In-Network Steerage Strategies for Employer-Sponsored Health Plans

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AHealthcareZ - Healthcare Finance Explained

AHealthcareZ - Healthcare Finance Explained

2 ай бұрын

In-Network Steerage Strategies for Employer-Sponsored Health Plans.
This video is the sequel to the previous video 'Get Serious About Healthcare Costs' Link HERE: • Get Serious About Heal...
Low Value Specialist care is one of the Largest drivers of Employer-Sponsored Healthcare costs. Low Value... as in Low Quality and High Cost. Therefore, steerage AWAY from Low Value Specialists and TOWARD High Value Specialists is an important solution.
Employee health plan members ARE going to be steered... Either by the Health Plan or by the local Hospital Systems. It's not a question of 'If.' It is a question of 'By Whom.'
Health Plan steerage ranges from Most (HMO with PCP Gatekeeper) to Least (PPO with low deductible and copays). In between are 1) Narrow Network, 2) On-Site/Near Site Clinic and 3) Tiered Network Strategies.
Hospital System steerage ranges from Most (Hospital Employed PCP, Hospital Owned Urgent Care, Hospital ER) to Least (Independent Physician Practices).
The current combination of the Least Health Plan Steerage (PPO) and Most Hospital Steerage (Hospital System PCP, Urgent Care, ER) results in the highest cost, lowest value healthcare for employees and their employer-sponsor health plan.
Video on Purdue University strategy to lower healthcare costs: • Employee Health Plan C...
AHealthcareZ is 400+ Healthcare Finance Educational Videos.
💥 BOOK: Check out Dr. Bricker’s Book 16 Lessons in the Business of Healing here: www.ahealthcarez.com/healthca...
AHealthcareZ Viewers Include: Employee Benefits Professionals, HR, CFOs, Insurance Brokers, Benefits Consultants, Doctors and Nurses in Leadership Roles, Hospital and Health System Administrators, Health Insurance Carrier and PBM Professionals, Pharma and Med Device Professionals, Academic Professors and Students in Healthcare Administration and Public Health.
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Пікірлер: 17
@sas20101
@sas20101 Ай бұрын
You are awesome Dr. Bricker. I am a hospitalist physician with MBA and very business minded and see all of the waste in healthcare.
@ahealthcarez
@ahealthcarez Ай бұрын
Super! We need your help!!
@claashorst
@claashorst 25 күн бұрын
Many thanks for information & clarification!
@ahealthcarez
@ahealthcarez 25 күн бұрын
Thank you for watching.
@nathanshatzer1646
@nathanshatzer1646 Ай бұрын
Great diagram and explanation. Very helpful video
@ahealthcarez
@ahealthcarez Ай бұрын
Thank you for watching and for your feedback.
@abdelmahmoudMD
@abdelmahmoudMD 2 ай бұрын
Awesome video as always, the continuum layout you did captures it v. well!
@ahealthcarez
@ahealthcarez 2 ай бұрын
Thank you for your feedback.
@davidpauer1108
@davidpauer1108 2 ай бұрын
Dr Bricker. Very insightful. All members on an employee health plan already experience steerage - health plan administrators need to make sure its navigating toward high quality care and away from low value care.
@ahealthcarez
@ahealthcarez 2 ай бұрын
Thank you for watching and for your comment.
@njhealthinsurancepro
@njhealthinsurancepro 2 ай бұрын
How do you suggest they do that? It doesn't seem the tools are available for folks that aren't in a large self funded plan. Is there anything else out there you suggest for finding high quality providers? Or what to look for to avoid "bad" ones?
@robertycmat3034
@robertycmat3034 2 ай бұрын
Thanks Dr. Bricker. On your hospital steerage continuum, where would you place IPA-affiliated physicians or practices, between independent practices and JVs, or elsewhere? Yet another good video!
@ahealthcarez
@ahealthcarez 2 ай бұрын
Yes, that’s a good spot… between Independent and JV.
@user-pw2qm2zk6b
@user-pw2qm2zk6b 2 ай бұрын
Interesting question.
@jessicamillerr
@jessicamillerr 2 ай бұрын
Hey! 🌵🌵🌵🌿☘️ KZbin recommended one of your videos, and I must say, you post awesome stuff. I love it, and I want to see you on top! By the way, I was wondering if you or your friend need a video editor or thumbnail designer. I am Mohan, a professional video editor and thumbnail designer with 4.5 years of experience in creating engaging and high-quality videos and thumbnails for KZbin. If not, please reply with "NO" and I will remove you from my follow-up list. Keep creating amazing content! Best regards, Mohan
@ahealthcarez
@ahealthcarez 2 ай бұрын
NO
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