, Employers and Employees save between 20 to 40% by implementing an RBP program. Thereafter, incremental annual increases are based on inflation.

The RBP model is cost-effective and consumer-centric providing Education, Communication, Enrollment, and Data Management to Employers and Employees for successful and Ongoing Implementation and support.

Want more information?
Let’s talk to see if the RBP Solution can work for you.😀

Philip W Eide, Eureka!!, President   .   Mobile/Text: 216.577-5579    Email: phil@vestabp.com   .   www.vestabp.com

Can Brokers & Employers Reduce Health Plan Costs & Increase Quality?

  

Yes - Eureka!! offers Brokers and Employers a Proven, Sustainable Solution to a Nagging Problem!

How to Reduce the High Cost of Health Plans and Employee Benefits while Increasing Employee Satisfaction?       

The Eureka!! Solution – Reference Based Pricing (RBP) -Reducing Costs by 20% to 40% or More! 

We Combine RBP with a time-tested System for Employee Education, Communications, Enrollment, Data Management & Ongoing Service! 

What's wrong with existing Health Plans?

6 Factors that Contribute to High Costs:

     1) Hospitals, Medical Centers, Healthcare Providers & Drug Companies(PBMs) have long been raising prices at will! Brokers and Employers are unable to negotiate prices with these entities.

     Our Solution - RBP eliminates wide variations in the cost of health care for Employees compensating providers equally for the same care.

     2) PPO Networks -- Fail to deliver reduced cost and improved quality of care for two main reasons: 

     a) In most markets, 90-95% of the available providers are “preferred”, meaning they are in the PPO plan. The bar for being preferred is clearly low.

     b) With most PPOs any provider of care can join the PPO and there is no discounting. Patients don't know how much services will cost until they are billed.                                     Our Solution - Our RBP Plan does not utilize PPO Networks - Our plan reimburses the same amount—no matter which healthcare provider members choose. So there's no need to worry about out-of-network charges.

     3) Health Insurance Plans -- Insurers are not positioned to negotiate provider pricing and have limited access to data. Insurers merely pass along costs to Employers and Employees.                                                                                       Our Solution - The RBP Plans provided by Eureka!! replaces the traditional Health Insurance Plan and the PPO.

     4) TPAs (for Self-Insured Plans) -- Have limited leverage or capacity to negotiate billings for services provided to Employers/Employees! They are at the mercy of Care Providers and Stop-Loss Carriers.                                                   Our Solution - Eureka!! utilizes TPAs who specialize in RBP and are seasoned in setting prices for health services instead of negotiating with providers. We select a TPA to meet the specific needs of the Employer and Employees and provide Concierge Services.

5) Brokers & Consultants -- Have limited understanding of the RBP Strategies and Plans. In addition, they find it difficult to explain RBP plans to Employers and Employees.                       Our Solution - We work with Brokers and their clients to understand the inner workings of an RBP strategy and Plan and the processes for implementation to generate significant savings. 

6) A Lack of Employee Education and Communication --Most Brokers and Employers do not have an integrated strategy for educating their Employees about the Health Plan and its utilization.                                                                             Our Solution - Eureka!! and our affiliates deliver a time-tested system of Employee Education, Communications, Enrollment, Data Management combined with Ongoing Service. We empower the Employer's Management and  Employees to make informed, empowered decisions!   

RBP is a Strategy and Plan that Works!

If you are a Broker or Employer looking for a way to Reduce Costs, Better Quality of Care while providing Better Benefits, you can start saving now!                                                                 Note - If you're in the middle of a plan year - or have already accepted the best the insurers had to offer - you can start RBP now without penalties!

Let's schedule a time to discuss the above and your options -- 

Phil Eide -- Message/Text - 216.577.5579 / Email - phil@vestabp.com / www.vestabp.com