In-Network Steerage Strategies for Employer-Sponsored Health Plans

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...
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[@claashorst]

Many thanks for information & clarification!

[@ahealthcarez]

Thank you for watching.

[@nathanshatzer1646]

Great diagram and explanation. Very helpful video

[@ahealthcarez]

Thank you for watching and for your feedback.

[@sas20101]

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]

Super! We need your help!!

[@davidpauer1108]

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]

Thank you for watching and for your comment.

[@njhealthinsurancepro]

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?

[@abdelmahmoudMD]

Awesome video as always, the continuum layout you did captures it v. well!

[@ahealthcarez]

Thank you for your feedback.

[@robertycmat3034]

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]

Yes, that’s a good spot… between Independent and JV.

[@StephenGriffith-j1d]

Interesting question.

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[@ahealthcarez]

NO