How Much Do Employees Value Healthcare?

The mission of Captiva is to partner with your business to make purchasing benefits for your employees more affordable — and to make those benefits more effective for everyone involved. That means an approach that forgoes the status quo, using new business models and new methods in order to provide a benefit process that is the best case scenario for everyone involved.

With the costs of healthcare perpetually on the rise, there might be a temptation to forgo offering health benefits to employees at all. Unfortunately, many smaller businesses take that route.

However, that choice can cause real and lasting damage to both your employees’ satisfaction-- and your ability to hire employees to begin with.

According to a poll taken last year by Glassdoor, one of the leading job search services in the United States, benefits rank only barely below salary on the list of job seekers’ priorities. And a crucial part of any benefits package is the healthcare portion.

The reasoning isn’t hard to understand: no matter how good your salary is, a medical disaster can eat it up in a matter of days if you’re uninsured or underinsured. As a result, a lot of career advice is centered around the question of balancing a salary offer and a benefits package when choosing from a list of potential job offers.

Once you’ve attracted quality applicants to your business and hired them, ideally you’ll want to keep them there. Employee retention is a crucial part of any company strategy, as having employees stick around for longer often means that profits stay consistently higher. Having personnel continuity lends itself to more employee satisfaction and a smoother workflow.

According to a 2018 survey, the quality of the healthcare benefits are a significant factor in why more than half of employees stay at a given job. Their overall satisfaction was driven by the type of coverage, cost and how much control of options they had. But the number one reason for dissatisfaction? Cost.

Even if your employees don’t actually leave the company, the anxiety, stress and dissatisfaction of having inadequate healthcare is likely to impact workplace morale, which in turn reduces productivity.

Employees who do not feel like they are able to get health issues cared for before they progress to something extreme may ultimately find themselves facing costly bills and crises that make them unable to come into work for days or weeks at a time.

It’s clear that the cost of not having affordable, adequate healthcare benefits offered to your employees is real — both for the overall health of your company, and for every individual who is a part of it.

At Captiva, we can help you connect your benefit needs to solutions that will keep costs down and deliver effective care to your employees.

If you’re ready to get started implementing a system that will allow you to offer more for less spend, attract more skilled employees and keep them longer and confidently navigate a chaotic healthcare landscape, give us a call!

How Much Do Employees Value Healthcare? is courtesy of: www.captivabenefitsolutions.com

How to Beat the Pharmaceutical System

We’ve spent some time talking before about how legislation is developing to challenge out-of-control pharmaceutical pricing.

Developing that legislation is likely to be one of the key bipartisan meeting places at a time where one party holds the Senate majority and another holds the House. 

20-25% of most employers’ healthcare expenditures go to pharmaceuticals. As we’ve explained in the past, part of this is due to PBMs (Pharmacy Benefit Managers) incentivizing higher drug spends.

An oft-cited case study for this problem are diabetes treatments like Metformin and insulin. The price of insulin has more than doubled within five years — and many professionals believe that PBMs are to blame.

When it comes to insulin, the price point can be a matter of life and death. More and more stories are emerging about diabetic patients turning to black market sources or else attempting to ration their insulin, which often results in death.

Metformin, another primary treatment for blood sugar in diabetics, has also seen a dramatic increase. 

This obviously dire situation has quickly attracted the attention of lawmakers, who aim to prevent manufacturers and PBMs from continuing to drive up the prices. But for health benefit providers who are trying to cover the cost of their members’ vital prescriptions now, the legislative process can feel dangerously slow.

What can you do to protect your employees from those kinds of harrowing choices? Captiva and other companies adhering to the Health Rosetta are working to do exactly that by holding their partners accountable to a standard of transparency.

This model works by only partnering with PBMs who are willing to allow full access to the pricing data, accepting that purchasers have the freedom to use that data to shop around for the best possible prices. Better PBM contracts have been proven to reduce pharmaceutical spends by 5-10%.

Captiva partners with you in the process, helping you assess the available information in order to find the best possible price.

Captiva also assists in helping you understand and navigate the many moving parts of the pharmaceutical industry and PBMs, demystifying a notoriously opaque system. Understanding the forces that are driving drug prices up helps you circumvent the system — and pass those savings on to your employees in the form of life-saving necessities.

If you’re ready to find out more about how we can push back against the skyrocketing pharmaceutical prices together, give us a call.

How to Beat the Pharmaceutical System was first seen on: https://captivabenefitsolutions.com

How Concierge Style Care Breaks Open Healthcare Silos

One of the most frustrating parts of the healthcare experience for any patient seeking treatment is simply knowing where to get started.

There is a massive amount of information out there about hospitals, doctors and the services they offer, and sifting through it and establishing how to connect different services can be daunting.

Making an on-the-fly decision about where to start based on the symptoms you’re experiencing can be difficult, even impossible. This can ultimately cause further health complications as conditions go untreated and unchecked due to the inadequacy of the system in place.

This is the kind of scenario that you as an an employer want to prevent for your employees. We’ve explained how concierge style customer service in healthcare can do exactly that.

Let’s take a deeper look at how this type of care specifically combats healthcare information silos.

When we refer to care being in silos, what that means is that data is often stored in independent units, or “silos,” of information. Doctors don’t always talk to a patient’s other doctors and specialists. Hospitals don’t always communicate with other hospitals.

Picture each care provider as a towering, walled-in grain silo, holding granules of information that never travel from their container to any other nearby silos.

Healthcare silos have created a massive problem for patients to receive the care they need. Without specialists communicating well, tests are often repeated or symptoms are missed — causing frustrating delays.

Treatment can involved dozens of different healthcare professionals, and with the current standard model, those professionals are making decisions based on only partial information about the patient.

Even patients themselves might not have access to the best information about their own care to begin with, as we mentioned above.

Beyond the individual picture, healthcare as a whole suffers from the lack of information sharing. With access to fuller descriptions of cases, doctors could more quickly diagnose patients.

