For Employers Held Hostage by Managed Care Companies – A Plan of Escape

Despite healthcare reform debate, rising medical plan costs continue to pummel U.S. employers. Corporate health plan costs are projected to increase again this year by more than 6%*. Since 1999, costs have increased by 134%**, nearly five times the cumulative rate of inflation.Ironically, during this same 10-year period, private health insurers posted record profits, while holding their employer-clients as hostages, feeding them only soaring costs, poor service, and lots of excuses.
But one major east coast company escaped the hostage situation and just celebrated its 8th straight year without a medical cost increase. In fact, while other companies reduced benefits to lessen crippling rate increases, this employer, whose medical plan covers 45,000 lives, actually enriched its benefits program. Today, its annual health plan costs per employee are 60% below the national average.These astonishing results were achieved without a major insurance company’s help. The employer simply eliminated the managed care middleman entirely and contracted directly with doctors and hospitals.Cutting out the middleman is an age-old idea, but when it comes to employer health plans, insurance carriers still hold employers hostage. Large managed care networks, controlled by profit-bloated and increasingly monopolistic private insurers, have emerged as the only means of coverage for employers. They’re also the dominant source of patient revenue for doctors and hospitals, so medical providers are held hostage, too. Consequently, the middleman controls both sides of the healthcare equation and effectively prevents buyer and seller from doing business directly with each other.Though highly effective, direct contracting is still largely unknown to CEOs whose companies are held hostage. Whipsawed by relentless cost increases, their benefit departments still rely on profit-centric insurance companies for cost-containment strategies, most of which are based on conventional managed care networks and cost-shifting onto employees. As true hostages of the big carriers, employers have been effectively brainwashed into believing there’s no viable alternative to the carrier’s approach. They’re convinced that if the big insurers like Blue Cross, United Healthcare, Cigna, and Aetna don’t have the answers, no one does. But direct contracting proves otherwise.Direct contracting creates a “win-win” business relationship between employer and medical provider, the true “buyer” and “seller” in the managed care equation. By cutting out the managed care middleman, the employer and provider eliminate the inherent disadvantages and financial shortcomings found in commercial managed care contracts. The direct agreement saves the employer money without shortchanging the medical provider. It creates a strong, stable, long-term, and mutually beneficial business relationship.Employer-owned networks are comprised of doctors and hospitals that provide medical care according to the employer’s health plan. For instance, the east-coast employer mentioned earlier has direct contracts in place with more than 10,000 physicians and 80 hospitals across 15 states. Direct agreements give employees and dependents easy access to medical care, while paying those providers quickly, fairly, and without administrative hassle.Direct contracting bears no resemblance to the complex, adversarial, and financially disadvantageous network agreements forced upon medical providers by insurance companies. Direct networks truly unite physicians and employers in the goal of providing accessible and affordable medical care to employees, without the obstacles and costs found in commercial PPO networks.As an alternative to HMOs, PPOs, and other commercial managed care approaches, direct contracting is a proven solution for employers who are desperate for relief from soaring costs. For employers held hostage by insurance carriers, direct contracting is a bold plan of escape. However, for such a plan to work, it requires strong executive-level leadership and a willingness to take risks along the way. But for those companies that do, the rewards of freedom from the carriers can mean huge savings, happier employees, and better control over future health plan costs.* According to Towers Perrin’s 2009 Health Care Cost Survey, the average corporate health benefit expenditure in 2009 will be $9,660 per employee–an increase of 6% over 2008 figures.** Kaiser Family Foundation Employer Health Benefits 2009 Annual Survey.

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Where Can I Get Health Insurance Help?

Here is some good health insurance help for people who want to apply for a health insurance policy, but do not have any knowledge about health insurance. However, before discussing in detail about health insurance plans, let us observe why health insurance is important.A need for health insurance plans has arisen due to rising medical costs. It is impossible for individuals to bear all expenses on their own during certain situations when unplanned health expenses creep into their budget. Therefore, it is necessary for people to opt for ideal health insurance plans.Types Of Health Insurance Plans:When individuals approach any health agent for health insurance help, insurance agents suggest four types of policies to them. They are as follows:Major medical plan:Major medical plans are those plans in which individuals need to pay deductibles to health coverage companies to obtain benefits. Deductibles are nothing but a part of the amount, which people have to pay while applying for a policy. Later, health insurance firms pay about 80% of medical bills and insurers have to pay the remaining 20% of billed amounts.Buyers may select any doctors to get medical services and pay fees to these doctors directly. However, they need to obtain a bill and furnish it to the insurance companies, who in turn reimburse 80% of the bill amount to the insured. This type of health insurance plan is a traditional health plan.HMO plan:An HMO (Health Maintenance Organization) is a type of health policy that focuses mainly on life long health care of the insured. This plan is more affordable than the major medical plan. People need to select their doctors from a list of doctors furnished by insurance companies. These doctors provide medical services to them. If required, they also co-ordinate with other specialists and hospitals, to provide the best available health service.As a result, most people across the US prefer this type of health plan.PPO health plan:PPO (Preferred Provider Organization) is similar to an HMO plan. Health insurers refer in-network doctors and insured people refer their own out-network doctors. Here, people may choose in-network or out-network doctors as per their wish.However, if people choose out-network doctors they will have to shell out a huge amount as fee because in-network doctors charge a reasonable amount. Whether insured people choose in-network or out-network doctors, health companies pay only 80 % of the medical bill amount to insured people.POS Health Plan:POS (Point of service) health plan has properties of both PPO plan as well as of HMO plan. Here, people need to select the doctors referred by insurance companies. However, people may then seek treatment from out-network doctors after informing and taking permission from their in-network doctors. This plan is slightly more expensive than other health plans.Thus, refer to this health insurance help and choose the best health plan to cover the medical bills so that the unexpected cost does not hamper the monthly budget.

