If you are an employee benefits broker, you know how challenging today’s healthcare environment is. In a highly competitive industry with a heightened degree of uncertainty because of COVID-19, the pressure is on like never before to prove your value to your customer (the employer).

Value is the key. Employers are in desperate need of innovative solutions that can:

  1.     Aggressively reduce health benefits costs
  2.     Provide personalized member care 24/7/365

If you can help your customers meet these goals, which appear mutually exclusive, then you are gold. Fortunately, value-based pricing (VBP) proves employers don’t have to choose between cost savings and a high-quality customer experience for employees.

RBP Without the Negatives

VBP plans, the latest generation of reference-based pricing (RBP), deliver 25% to 30% savings the first year, then hold health benefits costs steady and below the average rate of increase. VBP plans deliver many of the same benefits of previous RBP plans, without negatives like hidden fees and balance billing problems.

Increasing numbers of employers nationwide, many of whom are moving toward self-insuring?or providing healthcare services directly to employees?are integrating VBP into their plans. This gives them flexibility in fine-tuning details to meet their individual needs rather than trying to implement a cookie-cutter template.

Whatever the specifics, VBP plans leverage:

  • Careful attention to the healthcare status of employees and their families, with an increasingly holistic approach
  • High levels of personal attention, including expanded use of telehealth
  • Better use of data from both the individual and the larger community

This strategy emphasizes high levels of service from a care team, plus the power of real-time data to better inform decision-making. This comprehensive information, shared nightly with the care coordination team and assimilated into existing data, enables the care team to better help employees and their families manage their health, especially complex or chronic conditions.

And a value-based plan design can encourage employees to get care for chronic conditions before they escalate (and become even more costly, both physically and financially).

VBP’s Time Has Come

“The COVID-19 pandemic … has highlighted like never before the pitfalls of paying for healthcare based on the number of patients seen and services rendered,” Modern Healthcare reported in a June 13 story. “It simultaneously reinforced the benefits of financing healthcare in a way that’s tied not to volume, but to value.”

More recently, Modern Healthcare highlighted five attributes shared by several healthcare companies that remained financially strong despite the COVID-19 pandemic. Value-based contracts topped the list. For those with a higher proportion of revenue tied to such contracts, “money kept flowing even as volumes dried up” and procedures were put on hold. For providers that own insurance plans, “even as claims expenses dropped, premium revenue kept flowing.”

As the largest administrator of value-based pricing plans in the United States, Lucent Health offers deep knowledge and experience, dedicated VBP account executives, a dedicated eligibility specialist and member-centric VBP customer care support. Let us know if we can help you demonstrate your value to your customers with value-based pricing.

To hear more about how three companies were able to generate meaningful, sustainable savings for their businesses, while ensuring that employees were taken care of, watch our Webinar: Lucent Health’s Concierge and Complex Care Management Powered by Narus Health.

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