Often when assessing a complex situation, it’s not that data regarding prior case studies doesn’t exist for doctors to study. It’s simply that healthcare is structured so they do not have access to it.

Sometimes breaking down a systemic issue can start on the level of one patient at a time, and concierge style care is doing exactly that.

This concept encompasses a model where patients have access to information distilled down and personalized for them. It means direct relationships with care providers operating within a network streamlined to include the most important and effective care to patients.

Although concierge care has been offered by individual hospitals or doctors to patients, usually that kind of care is very costly and requires additional insurance for catastrophic scenarios.

In order to make concierge medicine both effective and affordable, Captiva’s model invites benefit providers to combine the concept of concierge care with reference-based pricing and the full support of the rest of the Health Rosetta components.

This approach keeps the cost down while still allowing for all the benefits of direct relationships between patients and their care team. This tight and transparent relationship between patient, doctors and benefit providers breaks down the information silos, creating clear communication.

If you want to understand more about how our model of care can help both your employees and their doctors make more informed decisions, we’re happy to answer your questions.

How Concierge Style Care Breaks Open Healthcare Silos was originally seen on: https://captivabenefitsolutions.com

Could 2019 Be the Year of Transparency?

We’ve been talking about the importance of transparency at Captiva for a long time.

Over the past few months, the rest of the country seems to have caught up, as new legislation requiring chargemasters to be posted publicly went into effect at the start of the year. The legislation is part of a snowballing bipartisan conversation on better legislation to encourage healthcare transparency.

Back in November, Gary Kaplan (CEO of Virginia Mason Health System) shared in an editorial for Harvard Business Review:

“I believe it is impossible to have complete transparency with patients without first developing a strong culture of internal transparency — among all team members, at all levels, on all issues — throughout the health care organization itself.”

Kaplan continues to unpack the ways that transparency is important not just for pricing effectiveness, but also for safety.

A culture of secrecy in healthcare often enables the same mistakes to keep happening, over and over, rather than being brought to light and fixed.

He concluded:

“In the United States, we have more information than ever about how to provide appropriate, high-quality care and keep patients safe. Transparency with internal and external stakeholders is essential for quality, safety, accountability, and informed decision making.”

Washington shares Kaplan’s perspective. So far, 2019 has held bipartisan efforts to address drug pricing transparency. 

Several members of Congress selected guests for the State of the Union address who were victims of balance billing (surprise medical bills when insurance doesn’t cover what a patient expects) or drug price disputes.

The conversation is going all the way to the top, with President Trump himself committing to end the often devastating impact of surprise medical bills. 

The question that more and more hospitals and healthcare providers are beginning to ask is how the big picture of new legislation will trickle down.

The chargemasters that the government required to be made public earlier this year are, as we discussed, not actually a great point of reference for what the cost of care will actually be. Some hospital CIOs are addressing the problem by also implementing cost estimators for patients to use. This allows consumers to have a better sense of what to expect heading into a hospital visit.

Those small changes are going to save patients and benefit providers like you big money. A recent study out of the University of Michigan revealed that when New Hampshire launched a healthcare pricing transparency website, consumers saved 5% and benefit providers saved 4%.

That was just one small effort in one state, with the results tracked over a 5 years period. Longterm, with more widespread measures introduced, those savings could be even higher.

What all of this means is that the time for benefit models like the one Captiva has built has finally come.

2019 might be the year when we see transparency championed not just in providers following the Health Rosetta, but all over the country.

If you’re ready to get started now in bringing this level of transparency to your employees’ healthcare, we stand at the ready. Let's talk.

Could 2019 Be the Year of Transparency? was first seen on: Captiva Benefit Solutions Healthcare Blog

Healthcare Job Increase Signals A Need For Efficient Care

As the 2018 year-end reflections turn towards 2019 predictions, one consistent theme is clear: the healthcare job market is growing, and it shows no signs of slowing down any time soon. 

Healthcare created a lot of new jobs in 2018 — 346,000 of them, to be specific. And the projection is for that growth to continue, with the Center for Health Workforce predicting a 20% increase in health care jobs from 2016 to 2026.

By the end of 2018, nearly 11% of the American workforce was employed in healthcare jobs. Additionally, 6 of the 8 fastest growing jobs overall are healthcare related.

We could share even more statistics, but suffice to say very few other fields are growing at that extreme pace. This naturally leads us to ask questions about why.

One simple reason is that the average age of American citizens is simply skewing older. With an older population, the need for medical services increases. Supply always rises to meet demand, and it’s clear that the demand will continue to rise with the median age of U.S. inhabitants.  

Another likely cause of increase is that under the Affordable Care Act, more people are insured, meaning more people have the freedom to seek care.

As you’d expect, this increase in demand poses challenges for hospitals. Some of the highly needed positions include pharmacy technicians, nurse practitioners, registered nurses and additional non-clinical jobs like medical secretary and medical coding technician.

The needs on display certainly include basic care, but also show the struggle to keep up with processing data effectively. There continues to be a chronic shortage of practitioners in some fields, notably in primary care.

The fact that healthcare jobs are needed faster than they can be filled proves that efficiency is more important now than ever.

Connecting patients to the care that they need, from the practitioners best equipped to deliver it, cuts back on how often patients hop between doctors and hospitals. Centering the primary care provider in a patient’s care plan saves time and money for everyone involved — and ensures that no patient is left behind due to growing pains of the healthcare system. 

By empowering you as an employer to have a direct health benefits relationship with your employers and a direct financial relationship with top notch care providers, Captiva helps you make sure that the process is streamlined. Your employees get the care they need, without the headache of sifting through endless data in a rapidly expanding list of options.

Ultimately, this system promises to improve the healthcare landscape as a whole by creating long-term patient and provider relationships that solve the high turnover rates currently plaguing many healthcare positions.

Are you ready to be part of this revolution? Contact us to get started!

Healthcare Job Increase Signals A Need For Efficient Care is courtesy of: Captiva Benefit

Blockchain Is Changing How We Think About Healthcare Data

We’ve already spent some time the past few months talking about how data is a hot button conversation topic in the healthcare world. One of the most sobering studies last year revealed how much healthcare data is being leaked.