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Mind-Body-Spirit Wellness And The Search For Powerful New Health

The mind-body-spirit debate has developed into a well known researched fact over the past decade. While there has always been some amount of contribution given to the mindset of any patient, only recently has the concept of caring for the “entire self” become a common practice in today’s modern medicine and prevention programs. Mind-body-spirit wellness has reached new levels of inclusive factors for today’s health conscious individuals. Holistic health has finally reached acceptance in many offices of doctors and practitioners of medicine.The power of caring for one’s entire body is really quite impressively powerful. Individuals who have opted for total mind-body-spirit wellness have been able to determine great levels of health and energy within their own framework by allowing their entire being into account. Studies on the power of the mind have shown some shocking results, the effects have been proven to be of course, mind-blowing.Holistic health is essential in providing high quality total care for your self, your family, and your overall well being. Studies have proven that holistic health practices have dramatically reduced the number and frequency of illnesses related to common every day exposure. School children living in mind-body-spirit wellness focused homes miss less than half of the school days due to illness than that of their classmates still living in traditional Western medicine focused homes.Accounts of real world individuals being able to provide testimony to the effects of holistic health practices on their daily lives are continuously increasing. Many individuals offer that the mind-body-spirit wellness approach to life has given them not only their physical health back, but their emotional health as well. For those who place more emphasis on the testimony of physicians and health care practitioners, there are an increasing number of offices that practice mind-body-spirit wellness as part of their routine care.Holistic health and the mind-body-spirit wellness approach to life has also opened up a while new industry for the entrepreneurial spirit. Many manufacturers feel that it has been nothing short of a blessing to fully endorse their product without doubting the word of their advertisers. There is a vast and endless ocean of new and improved products which adhere to holistic health practices and principles which have emerged onto the market as of late, and for the most part, these products actually do what they say they are going to do. Of course, we wouldn’t be an enterprising society if a few unscrupulous manufacturers didn’t sneak in there for their piece of this multi billion dollar industry. Our culture responded appropriately by deeming specific authorities on the topic to be the final word in quality and effectiveness.By developing institutes that focus completely on mind-body-spirit wellness and awareness, there has been a successful and remarkable overhaul in the basic integrity of holistic health materials and products. While of course there are still some scam factories out there, the vast majority of holistic health companies want to be part of this ever growing, popular, and health enhancing trend that is changing the lives and souls of everyone involved.Holistic health products that are able to make claims of providing “miracle” results are generally not considered to be authentic products endorsed or even recognized by any authority of holistic health practices. Rather, while there have been case reports regarding “miraculous results” on an individual basis, the mind-body-spirit wellness community does not promote grand promises but instruction, focus, and of course, directives that help individuals enhance their mind-body-spirit connection. Very few products on the holistic health market today receive genuine endorsements or “approval” from these authorities. Those that do have not only been proven to deliver what they promise, but also meet a strict standard of what constitutes and actual holistic health product.As the mind-body-spirit wellness and awareness movement grows and matures over the next few years, there is bound to be growth in numerous areas of product development. What has reached the market now can be considered to be some remarkable enhancements in the holistic health practice. In fact, there have been a few products which not only earn the endorsement of leading authorities, but actually are not expected to be able to be produced better than they are right now. This is a pretty bold statement considering that technology and education will never be static yet those few products out there that are being praised and sung by the leading authorities have literally taken the holistic health product market by storm.Our society will most likely continue the never ending search for powerful new health remedies and holistic health products which enhance the mind-body-spirit wellness experience with great enthusiasm and vigor over the next ten years. After all, what is considered a relatively new phenomenon in this country has been considered to be tradition in other societies for centuries. There is a wealth of knowledge waiting for us to uncover as time goes by.The mind-body-spirit wellness movement and the holistic health practices that are now finally being viewed as medical advancements will continue to offer our society a new way of looking at health, not to mention a vast assortment of new health treatments. This can only be considered to be good news for those who suffer from chronic conditions, serious health problems and illnesses, or the healthy who wish to remain that way.

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