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Transparent Health

transparent-health-badgeWe are trading in the 1957 T-Bird for a brand new Corvette! Employers have continued to sputter up the same hill year after year dreading their health plan renewal, shifting carriers/administrators and not receiving the proper transparency to truly solve their rising healthcare costs. BDS has found the solution which involves removing all the unnecessary expense layers that have driven up cost on your health plan in the past, injecting programs that will drive down healthcare cost and present full transparency on where every dollar of your healthcare investment is being leveraged.

Transparent Health is a fit for employers with 50 or more employees. By removing any type of carrier intervention in your health plan, only renting their network, we are able to focus on building health plans for the right reasons. Transparent Health will create the long term health plan solution that employers need as we transition through the rising costs in years to come. We look forward to presenting how Transparent Health can change your opinion about your current employee benefits package!

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1. Full Transparency & Reporting

Where have your premium dollars been going in the past? 99% of employers cannot answer that question with certainty. Under Transparent Health you will become the 1% of employers that can account for the value of each dollar being spent. In addition to finally having accountability on where your money is being spent, you will now have access to real-time reporting data which will give you the control to customize your health plan in future years to address certain “problem areas.”

2. Prescription Drug Carve Out & Management

We have removed the direct carrier contracting with the Prescription Benefit Managers (PBM). Carriers are no longer entitled to your prescription rebates or up-charging prescriptions on the back end which increase claims cost. Transparent Health uses one of the only fiduciary & transparent PBM’s in the country, there is no longer money shifting around behind the scenes, you will see exact cost of your prescription drug expenses. In addition to now having PBM control and transparency, you will also be working with a PBM manager who will be monitoring employee compliance, building your custom formulary and engaging employees and providers in proper prescription management. The goal in PBM management is to not only reduce unnecessary prescription drug expenses but also to assist in compliance and education to avoid costly high claimants in future years.

3. Employee Price & Quality Transparency

We have all preached consumer driven healthcare for years, but what tools have we given consumers to effectively shop for their healthcare? NONE. Transparent Health offers solutions to employees that now give them cost and provider quality before having a particular procedure. Employer incentives help ensure employees continuously use this service before each procedure. By engaging employees in their spending and quality decisions during and after their deductible, claims cost will decrease and they will become informed consumers. We are able to show true savings through employee transparency since we have now removed the health plan from carrier control.

4. PRO-ACTIVE Disease & Wellness Management

A team of nurses monitor your employee healthcare data continuously to provide PRO-ACTIVE Disease Management. Many employees are not fully educated on their conditions with an understanding of the importance in ongoing treatment compliance. Under current circumstances this leads to the same cyclical cycle of new high claimants driving plan cost each year that could have been avoided. By engaging the member from the point of diagnosis and focusing on employees who truly want to change, we are able to drive down claims cost while improving the quality of life for your employee population.

5. High Claimant Billing Audit & Clinical Review

High claimants typically drive over 70% of the cost within a group health plan, but nothing is being done to audit provider billing and provide clinical review today. For these employees, claims are just being paid. Transparent Health immediately enacts these services when claims exceed a particular threshold. High claims are unavoidable in any size group health plan, but having an independent third party reviewing the accuracy and validity of the treatments and billing is extremely important in helping to control the cost of your health plan.

Why Transparent Health Over Any Alternative Solution?

Accountability Through Transparency

Transparent Health is the only solution to specifically target all the problems that exist in the current healthcare industry. Some alternatives attempt to solve one or two issues but cannot provide you reporting or accountability to prove the outcome of your investment. Transparent Health will present you with reporting which illustrates where every dollar of your healthcare investment is being spent and exactly how our cohesive five step program reduced your cost while building a sustainable model for the future.

Cost Savings

In addition to all the added benefits provided through Transparent Health, this model is the most cost effective when compared to alternatives. By removing all the layers that have typically made money through your health plan in the past, we are able to cut out the middle men that exist in other alternatives. BDS was able to cut these layers out by taking control of all elements involved in a health plan and only renting the carrier network.

Flexibility and Control

Having BDS control and administer your medical plan gives you the flexibility to customize your health plan however you wish! Your renewal each year is not a painful experience or a three month epidemic with carrier changes. Under Transparent Health your renewal will be an opportunity to mold your health plan to address your specific pain points. Instead of a dreaded process each year, we work on strategies to continue driving down cost and engaging employees. We have now traded up to the new Corvette, let’s take care of it!

* None of the elements outlined in Transparent Health are meant to imply a “Big Brother Approach” towards your employee population. The largest gaps in healthcare are due to lack of education and resources, we aim to work with employees that want to create a better quality of life for themselves and families. If employees are reluctant to engage in Prescription & Disease Management, they will not be forced to participate.

Contact us to find out more

Benefit Design Specialists, Inc.

BDS offers a range of services and products dedicated to a two-fold goal; delivering quality, cost-effective employee benefit plans coupled with hassle-free benefits management for our clients HR departments.

4550 Lena Drive
Mechanicsburg, PA 17055

Toll Free: (888) 273-7036
Phone: (717) 766-8844
Fax: (855) 289-2602

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