2019 has started with assessing how the inaccurate patient matching system can be improved. Now, the news has broken that some major players in the healthcare industry are utilizing blockchain technology to address some of the issues we’ve been covering.

Blockchain is a information storage system that was developed to support cryptocurrencies like bitcoin. The technology works in a structure that allows data to be collected, stored in chronological order and accessed in a more effective and secure way than past digital models. If you want to understand a little bit more about how the technology works, Blockgeeks has a walkthrough.

The news broke this week that health insurance network Aetna, provider Anthem and Health Care Service Corporation (HCSC) are partnering with computer hardware company IBM and PNC Bank to apply blockchain to healthcare. This effort is being propelled forward by a collaborative effort called the Synaptic Health Alliance.

According to the Alliance’s white paper, “The Alliance views blockchain technology as a means to a critical end: ensuring that data is accurate and sharable for reliable use across the healthcare ecosystem. Thanks to the members' large collective data volume and national footprint, this collaboration could prove the business value of cross-company data sharing in healthcare and, ultimately, help facilitate a significant positive impact in the healthcare market space.”

In a statement about joining the initiative, Aetna chief technology officer Claus Jensen said “Through the application of blockchain technology, we'll work to improve data accuracy for providers, regulators, and other stakeholders, and give our members more control over their own data.”

It’s easy to see why some of these industry giants would find this technology attractive. With its streamlined and accurate model, blockchain could help solve some of the ongoing data problems that major healthcare corporations struggle with.

The core issues they’re trying to solve are accuracy and security of data stored. Of course, at Captiva we’ve already been solving those problems with the model established by the Health Rosetta. 

By fostering direct relationships between benefit providers and caregivers, the patient data storage system is personalized. Sensitive information isn’t shared between near as many parties, centralizing care.

Sustained relationships between those paying for benefits and the hospitals treating the benefit recipients makes communication clear and smooth. The transparent relationships at all levels result in a higher level of trust. Whatever data storage advances are made through blockchain will be just amplified in effectiveness when they reach the care providers that your business will interact with.

As blockchain transforms how the healthcare industry thinks about data, Captiva continues to help your business stay a step ahead in providing benefits for employees. Contact us today to find your solutions!

The following article Blockchain Is Changing How We Think About Healthcare Data is republished from: https://www.captivabenefitsolutions.com/

Solving the Patient Matching Problem

One of the early stories in healthcare news for 2019 revolved around the question of patient matching. The Government Accountability Office released a report revealing that two base-level problems continue to make matching difficult: records corresponding to the wrong patient are often matched, and multiple existing records for the same patient are not matched.

The report took into account interviews with a wide range of providers and vendors. The conversation centered in part around what standards would effectively make a dent in the problem. Many ideas focus on the concept of standardizing the systems for collecting healthcare-related data.

This is one of the essential flaws that the Health Rosetta paradigm has already been seeking to fix — and at Captiva Benefit Solutions, we’ve been helping businesses use their model to effectively create change.

First, it’s important to understand what exactly this efficiency problem is costing us.

The reality is that in a lot of companies, 6% of the employees are spending 80% of the health benefit plan dollars. Those employees are those with complex, usually chronic health challenges, needing specialist care. These patients are often referred to as “outliers” within the medical system.

With complex health problems, usually multiple specialists are involved. With poor patient matching and scattered models of care, often those specialists are not in communication and cannot access all of the data on an outlier’s needs. This leads to an abundance of procedures and tests that actually were not necessary.

For example, some studies show that as many of 40% of transplants are unnecessary. Some patients are receiving transplants where they are not needed, while others are on endless waiting lists due to short supply caused by poor communication.

The cost is clear: expensive procedures that eat up plan dollars plus a significant cost in time and suffering for patients.  

The Health Rosetta solution is to hone in on a network of confirmed, credible care providers, removing hospitals that are unlikely to be a good fit from the equation.

Often, this involves developing direct contracts with "centers of excellence" that are able to serve as referral centers, offering second opinions and connecting patients with the highest quality specialists.

Narrowing the field of options for all patients, including outliers, makes it significantly easier for the right data to get to the right person. Another way that patient matching process is streamlined is through placing the primary care physician as the central hub of anyone’s care.

These direct relationships between care providers and benefit providers cut out the middlemen and clearly define a path for moving through the appropriate care plan for even the most complex cases.

The return on your investment as a provider of benefits becomes significantly higher.

With higher quality care provided at a lower cost to everyone involved, it’s clear to see why the Health Rosetta’s model is already solving the healthcare problems the news is talking about.

Find out more about our approach to saving you and your employees money on benefits!

Solving the Patient Matching Problem is available on: Captiva Benefit

Pharmacy Pricing Without the Confusion

Chances are high that you’ve been here before: you go to the doctor for an ailment, an affliction that’s easily combated by rest and the proper prescription.

You get the prescription information and drive to the nearest pharmacy to pick it up. They hand you the bottle of pills — and the accompanying price tag.

This is the part where many Americans end up walking away from the pharmacy counter without the medicine they need because of prohibitive costs.

Multiple publications this year have shared the stories of diabetic patients who have rationed their insulin due to its cost, resulting in difficulty functioning or even death.

This is just one common example of the life-threatening effects of pharmaceutical drug pricing, effects that your employees are subject to under traditional health benefit models.

Unfortunately, the skyrocketing prices of pharmaceutical drugs is an ongoing trend. A quick look at the 20 most expensive retail drugs of 2018 makes it clear why some patients are choosing to simply go without. The demand for most drugs is not likely to disappear, meaning that Big Pharma can continue setting their own prices and profiting off patients.

The result is that expenditures on drugs has nearly doubled since the 1980s. Most of the time, consumers are not even aware of their options, being left to navigate confusing and expensive drug pricing on their own.

This is a problem that could be prevented at multiple levels, and the Health Rosetta offers the groundwork for the process. First of all, ensuring that primary care physicians have a full grasp on patients’ entire health picture in order to only prescribe medication as needed automatically cuts back on costs at all levels.

