When it comes to health care and group health insurance, Hoosiers have always preferred PPO networks which allow the member to choose which medical provider they want to receive treatment from. With any group health plan, Indiana employees have demanded that they could choose their medical providers. This is starting to change because the cost of care in Indiana is one of the highest in the country.
Insurance companies, medical providers and TPA have started to develop their narrow health care networks all so known as skinny networks.
Medical providers have introduced their own health insurance plans in an attempt to attract employers that want to control costs. These networks come in the form of Health Maintenance Organization (HMO) and Employer Preferred Organization (EPO).
IU Health Plans has its own hybrid HMO plan that has slowly gained membership. They offer a hybrid HMO that also provide a traditional PPO network. These options can be competitive but the real cost savings comes from their tier 1 network which is a true HMO. This HMO can deliver a 25% reduction in the premium vs. a traditional PPO plan. IU Health plans promote an integrated care experience for members, where are the medical providers are in communication with one another. The integrated model is supposed to deliver better treatment outcomes and a better overall experience for the patient.
St. Vincent’s recently launched their own health plan called Advantus which utilizes a skinny network of St. Vincent’s and affiliated medical providers. AdvantUs is offering a self-funded/level funded health plans in the small and mid-size markets. These plans are potentially reduced costs by 10% vs other level funded products. IF compared to a traditional fully insured PPO plan, the initial saving is more like 30%.
Anthem recently launched their own skinny network called health sync which is an HMO that currently utilizes the Franciscan network. The product is for both small and large group. There is upfront savings vs. Anthem PPO network along with innovative programs to control future medical costs.
Employer Direct Contracting with the health provider. Large employers can contract directly with the medical provider, which could exclude the traditional insurance company. Negotiating directly with the medical provider for an exclusive contract can lead to a significant reduction in the cost of claims. In some of Indiana’s communities, this approach could reduce medical costs by as much as 50%.
In the past Indiana, employees have been reluctant to accept narrow networks, with the skyrocketing medical cost now being revealed to the general public, employers are starting to entertain these cost controlling techniques. The younger millennial generation is open to using skinny networks, which may lead to employers implementing these plans.
If you are interested in learning more about these options, contact us.