We understand the challenges you face
Employers are under immense pressure to significantly reduce healthcare costs, while offering a quality benefits package that attracts and retains top talent. Continued pressure from increased healthcare costs, tighter budgets and an ever changing workforce will affect your bottom line and the employee benefits offered to your employees.
As your employee benefit and wellness partner, we work alongside our clients to develop a multiyear strategy that addresses your short and long-term goals. Every client has a multidisciplinary team of data analysts, health coaches, nurses, benefit specialists, compliance and other employee benefit and population health management professionals to manage all aspects of your employee benefits program.
Employee benefits is not a one size fits all
We design competitive and cost-effective employee benefit strategies that drive sustained, positive behavior by encouraging members to participate in wellness activities that deliver healthier outcomes, greater productivity and lower costs.
We also provide the tools and services to make healthcare delivery and consumption more efficient and understandable for our members.
Strategies that drive value, claim savings, and positive health outcomes
Unnecessary medical procedures: A large discount on a medical procedure or service that never should have been performed is medical waste. Your claim data feeds a care management intelligence system that triggers interventions to help your employees get the right care at the right price.
Our long-term strategies reduce the impact of significant rate increases through negotiated terms and conditions in stop-loss contracts and through our captive solutions, which also offer annual rate caps and the elimination of future lasers, thereby providing greater stability and reduced volatility of self-funded programs.
Nurse Advocacy Services
Denied claims, confusion with providers and carriers, and miscommunications are stressful for members and their families. These situations create the perception, whether right or wrong, of a poor benefits plan, which ultimately reflects on the employer.
Our nurse advocates work with members on claim disputes, denied pre-authorizations, understanding their benefits, and acting as the members liaison between the doctor, hospital and carrier, thereby eliminating stress to the employee and HR.
Pharmacy Benefit Management
We design innovative, affordable and flexible solutions that control rising pharmacy costs.
Our prescription strategies are custom designed to meet the financial and quality care needs of our clients and their employees. Our pharmacy solutions include:
Driving Better Health Outcomes While Reducing Overall Cost
We design specialty programs and services that reduce medical cost and deliver appropriate care. In addition, we work with centers of excellence (COE’s) to help avoid unnecessary and inappropriate surgeries through better diagnosis, appropriate treatment facilities and a multidisciplinary, team based approach in the evaluation and treatment of patients.