Second, transparent pricing would offer clarity in advance on what medications are affordable. When Captiva partners with your business, they educate you on pricing options, allowing you to assist employees in shopping around for the best pricing on necessary prescriptions.

This removes the confusion and guess work, allowing for informed decisions and lowest possible prices. Even giants like CVS have started to understand how much this could improve the process, recently announcing that they will be rolling out their own prescription benefit plan to improve pricing simplicity and transparency.

Finally, it’s important to understand that improving pricing transparency would save money not just for consumers of prescription drugs, but for their employers providing benefits as well. With employees educated and able to choose the lowest cost options for treatment, benefit providers would be paying out less to keep their employees covered. Cutting back on the confusion in the process would ultimately streamline the process at every level.

To find out more about how we can partner with you in overcoming pharmaceutical confusion, contact Captiva Benefit Solutions.

Pharmacy Pricing Without the Confusion is courtesy of: Captiva Benefit Solutions

Here’s What Healthcare Consumers Are Looking For

The end of the year tends to serve as an opportunity for reflecting on both the year that was and what’s to come.

When it comes to the rapidly shifting realm of healthcare and health benefits, that annual conversation is particularly vital, with the year’s end serving as a chance for health industry professionals to take stock of consumers’ needs and adjust their strategy.

According to a survey published by patient-to-provider matching service Kyruus, one of those major needs boils down to convenience.

That drive for convenience is particularly prevalent in millennials, a generation with full schedules and limited budgets. Millennials were likely to search for health care providers based on who could get them an appointment fast — moving past anyone who couldn’t. However, convenience-based decisions held true across all generations surveyed. Unsurprisingly, most of those decisions are being made by searching online.

These findings are backed up by research done by online brand builder Reputation. They found that consumers hunting for healthcare lean heavily on positive online reviews and ratings to narrow down their search, skimming through assessments left both on Google and on individual provider websites.

There are a few crucial takeaways from these findings. First, we know that healthcare providers without openings when patients need it are missing out on business (and patients are potentially missing out on care). Second, we can conclude that where reliable and credible reviews of providers and practices are not quickly available, consumers are left in the dark.

The model that Captiva Benefit Solutions helps businesses implement, as consistent with the values of the Health Rosetta, can solve both of these problems.

With our focus on value-based primary care, patients are matched with primary care physicians who can much more quickly find the right fit for any specialized needs. Honing in on quality care instead of leaving a massive quantity of providers to sort through, hoping you win the schedule availability lottery, ultimately means more preventative measures are possible (which saves everyone involved time and money in the long run).

By providing concierge style customer service, Captiva’s model also removes the guesswork out of sifting through online reviews. With clearly defined options and networks of only vetted and approved options, the process becomes as hassle-free as possible. Having access to more information also allows patients to make decisions that make the most financial sense; with proper education about their options, they’re less likely to get pressured into unnecessary tests or procedures that quickly add up.

Captiva’s approach disrupts the status quo and easily answers the health care consumer priority of convenience. If you’re ready to bring that kind of healthcare to your business’s employees, please get in touch with us.

Here’s What Healthcare Consumers Are Looking For is available on: https://captivabenefitsolutions.com

Returning Power to the Patient

The number of hurdles to acquiring health insurance and healthcare continues to increase.

A clear barrier is financial, with a very high percentage of the uninsured workplace citing cost as the reason they’re foregoing insurance. However, the cost of care itself continues to be problematic even for employees who do have health benefits.

Many times, patients are faced with deciding between getting desperately needed care and getting bills paid. Sometimes, they have to decide which health problem is actually severe enough to warrant care, leaving other needs untended.

The problems with access don’t end there. Transportation is another lesser discussed issue, causing particular problems for those in rural areas or those living with chronic illnesses. Simply understanding the options for getting to healthcare facilities is lacking for many patients.

Another common barrier is language. Especially for Hispanic populations, not being able to understand or be understood in a healthcare setting poses significant challenges to both becoming insured and receiving medical services. Sometimes this can even lead to mistakes on vital paperwork and prescriptions.

A lot of other healthcare hurdles boil down to lack of education. Without understanding what problem solving solutions are available to them, how are prospective patients supposedly to choose accurately?

Navigating the contemporary healthcare field can be like trying to walk through a wholly unknown minefield, unsure what missteps might cost dearly in the form of financial, legal or health headaches. 

This is one of the many problem areas that the Health Rosetta is committed to helping companies solve for their employees. Most of the time, employees are being left to navigate dense swaths of confusing and even conflicting data to make any kind of decision about their healthcare.

This is costly not just in terms of the care that isn’t being received; it also means that sometimes the care that is being recommended and administered is ineffective and non-evidence based.

For a lot of patients, the information (confusing or not) simply isn’t available at all. The silo model of healthcare, in which each type of care and care provider exists entirely independently with very little data sharing. This makes it very difficult for anyone to accurately compile and compare information from different sectors to make the most informed opinion. Keeping the data segmented also makes it harder for the most effective and cost sensitive solution to be found.

As we at Captiva follow the Health Rosetta’s model, we’re committed to information transparency at every level: for care providers, for companies and for the employees they benefit. We make sure that information is always available for employees when they need it so that they can make an informed decision.

A crucial part of Captiva’s ongoing model for your business as you continue to provide benefits to your employees is providing education. This ensures that employees can continue to overcome barriers to care that might arise in the continually shifting healthcare landscape.

Returning Power to the Patient was first published on: https://captivabenefitsolutions.com

Concerns as the Aetna and CVS Merger Closes

2018 has been a year full of game-changing shifts and innovations in the health insurance landscape. One of those milestone changes we’ve referenced before is the recently approved merger between pharmacy major player CVS and health insurance network Aetna.

One of the initial hurdles it had to overcome was a potential block from the Department of Justice. The block was requested by New York Assemblyman Kevin Cahill, who voiced concerns that the move would reduce competition, forcing up drug prices.

