- Strategic cost management of health care programs working with a broad spectrum of clients, ranging from the restaurant and hotel business to health care to high technology.
- Specialties: Creating, implementing and running health & welfare programs for companies ranging from 100 employees to over 5,000 focused on consumer-driven health plan education and adoption.
- Recipient of 2010 HR Symposium's Excellence in Partnership with HR award.
- All 7 Best Practices
- Pre-Call Discovery Process
- One-on-One Call with Expert
- Session Summary Report
- Post-Session Engagement
Consumerism and Transparency in the Health Care Marketplace
Consumer Driven Health Care occurs when providers of health care adapt to the new environment where users become more aware of the cost and quality issues in health care and factor them in when making choices about what health-care providers to use.
- Claims experience
Claims experience is the pattern of how a group of insured patients sees health-care providers and creates claims against their health insurance. A high level of claims experience can be a negative for an employer that subsidizes employees' health insurance.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers who lose their health benefits the right to continue those benefits for themselves and their families for a certain amount of time, depending on what life event caused the benefit loss.
Participants in a High Deductible Health Plan are responsible for a larger amount of their health care expenses than participants in a more traditional plan, such as an HMO or PPO. In exchange, the premiums for a HDHP are typically much lower.
- Health care consumerism
Health care consumerism occurs when the users of health care become more aware of the cost and quality issues in health care and factor them in when making choices about what health-care providers to use.
A Health Maintenance Organization is a health-insurance plan that typically requires its users to first see a primary care physician and obtain a referral before seeing a specialist. Because of this restriction, an HMO typically charges lower premiums than a PPO.
Health Reimbursement Arrangement: An HRA is similar to an HSA with two exceptions. The person who benefits from the HRA can't contribute his or her own money. And unlike an HSA, where the employer contribution "vest," or belong to the employee as soon as they are made, the balance in the HRA goes back to the employer if the employee leaves the company.
Health Savings Account: The owner of an HSA can use money in the account to pay for a wide variety of medical expenses. Both the person who owns the account and that person's employer can contribute to it. Contributions by the account's owner are tax-deductible, and money withdrawn from the account is tax-free when used for eligible medical expenses. Money in the account "rolls over" into the next year.
A Preferred Provider Organization is a health-insurance plan that allows its users to visit a wide range of health-care professionals, including specialists, at the users' discretion. PPOs typically charge higher premiums because of this flexibility.