Overview
Skyrocketing health care costs are a growing national crisis, impeding business operations and imposing financial hardship on employees. Traditional insurance cost saving strategies (steeper provider discounts, higher co-pays and deductibles, etc.) do little more than shift the cost burden to those least able to afford it and have proven ineffective at changing the cost curve of health claims.
The complexity of integrated, broad-based solutions is daunting, and subject to substantial legislative and regulatory uncertainty. However, many forward thinking organizations have tried to address their cost concerns using local arrangements designed for the specific community demographic needs to mitigate problematic cost trends, particularly in certain key clinical areas, such as:
- Enhanced Primary Care access utilizing provider centric patient outreach
- Focused RX Management, including adherence and cost reduction strategies
- Prefatory and point-of-service Emergency Department diversion alternatives
- Integrated Hospital/Provider ventures to enhance patient and population health outcomes, particularly within discrete, definable populations
- Integrated Chronic Condition Management
- Use of FQHC Provider Networks