According to Cahill, "The sheer magnitude of this vertical restructuring is likely the biggest in healthcare and perhaps in the history of commerce in our nation."

That was a concern shared by some legislators in California as well. Their concerns led to clearing the deal with a condition: a promise that premiums wouldn’t increase as a way to cover merger costs.

At this point, it’s still unclear exactly what the long-term impacts on premiums in future years might be. But CVS got everyone on board, and on Nov. 28, the merger was officially approved. 

The healthcare world is bracing for how this is likely to change the playing field. As we said earlier, the most obvious problem is the one that has given legislators pause: the risk of narrowing market options, reducing competition and subsequently driving up prices.

There is a very real possibility that any potential savings that occur from consolidating will just go to further line insurance companies’ pockets rather than actually reaching the consumer.

Another potential impact that critics have pointed out is the possibility that this will allow providers in Aetna’s network to limit consumer’s options while raising the prices.

This concern is well-grounded given that two monolithic institutes combining gives them a lot of power to decide what kinds of care and prescriptions are covered (and which are not).

Beyond just the limitations that this could pose to consumers, the merger puts other healthcare providers in a hard place as well. The DOJ recently also approved a similar merger between Cigna and Express Scripts.

In an era where power is consolidating to a few heavyweights, smaller companies might be forced to consider consolidating — or be crushed under the momentum of the giants.

Captiva exists to help your business bow out of those risks entirely. We’ve known for a long time that outrageous pharmaceutical costs and unchecked insurance providers should not be the status quo.

The Health Rosetta paradigm was developed to define a better way to provide benefits, and we’re here to apply that to your company. In the process, you’ll be freed from concern over the problems big business mergers could fuel.

The following post Concerns as the Aetna and CVS Merger Closes was first published to: Captiva Benefit

How the 2018 Midterm Results Impact Healthcare

In this final quarter of 2018, most of the attention of the news cycle has been fixed on the U.S. Midterm Election. Within that complex national conversation, as we’ve shared before, the biggest player was healthcare.

According to exit poll data, 41% of voters ranked healthcare policy as the top priority issue. In fact, it was the top priority by a significant percent, with immigration coming in second as a priority for only 23% of voters.

We can reasonably surmise from numbers like this that the questions of who gets healthcare and how have perhaps never been more crucial and pressing for the majority of Americans.

Here are a few key points to keep in mind about the midterms’ impact on healthcare and providing benefits to your employees.

 

Healthcare Changes Likely to be State-by-State, Not Nationwide

The biggest news from the midterms was that the Democratic party now holds the majority in Congress. 

Meanwhile, the Republican party strengthened its Senate majority. With a more bipartisan leadership in place in Washington, there’s a likelihood of gridlock over any major policy changes — which leaves any potential policy updates to occur on a state-by-state basis.

Although any chance of repealing the ACA or major national Medicaid changes seem to no longer be possible, state governments do have the ability to make significant decisions about whether to expand Medicaid or not in their individual states.

Adjustments on that front could be the biggest changes in policy to navigate over the next two years.

 

The Status Quo is Stabilizing

With the above mentioned slowing of policy change, the healthcare status quo is likely to be more stable than it has been in years.

The downside to that is, as we all already know, the status quo isn’t working. But the good news is that Captiva already has a plan in place to solve your benefit problems in this current climate. Policy won’t change much. Neither will our ability to bring your costs down.

 

Get Ready for Drug Pricing Conversations

Although overall the Democrats and Republicans have different priorities, there is a good chance there is one item they can agree on: pharmaceutical drugs are priced outrageously high. Any bipartisan progress to be made could well center on curbing this issue.

Bringing drugs to an affordable price is a mission that Captiva has been on already. We work towards transparency to uncover hidden pharmaceutical costs and do the hard work of shopping around for the most fair price.

If you’re ready to learn more about how Captiva can help your business’s benefits culture thrive regardless of the political climate, talk to us to find out how. 

 

The article How the 2018 Midterm Results Impact Healthcare was first published on: Captiva Benefit Solutions Blog

Healthcare a Top Issue in 2018 Midterm Elections

The 2018 Midterm Election is upon us, and once again, politicians are ramping up rhetoric about healthcare.

And rightly so. According to a report by the Wesleyan Media Project, healthcare is the top issue of concern to voters in the November General Election.

Similarly, new NPR/PBS/Marist Poll finds healthcare as the No. 2 issue (following the economy and jobs) concerning voters in 2018 — with 17 percent saying it was the most important thing driving their vote.

Over the last month or so, nearly half of political advertisements in federal elections predominantly mentioned healthcare, and about a third of gubernatorial airings included the topic. Both parties are mentioning healthcare, but it is featured more heavily by Democratic campaigns, appearing in 54.5 percent of that party’s ads.

It’s interesting to see how the parties have treated healthcare in the last few election cycles. Wesleyan Media Project found that after the Affordable Care Act passed in 2010, healthcare became a prominent issue in a third of all national pro-Republican ads. Democrats, by comparison, only used it 8.7 percent of the time in 2010.

Republicans talked less about it in 2012, 2014 and 2016, as mentions declined to 28.4 percent, 20.8 percent and 16 percent, respectively. Now, in 2018, the GOP saw healthcare mentions surge to 31.5 percent of their ads — almost as much as they did when the ACA passed in 2010.

So what are they saying?

Essentially, Democrats are campaigning to save the ACA, and warn that Republicans’ current and future plans to scrap the Act will hurt Americans. Republicans, by contrast, are campaigning that they’ll come up with a replacement plan to provide healthcare to Americans by strengthening the private sector.

It’s a big deal, especially as Republicans gutted key provisions of the ACA while not replacing them. The federal mandate to purchase insurance has been all but removed, and experts predict millions more Americans will be uninsured.

Meanwhile, plenty of Americans -- especially middle class Americans caught in the coverage gap -- don’t see the ACA as it was as a viable answer. ACA or no ACA, prescription costs, doctor/hospital fees and insurance premiums continue to rise, with no end in sight. 

