Question

cost and control strategies of self funded health plans fir ebrollment periods

Answer 1

Self funded health insurance plans are on it's rise in order to provide coverage for employee's health care services. In the scenario for maintaining a healthy work force the employers face significant expenses, if the issue is not been properly addressed. As per reports published by Integrated Benefits Institute around $227 billion worth productivity is lost due to the illness or illness related poor performance of the staff in hospitals.

Managing the expenses along with maintaining a healthy workforce is challenging. One method to reduce the expense is early identification. Periodic biometrc screening of employees helps in identification of risk factors at an early stage. There by employees under moderate or high risk groups can be enrolled for sponsored health schemes, which reduces the expenses and as they recover they will fall in low risk category without any compromise in productivity.Managing chronic illness among employees already diagnosed with such illness also prevents deterioration of health and reduces expenses. Two factors that keeps individuals away from health care services are accessibility and convenience. By sponsoring the health care needs, individual expenses also will be lowered and providing easily accessible services improves utilization of such services at an earlier stage and with an improved health status employees can concentrate on patient care better.

Periodic audits on medical claims can rule out fraudulent claims and helps to determine if the self funded plan is functioning efficiently or not. Conducting review of billings with the provider may also prevent errors and saves additional expenses. Avoiding rushed payment may provide time to examine the bill for improper claims.Paying the scheme amount through third party intermediaries can save significant amount on payment of premiums.