There are many ways a TPA is involved in managing plan costs, but two things immediately come to mind when considering this question. The first is health claim review and how diligent TPAs are in monitoring member claims to identify any discrepancies or problem areas. If you haven’t heard me say it before, this is often an area where huge savings are realized.
The second area, and the one I’d like to focus on here, is the strategic third-party partnerships TPAs form with the end goal of teaming up to help clients save money. I’m speaking on behalf of Cypress when answering this, of course, but I know that many TPAs across the country are just as thorough about choosing the companies they partner with. These affiliations are a critical factor in making savings opportunities a reality.
I like to describe our partnerships as “best-in-class.” Once we identify an area with real savings potential for our clients – take telemedicine, prescription cost management or on-site medical services for example – our job as a TPA is to find the partners that offer the best, most effective solutions. This can happen through referrals or our own research and discovery. It isn’t just an automatic “yes” to partnering, though. The process involves studying the history behind those companies, getting to know their teams and evaluating just how well our philosophies match up.
For Cypress, these partnerships aren’t taken lightly. Our goal is to identify companies that follow the same forward-thinking approach as we do, with a focus on quality and a willingness to embrace new technologies. It’s also important for us to understand how a prospective partner has helped its clients experience cost savings and what kind of impact these added dollars have had.
Let’s go back to that telemedicine example I referenced for a minute. Cypress currently partners with Teladoc. This benefit option gives our clients the ability to save considerable amounts of money by offering members 24/7 access to a physician through electronic channels at a cost-effective price. Teladoc has a 95% member satisfaction rate and it’s the only telehealth company to be certified by the National Committee for Quality Assurance (NCQA) in any category so far.
How’s that for a best-in-class partnership that’s focused on keeping plan costs down?