Regardless of how most voters feel about each party’s strategy for healthcare, the Motley Fool’s Sean Williams said it best: government is trying to “fix” the wrong problem:

Lawmakers continue to center around the idea that access to health insurance is the biggest problem, when the issue at hand is the underlying inflation of medical care, not access to health insurance. If the cost of underlying medical care stopped outpacing inflation and wage growth nearly every year, access to health insurance wouldn't be an issue for most folks, and we wouldn't even be having this debate. In other words, they're trying to fix the symptoms without getting to the root cause of the problem.

Those issues include the unchecked pricing power of the pharmaceutical industry — something Congress has only just started to pay attention to — ballooning administrative healthcare costs, rising provider costs and more. Williams summarized what we at Captiva say every day: “Congress is trying to close a gaping wound with a Band-Aid.”

It’s been bad enough that an increasing number of private enterprises like Amazon and Google are dedicating significant resources towards developing industry-disrupting solutions.

If there’s anything we’ve learned watching the political landscape over the last few decades as it relates to healthcare, it’s that there haven’t been any changes that have resulted in lower overall costs to Americans.

There’s really no reason to think that with an access-minded approach to healthcare still very much ingrained in Congress, that things will be any different this time around.

But change is possible — regardless of current and future political proceedings.

Captiva Benefit Solutions and the Health Rosetta community use pricing tools and accountability measures that will provide better healthcare for less money to your employees. Your company will have the tools and partnerships available to smartly negotiate better pricing structures, demand transparency and accountability in billing, and comparison shop for the best deals.

If this is a future you’ve been waiting for, wait no longer. Let us consult with your benefits manager to share just how Captiva can make a big difference right now.

Healthcare a Top Issue in 2018 Midterm Elections was originally seen on: Donnie Marcontell

Employers Fight to Absorb Higher Healthcare Premiums

As health insurance costs continue to rise, employers are struggling to stop the expenses from overburdening their employees.

A recent study by Aon found that throughout the course of 2018, healthcare premiums have overall risen by 3.5%. However, most employees only experienced a 2.2% rise, as employers have chosen to absorb some of the increase themselves.

This means that employers were paying 3.9% higher premiums in 2018. That's a big pill to swallow as companies are trying to make a profit and stay afloat.

This information has several important things to tell us.

First of all, it tells us what we already know: health costs, including premiums, are continuing to make up a disproportionately high percentage of expenditures.  The increase rate is three times the rate of general inflation.

And unfortunately, initial analyses suggest that 2019 might see an even higher price increase.

But Aon reports tell us about more than just bare facts about the statistical rise of premium costs. It also tells us that employers are taking an active role in trying to triage the situation so that their employees aren’t saddled with the extra costs.

A lot of that active negotiation of costs has involved experimenting with non-traditional methods of providing healthcare benefits. Even with premiums increasing, alternate options are increasing also.

This is where Captiva Benefit Solutions comes in. We believe there is a better way than just paying the increasingly rising premiums that insurance providers demand.

Utilizing elements of the Health Rosetta like transparent open networks and advisor relationships, we can help your business stay ahead of the premium increase curve.

The Aon data that proves that more employers are trying to negotiate better options for their employees is proof that Captiva is on the cutting edge of combating premium hikes.

Our model joins companies like Walmart, Boeing, Cisco and Intel in opting to enable the employer to negotiate directly with healthcare providers. That approach cuts back on overhead, provides more personalized care and removes unnecessary costs so that premium increases are removed from the equation entirely.

Getting out of the way of snowballing premium increases is just one of the ways in which Captiva can help your company provide more affordable, more streamlined, more effective benefit options to your employees. If you’re ready to take the next step towards better benefits, contact us to get started.

Employers Fight to Absorb Higher Healthcare Premiums is courtesy of: Captiva Benefit Solutions

How Employee Education Will Transform Health Benefit Effectiveness

There are a lot of complex obstacles in the way of employers providing the best possible healthcare benefits coverage to your employees, but one of the biggest is simple: a lack of education.

Traditional healthcare benefit arrangements brokered with large providers can be frustrating and complicated for employees to wade through and understand. The vernacular alone can prove to be prohibitive. And if your employees don’t have coverage through work and have to navigate the marketplace, the difficulty can be even worse.

According to the latest yearly study by PolicyGenius on healthcare consumers, 80% of those enrolling in healthcare through the marketplace aren’t aware of the key elements that providers are required to offer under the Affordable Care Act.

A quarter of survey respondents actually believed that the ACA (better known as Obamacare) had been repealed.

The confusion has been especially centered on changes made in recent years to the healthcare marketplace, an understandable side effect to a tumultuous several years in the political and health insurance landscape.

But the consequences of that lack of understanding are real. We’ve talked before about the staggering numbers of workers and their families who remain uninsured.

That risky position leaves workers without preventative care — or stuck under the impossible weight of extravagant hospital bills.

That’s why Captiva has built into our approach employee education at every step of the way. We equip you to educate your employees on reference-based pricing so they understand how it works.

We put in place concierge-style customer service that allows employees to have personalized input and access to real facts to choose what they need (a practice Fortune says automatically cuts costs).

And we support you in continued yearly education efforts so that when the healthcare industry continues to change, your employees can learn how to navigate it.

When employees are educated about their healthcare and how it’s being implemented at every step of the process, it’s a win for everyone: workers spend less time sick and have their care more effectively covered when they do need it. Your business is able to offer more effective benefits at a lower cost to both you and the recipients.

Are you ready to implement that kind of win-win scenario in your own business? Captiva Benefit Solutions is here to empower employers and employees of the Dallas-Fort Worth Metroplex to make the best healthcare decisions. Contact us to get started today.

How Employee Education Will Transform Health Benefit Effectiveness was first published on: Donnie Marcontell

Healthcare Startups Are Making Their Mark

CNBC recently released their list of the top 100 startups to watch, and the yearly list has some noteworthy implications for the healthcare landscape.

