Ever Asked a Hospital What a Procedure Costs Them?

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Can the cost of a hip replacement in Philadelphia really vary from $11,000 to $125,000?

From white papers to published books, much has been written about how difficult it can be to find out what a hospital stay or outpatient procedure will cost. And as Anna Wilde Mathews observed in her article Lifting the Veil on Pricing for Health Care, the mystery surrounding healthcare pricing stems partly from the fact that hospitals and other providers generally don’t publicize how much they’re paid for services, which varies depending on who’s footing the bill.

Much has changed recently. And while it is difficult for websites like healthcarebluebook.com to quote exact pricing, they do suggest what a reasonable price should be based on what insurance carriers have paid hospitals for certain procedures in a certain geographic region.

It’s easy to understand why hospitals are reluctant to share price information. Consider the results of a study on hip replacement surgery published by JAMA Internal Medicine. According to Dr. Joseph Bernstein, professor of orthopedic surgery at the University of Pennsylvania, while more than half of the 120 hospitals surveyed could not provide a cost for the surgery, those that did quoted prices ranging from $11,000 to $125,000.

How can your health plan achieve price and quality transparency? Treat healthcare expenses like other business expenses! Self-fund with Medicare Reference Based Pricing and partner with a TPA that has the willingness and know-how to hold providers accountable.

These are today’s keys. These are the things we do for our clients each and every day. To take control of your healthcare costs, give us a call at your convenience.

Tell Us How You Feel!

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Is Your Health Plan a Victim of Pharmacide?

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Over the past several months, the Trump administration has introduced several ideas intended to fight skyrocketing prescription drug prices – everything from forcing manufacturers to display prices in their television commercials to having Medicare base payments for costly drugs on average prices in other industrialized nations, which are much lower than in the U.S.

While some prefer to criticize or sit silently by as prices keep rising, we say keep the ideas coming. This is a crisis requiring aggressive action, like our Pharmasense program, that tackles the real problems driving the cost of specialty drugs used to treat complex medical conditions.

Prior Authorization (Pre-Certification) is at the core of Pharmasense. It helps self-funded health plans avoid potential conflicts of interest that enable massive mark-ups and other abuses go unchecked. Pre-certifying specialty drug prescriptions prevents hospitals or PBMs from reviewing authorizations and dispensing specialty drugs without any independent review process. The same is true when providers submit specialty drug prescriptions as claims under the medical plan rather than the prescription drug benefit plan. As an independent TPA, we use these tools to deliver quality patient outcomes and significant cost savings by avoiding the kinds of conflicts described above.

If your prescription drug costs are spiraling out of control, it’s time to take serious action. Talk to us about ways to prevent Pharmacide today!

Tell Us How You Feel!

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Help Diversified Group Support Operation E.L.F. for the Holidays

Diversified Group is happy to be collecting donations for Operation E.L.F. (Embracing Lonely Families) again this Christmas season. Operation E.L.F. is an organization that assists military families whose loved ones are overseas for the holidays.

12196362_1111921568825671_3251173012153062686_nWe will be taking donations through Monday, December 10th. Donations can include new, unwrapped toys and clothing. Please drop off items under the tree in our lobby. Gift cards are also welcome and can be placed in the basket inside our lobby. Volunteers are asking if you give clothing to please leave the tags still on and please remember to keep the gift card receipt with any gift cards given.

Military families in Connecticut receive these holiday gifts at a time when they may be unable to provide for their children as much as they would like to. Diversified Group is so grateful for everyone’s generosity and we are proud to help make Christmas a little brighter for these families.

To learn more about Operation E.L.F., please click here: https://www.facebook.com/ConnecticutOperationELF/.

 

Diversified Group Named One of Connecticut’s Healthiest Employers of 2018

This announcement from the Hartford Business Journal was published on December 3, 2018.

Meet CT’s healthiest workplaces

Hartford Business Journal’s first-ever Healthiest Employers Awards recognize organizations dedicated to employee health and safety in addition to their efforts to implement wellness programs.

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The awards program was done in partnership with the Healthiest Employers Group, which determined the finalists and winners using a scoring methodology managed by Springbuk, a privately held technology and data research firm.

Companies that participated in the awards program had to complete an hour-long online assessment. Companies were then ranked based on their performance on the following six measures: culture and leadership commitment; foundational components; strategic planning; communication and marketing; programming and interventions; and reporting and analytics.

CATEGORY: 0-150 CT EMPLOYEES

1st Place | Antea Group

2nd Place | FM Global

3rd Place | Gallagher

4th Place | Diversified Group

5th Place | Safelite AutoGlass

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Photo Source: Hartford Business Journal

Diversified Group

4th Place | Category: 0-150 CT employees

Industry: Employee benefits

CT Headquarters: Marlborough

CT Employees: 64

When Diversified Group (DG) started its fitness program back in 1985, it basically consisted of a boot camp-style fitness contest.

But over the years, commitment to health and wellness among employees has intensified to where DG now has a wellness department staffed by six certified health coaches, personal trainers and registered dietitians. The wellness team is responsible for spearheading the company’s wellness program.

DG has also maintained a modest fitness facility on its grounds, and within the last five years, certified instructors have been stopping by on a weekly basis for cycling, strength and yoga classes.

DG also hosts regular meditation workshops giving workers access to guided meditation sessions to decompress and recharge.

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Employers Investing More in Benefits

wellnessHealth and wellness are integral to employee performance, which helps explain why employers are investing more in their employee benefit offerings.

In June of 2018, the average cost of benefits rose by 2.9%, while wage costs rose by 2.7%, according to data released by the Bureau of Labor Statistics. Also on the rise is paid leave, which has seen a 4% cost per employee increase since 2017. This includes paid parental leave, which allows time off for a birth, adoption or foster placement of a new child.

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More Patients Texting

mobile phoneHealthcare professionals that aren’t utilizing text communications are failing to meet their patients where they are. A 2018 survey found 11% of patients would rather communicate via text message, a number that is expected to grow as the Millennial population begins to outnumber Boomers. Text alerts and communications can be used for a variety of services, including preventative care such as periodic appointments and flu shots, post-treatment care information, remote health monitoring and chronic disease management.

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Are Your Plan Members Sharing in Your Plan Savings?

A little skin in the game can make a big difference.

At our recent “Let’s Take Control” themed Solutions Day, Adam Russo of the Phia Group shared his story that earned front page coverage in the Boston Globe. He told the audience about a tactic Diversified Group has helped many employer groups implement over the years – sharing plan savings with employees who are willing to shop for high quality, lower cost providers.

As Adam illustrated, employees of Phia Group who do their part to lower costs receive 20% of the plan savings. A member who saves the plan $5,000 on the cost of an MRI receives $1,000. And that’s just one example – their plan places no limit on the amount of savings it will give back to a covered member.

Diversified helps many self-funded employer groups craft their plan document to include member incentives. Waiving copays on generic drugs and urgent care visits is an easy option to implement. Another powerful step is to reward plan members who speak with HR before arranging for a costly healthcare procedure such as surgery. Not only will this engage members and open their eyes to available savings, but it can often create an opportunity to better manage or perhaps even avoid a large claim in the future.

Incentivizing members is just one of the ways we’re helping employers “take control” of rising healthcare costs. To learn more about this and other solutions made possible by self-funding, give us a call at your convenience.

Tell Us How You Feel!

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