Telehealth, Advocacy, & Other

Non-Insurance Benefits Your Clients Need Now

Reid Rasmussen

1  

Ups & Downs of Benefits in 2014+

Medical Rates

OOP$ Employee

Contribution

Doctors First Dollar

Services

HR Time

What Are Non-Insurance Services?

Discounts Lifestyle Telehealth / Advocacy

3  

What is Telehealth?

Call 24/7, consult with a U.S. doc

& get a prescription written, if needed.

This is NOT Insurance.

with or without consult fee ( )

How Much Can Telehealth Save?

2 out of 3 doctor visits can be handled by phone 3.4

0.4 71% ER patients didn’t require emergency attention, Truven Health Analytics, 2013 70% or more Dr. Office visits are unnecessary, WELCOA, 2008

5  

This is NOT Insurance.

Average medical savings per call: $237 Cost of 4 hours lost productivity: $88

……………………………..……………………..………………….…………………

EVERY CALL SAVES: $325

!!!!!!!!!!"!!!!!!!!!!"!!!!!!!!!!"!!!!!!!!!!"!!!!!!!!!!"!!!!!!!!!!"!!!!!!!!!!"!!!!!!!!!!"!!!!!!!!!!"!!!!!!!!!!"

If they didn’t use Teladoc, where would these people have gone?

*Per Teladoc member reporting. Individual results may vary.

8% ER Visit ……………..……

42% Urgent Care ……………..……

39% Office Visit ……….……….…

11% Do Nothing ………..…………

$1,477/visit

$163/visit

$131/visit

What would these visits have cost?

$? Unknown future cost of neglected issues

How Does Telehealth Save?

Discounts Lifestyle

7  

Telehealth / Advocacy

What Are Non-Insurance Services?

What is Advocacy?

A health advocate helps consumers

navigate “the system”: medical care, price transparency, bills, insurance, & more!

This is NOT Insurance.

Unbiased advice & expert guidance!

8  

obtain 2nd opinion consults

research conditions & treatments

get cost estimates

assist with eldercare

negotiate medical bills

resolve claims ?s & issues

find health & dental providers

schedule appointments & transfers

9  

How Does Advocacy Help?

MEMBER ISSUE 2:

A member needed an MRI & 2 ultrasounds. Her doctor referred her to an imaging center that would cost $800.

RESOLUTION:

The member asked her Advocate if this was the best option & he found estimates with 2 other local in-network centers for $600 or $950.

Original Cost: $800 Selected Cost: $600

How Does Advocacy Save?

MEMBER ISSUE 1:

A member required care at an out-of-network ambulatory surgery center.

RESOLUTION:

Negotiation saved significant amounts off usual charges. Plus, the provider agreed to accept lower fees & not balance bill the member or the plan.

Billed Charges: $60,715 Negotiated Amount: $40,072

34% SAVINGS:

$20,643

EMPLOYERS & EMPLOYEES SAVE TIME, MONEY & FRUSTRATION!

25% SAVINGS:

$200

38% SAVINGS:

$1,245

MEMBER ISSUE 3:

Following surgery, an employee received a large bill from a non-participating anesthesia group.

RESOLUTION:

The Advocate negotiated an arrangement that reduced the member’s responsibility.

Billed Charges: $3,275 Negotiated Amount: $2,030

What Are Non-Insurance Services?

Discounts Lifestyle Telehealth / Advocacy

11  

 Where Did Discounts Come From?

•  20+ Year Industry •  History of Resellers •  2002: “Consumer Health Alliance”

– Discount Medical Plan Organizations – Compliant to Oklahoma Regulators

What Are Non-Insurance Services?

Discounts Lifestyle Telehealth / Advocacy

13  

Case Studies

don’t sell a product

solve a problem

12x2=1,000

TN Agent

Ease move to higher OOP$

1,000+

Small Agent East Texas

ASK: With every medical case

1,200

Aspect Software

Keep employees at work & engaged

*Non 5500-able

52 : 28

Small Manufacturer

Benefit for non-medical employees

18  

Dallas Broker

Prospect with fresh strategy

19  

18 mo 13

300 Rural

North State Grocery

Large groups save claims $

20  

Non-Insurance Benefits

Your Clients Need Them Now

Reid Rasmussen

21