Amid the usual tech and financial startup candidates, there are 14 different healthcare companies featured. These companies are  going to bat with the major players who have traditionally had a monopoly on where patient and benefit provider dollars are spent.

The abundance of startups rethinking the healthcare model prove that a lot of other companies agree with what we know at Captiva: the status quo of ridiculous pricing structures, low accountability and unchecked cost increases hasn’t been working.

Although these startups vary in their structure, purpose and mission, there are also a few common threads that prove an indicator of where healthcare might be headed.

 

Tech and Data-Driven Treatments

Many of the companies featured aim to revolutionize the way that care is provided through applying technology and big data to healthcare — themes we’ve talked about before. 

Aira Tech is using rapidly developing augmented reality technology to create glasses for blind and low-vision individuals. Keeps is engineering new ways to prevent hair loss and male pattern baldness. SciBack is creating new drugs that can combat diseases that resist antibiotics.

On the data side of things, Viome is analyzing patients’ genetic sequencing and microbiome to determine what nutrients they might need. RDMD takes patient medical records and analyzes them to develop new treatments.

One of the most clear and direct uses of big data comes from DocSync, a tool that directly analyzes data to increase healthcare practice effectiveness.

 

Telemedicine

Telemedicine is one of the most formidable forces in 2018’s healthcare landscape, estimated to be an industry worth $66 billion by 2021.

The startups making a mark through digitally provided distance medicine start with Buoy Health, an app-based diagnostic tool. Solv allows patients to cut back on wait time by booking same day appointments.

Some of the new initiatives hone in on specific kinds of treatment. Curology centers on skincare via online consultation, HabitNu offers digital programs for diabetes treatment and Nurx provides reproductive health services and education.

 

Streamlining Healthcare Provision

A few of these startups are focused on solving the big question that Captiva has already been answering for businesses: how can we streamline the process of providing healthcare for employees?

Carrot Fertility aims to come alongside employers to create plans specifically for fertility benefits for their companies. Their approach is centered around smart data and personalizing the process to better target care.

The reality is, a lot of these startups are tapping into aspects Captiva already knows work: concierge-style service. Sound data analytics. Elimination of the big corporate middleman, wherever possible.

If you’re ready for your company to join the cutting edge, Captiva can help. Contact us to hear how we can improve the way your business provides benefits.

Healthcare Startups Are Making Their Mark is courtesy of: https://captivabenefitsolutions.com

The Essential Elements of Transparent Open Networks

We know that the pricing system as it stands in the United States healthcare industry isn’t working.

Costs continue to skyrocket, and administrative costs and provider fees are a big part of why.

How can you as a business leader rein it in and make sure you know what you’re actually paying for?

Captiva Benefit Solutions answers that question by following the Transparent Open Network model, a key component of the Health Rosetta’s approach to revolutionizing how we think about healthcare. 

If you’re ready to stop paying the overhead, read on to discover the essential elements of what that kind of network entails.  

 

1. Transparency

That this would rank first on the list probably comes as no surprise. Transparency means that you know exactly what you’re paying for — and also that you know that what you’re paying is a fair price. One tool for achieving this is reference-based pricing. 

Earlier this year, CNBC reported: “Over the past nine years, employee out-of-pocket spending for a family of four increased 69 percent in the form of higher co-pays and higher deductibles, along with 105 percent employee premium contribution growth. Over the same period, employer premium contributions increased 62 percent.”

It’s clear that a lack of transparency is costing both employers and employees. With networks that lay out the facts, it doesn’t need to weigh down your spending any longer.

 

2. Bundled Payments

Bundled payments are the answer to one of the broken ways that costs of care are usually decided on. Most of the time, doctors charge per service performed in a given visit, allowing them to stack up fees and encouraging them to add unnecessary procedures.

Bundled payments push back against this fee-for-service model by setting one payment for an entire episode of care.

This model was actually encouraged by the Affordable Care Act. Some of the early health providers who have started using the model have already seen savings. Plus, getting just one bill cuts out both patient confusion and more administrative overhead.

 

3. Shared Risk

As we mentioned above, the fee-for-service method often means that health practitioners are encouraged to push for quantity above quality.

Shared risk basically requires providers to take responsibility for mistakes or complications within a certain window after the initial care was delivered.

The shared risk model is one that has already been present on some level in Medicare for years, and has been proposed for expansion. But under Transparent Open Networks, the model is brought into the private sector (and potentially your business) as well.

 

4. Efficient Administration

We’ve established that bureaucracy and unnecessary administrative middle men are a big part of the bleed on healthcare overspending.

One of the most important ways to make healthcare work for you is to create speed and efficiency. This can be done by streamlining the payment process, eliminating copay systems and paying providers directly and quickly. That’s a lot for an employer to handle without a big name insurance provider, which is why Captiva is here to help you.

 

5. Employee Education

Transparency need to go beyond the employer relationship with health care prices and providers; it needs to reach the employee level. One survey showed that as many as half of employees were confused and stressed by the health insurance options presented to them. Big words and confusing deductible structures can leave employees choosing options that aren’t even what they think they’re choosing.

Caring for your employees well means providing consistent, clear education on how a Transparent Open Network functions, empowering them to understand their choices.

 

6. Ease of Use

This final key element sums up all of the others: we believe healthcare should be easier to use, for employers, for their employees, for healthcare providers.

Easy access to appointments and quality care without paperwork headache greatly improves an employee’s quality of life. Less time wasted negotiating with opaque health insurance providers means more time helping your business thrive.

 

If you’re ready for an honest way to do healthcare, Captiva is ready to begin a substantive discussion about how to revolutionize the way you provide for your employees.

The following post The Essential Elements of Transparent Open Networks is courtesy of: Captiva Benefit Solutions Health Benefits

5 Innovative Ideas Changing Healthcare in 2018

With technological change and advancement happening faster than ever, it’s no surprise that how we do business is changing at every level, including how business is done with regard to the healthcare industry.

Beyond the medical science that is such a crucial part of saving lives, innovation at even the paperwork stage can make a radical impact on taking strides towards affordable and accessible healthcare for all.

