Relentlessly rising healthcare costs are choking American businesses, and as a result they’re being forced to shift more and more of the cost of health insurance onto employees, causing employee contributions such as deductibles to skyrocket. One result of this is that even fully insured patients are finding it harder to access the care they need. Cost-shifting may seem like a quick fix, but in the long run all it does is drive up costs even further by forcing employees to put off taking care of themselves until an issue becomes really significant (and often really expensive).
At Flume Health, we’re taking a different approach, based on a simple but powerful idea: better health outcomes lead to lower healthcare costs. By orienting health coverage around outcomes, we’re able to drive down costs and improve employee benefits at the same time.
How do we do it? Our plans are designed using a three-part framework.
One in four Americans report that either they or a family member put off treatment for a serious medical condition in 2019 because of the cost. But delaying care doesn’t save money in the long run, because it just allows issues to get worse and, therefore, more expensive.
When our members choose to see Flume Community doctors, we waive their deductible and coinsurance obligations outright. That way out-of-pocket costs don’t prevent them from taking care of themselves. Our plans also include Medical Management to monitor members’ care and make sure they aren’t directed to unnecessary, harmful, or low-quality treatment.
Our 21st century technology platform monitors claims to systematically eliminate fraud, waste, and abuse. This provides immediate savings, allowing our clients to take a long-term approach to healthcare costs while also alleviating immediate pressures. In 2019 our clients saved an average of $5,646 per employee per year.
We’re focused on building long-term solutions. The best way to do this is to reinvest a significant portion of savings back into the member. This might mean writing down employee contributions or expanding free benefits. The important thing is simply that we continue to make it easier for members to access the care they need. The more we can tear down barriers to care, the healthier members become and the less they need to spend on healthcare.
Many businesses today are trapped in a vicious cycle. Big carriers increase premiums by double digit percentages nearly every year, forcing employers to shift more of the cost to their employees. As a result, employees are less able to access care and small health problems begin growing into large ones, which just drives costs up even further.
At Flume Health, we’re flipping this cycle on it’s head and creating a healthcare flywheel. By focusing on member outcomes and eliminating fraud, waste, and abuse, we’re able to deliver incredible savings. When employers invest those savings back into their employees’ health, they’re finally able to make the system work for them, not against them.
In the final installment of our recurring series on healthcare arbitrage, we round up a few other tactics which don't require as much ongoing involvement, but which can still provide important savings opportunities.
In the latest installment of our recurring series on healthcare arbitrage, we break down how plans can use disease management programs to reduce costs associated with chronic diseases.