“Earth to employers/employees – BUCA networks permit 1,000% pricing variation for the same care in the same city in the same network. PHCS permits over 2,000% pricing variation. 80% of you don’t meet your deductible so you are paying out-of-pocket cash for all care.”
The Tail is Wagging the Dog. At CareGuide Advocates, we partner with innovative TPAs that also don’t let the tail wag the dog.
Tail wagging examples:
1. Co-pays and coinsurances. These are stupid. Simplify the health plan and get rid of them. Have a deductible. That’s it. Just like your car insurance. Anything over $1,500 your insurance will pay for. Bonus: you don’t need a bogus BUCA accumulator calculator for out-of-pocket expense. We set the rules. Not BUCA.
2. Must stay in-network for care. Earth to employers/employees – BUCA networks permit 1,000% pricing variation for the same care in the same city in the same network. PHCS permits over 2,000% pricing variation. 80% of you don’t meet your deductible so you are paying out-of-pocket cash for all care. It’s the price that matters whether in or out-of-network. It still pratters! Networks don’t save you money. CareGuide Adovcates does by telling you where you can go and what you should pay.
3. TPA BUCA network agreements. Don’t sign the standard ones if you are the employer. There are as little as 10 and as many as 20 clauses in these agreements that are illegal or favor the hospitals and BUCA or both. Your ERISA liability is large and looming. And locally, Heinz is pouring it on (pun intended) with Aetna and its lawsuit in regard to monetary abuses.
4. Thinking an app saves you money. I call BS. 1% use after one month from time of download until death. CGA will be your healthcare price defender for life. You can experience a relationship and a caring friend on the other end of the phone. Cost savings solutions exist for both before and after the care occurs.
5. Education works. Nope. I call BS. Better to create awareness. Someone has a problem with a big hospital bill or the price of care before they get it, they just want their problem fixed. They could care less how we did it. They just care that we did it. And we do it.
6. Emails for engagement. Think again. 18% open an email in a week. The rest never get opened. 92% read a text within 8 seconds. Change your thinking and technique. The real engagement tool is money. Money is the only motivator, either by plan design, eg no out-of-pocket for preferred providers for common care, or debit card money reward card incentive.
Call CareGuide Advocates, your healthcare price protectors, and save money on healthcare before and after the care. Quit letting the tail wag the dog. Serving MEC plans, indemnity plans and self-funded plans with TPA partnerships.