Here are a few of the big ideas changing the healthcare game in 2018:

 

New Corporate Partnerships

It seems like almost daily, a new partnership or venture is announced between tech monoliths and health insurance providers. We’ve shared about Amazon’s partnership with JP Morgan and Berkshire Hathaway and Google’s investment in Oscar.

Another major headline this year saw drugstore chain CVS acquiring health insurance provider Aetna.

Most of these new partnerships have one goal in common: eliminating middle men and streamlining the care provision process to cut increasingly skyrocketing prices.

It’s notable how many of the company names throwing their hats in the health insurance ring are tech-based. Corporate disruption is tied to the technology that allows health care to do what it has never done before.

 

Individualized Treatment

One of the major ways that technology is changing (and will continue to change) healthcare is through providing more individualized treatment.

Smart sensors allow for things like smart inhalers, cancer treatment based on individual genetic makeups and personalized rheumatoid arthritis treatment.

All of these developing treatment options eschew the one-size-fits-all model of treating diagnoses to be more effective and timely.

When treatment is both more successful (due to personalization) and quicker, the cost impact is guaranteed to start looking different. So is the relationship between hospitals and health insurance providers, who will quickly need to find ways to navigate billing on a more case-by-case basis.

 

Telemedicine

One of the biggest trends in healthcare is telemedicine. Telemedicine allows patients to receive consultations (or even prescriptions in some states) without needing to sit down with anyone face to face. Some estimates place the growing worth of this industry at $19.5 billion by 2025. 

But beyond the increasing ability healthcare providers offer to talk to a practitioner digitally before making the trip to the ER, telemedicine is also streamlining things like making appointments and paying bills.

As more and more is possible digitally, the only patients who will go to the hospital will be those who truly need it.

 

Big Data

Another element that makes it clear why companies like Google and Amazon would be getting involved with healthcare is the usefulness of big data. Both companies have a long history of utilizing detailed consumer data for endless applications.

The same thing is being done increasingly in healthcare. What that looks like for the health industry is that medical records, test results and research are changing the financial and practical choices healthcare providers are making. 

The biggest benefit that comes from strategic levering of constructed databases comes in at the patient level. Patients will benefit from better diagnostic accuracy and better management when the amount of information available is fully integrated into the system.

 

AI

Artificial Intelligence is a favorite tech topic of Hollywood thrillers and dystopian literature. But beyond the sci-fi industry’s take on the topic, AI has very real applications for our healthcare industry today.

We know that AI can be instrumental in sifting through data to retrieve the most crucial information. We talked about big data above. AI is crucial part of aggregating and sorting that data in a way that actually provides applications.

Additionally, AI has the potential to radically impact treatment itself. The opportunities for neurological treatment that partners with a patient’s brain, or analyzing scan and imaging results to a much higher degree of accuracy, are truly endless. 

A lot of these developing technologies and changes are in line with what we already are proving works: individualized, concierge style care. Removal of bloated health insurers who pay out exorbitant fees without examining the data.

If you want a revolution in how you’re providing healthcare to your employees, we can start one with you now. Contact Captiva Benefit Solutions for true health benefits innovation.

The post 5 Innovative Ideas Changing Healthcare in 2018 is courtesy of: https://captivabenefitsolutions.com/

Where The Advisor Transparency Status Quo Falls Short

If you’ve spent any amount of time looking at options for providing healthcare benefits to your employees, then you already know: the status quo isn’t working.

One major area where the system as we know it is broken is in the lack of transparency in advisor relationships.

Opaque, limited data and blame-shifting are the name of the game.

Captiva Benefit Solutions believes that we can (and should) do better. Find out how our approach, based on The Health Rosetta, challenges and changes the norm.

 

Year By Year Changes vs. Long-term Stability

Your average benefits advisor is going to shop around every year for a new insurance arrangement. Given how quickly health insurance costs are consistently rising, that almost certainly means they’ll come back to you with a higher cost every year.

Even worse, they might not actually be working to negotiate your cost down as much as you think they are.

Insurance brokers often get a cut of the profit, so it might not be in their best interest to actually find you the lowest deal. 

By contrast, we work with you to lock in a long-term game plan, looking 3-5 years ahead. We’ll make sure that you know where you’re headed, reigning in skyrocketing costs and yearly price surprises.

 

Blind Cost Acceptance vs. Negotiation and Compromise

Even if your advisor is doing their absolute best at shopping around and comparing prices, usually they’ll just take an insurance provider at offer face value.

Unfortunately, many of those providers are massively overcharging. Lawsuits against major providers disputing their charges have become commonplace, with Cigna most recently facing a class-action lawsuit for overcharging clients. 

Our approach removes the risk of blind faith in for-profit middlemen. With reference-based pricing and more direct relationships between businesses and health care providers, we make it clear to you what different services cost — and don’t expect you to shell out far over and above.

Captiva is able to use the Medicare cost for a procedure as a baseline and negotiate with hospitals on a price that allows them some reasonable profit margin while saving your business the staggering costs insurance companies have normalized.

 

Employee Blaming vs. Action and Ownership

Big insurance providers often default to blame shifting when costs keep rising, and the favorite scapegoat is often your employees.

As a result, they punish your employees by shifting more of the burden onto them with increased deductibles and copays. They also might blame your employees for not seeking preventative medical care, even though the only preventative measures available to them through big insurance are often overpriced and impersonal (both found to be major barriers to seeking care).

When your employees suffer, your business culture and effectiveness as a whole suffers with them.

Instead of scapegoating, Captiva Benefit Solutions analyzes the data to figure out exactly where higher costs are coming into play. We know that the only true method for lowering costs is through improving the whole benefits system.

Our core value of transparency means that we’ll be able to show you hard facts about where the money is going, and where you can eliminate costs.

If this sounds like a better option than the status quo, contact us today for more transparent, affordable health benefits.

Where The Advisor Transparency Status Quo Falls Short was originally seen on: https://captivabenefitsolutions.com/