Going Around Insurance Carriers Can Lower Costs and Increase Quality

Here’s a fact: in 2020, UnitedHealth, the largest healthcare insurer in the US, pulled in $257.1 billion in revenue, and $15.4 billion in profit. That’s an impressive amount of money, but also wildly inefficient. Could your business keep the lights on with margins that low? Probably not. Think you can do better? You probably can.

Direct Contracting and Bundled Pricing are two alternative reimbursements that allow you to step into the role of the insurer and work directly with healthcare providers. By doing your own negotiating, you can eliminate the inefficiencies of big insurers, lowering costs and ensuring high quality of care for your employees. 

With Direct Contracting, employers contract directly with providers, just as an insurer would. Because you set the terms with the providers of your choice, costs for care, both premiums and out-of-pocket, are completely transparent. Neither you nor your employees will suffer unexpected costs or surprise bills. And of course, because you eliminate the “middle-man” of insurers and their inefficiency, you and your employees can save on the true cost of care.

Generally used for surgical procedures, Bundled Pricing also lets you work directly with a provider, except this time, you arrange an all-in-one price per procedure. This allows you and your company to ensure fixed costs without surprise pricing – that often leads to enormous increases and variability in costs.

With surgical costs accounting for 31% of annual healthcare spending, it makes sense to prepare and know your costs ahead of time. A RAND Corporation study found that when employers used Bundled Pricing, they saved an average of $4,229 per procedure. In addition, if complications occur, you and your employees pay nothing more than the bundled price negotiated.

Both Direct Contracting and Bundled Pricing allow you to avoid the bloated costs of traditional insurance. However, the greatest benefit these alternative reimbursements provide is that you get to make arrangements with the high-quality providers of your choice. By not having to select from a given list, you have the power to ensure top-notch care for all of your employees, every time they need it. 

Ready to do better? Your company can.