reduce your health insurance costs
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A Solution to Manage Health Insurance Costs
THE PROBLEM: TRADITIONAL HEALTHCARE
Over UtilizationAverage Cost of a PCP Visit is $153Average Cost of a Urgent Care Center Visit is $350Average Cost of a Emergency Room Visit is $1029Doctors are Paid for Service.As we get older we tend to need more healthcare.Employees don’t understand the cost of service.Doctors practice “Defensive Medicine”.Most doctors’ offices closed over 75% of hours/week.
Avg. time to make an appointment, 3 weeks.Avg. time spent in waiting room, 23 minutes.Over 66% of ER visits are for non emergent reasons.
THE PROBLEM: Continued
Cost Prohibitive 25% of people have skipped a recommended medical test due to cost. 24% of people do not fill prescriptions. 16% cut pills in half or skip doses.
Untreated Stress 75 - 90% of visits originate from stress factors. 25 million Americans will have an episode of depression. Employees do not know where to turn when they are stressed.
No/Limited resources available. Uneducated about resources that are available.
Employees do not seek treatment for stress or depression. There is a stigma to receiving help to improve mental health.
THE RESULT: Increase in claims. Skyrocketing insurance premiums. Insured employees do not behave like consumers. Individuals visit Immediate Care Clinics & E.R.s instead
of their PCP. Individuals who wait to receive treatment seek care
when their illnesses becomes more severe. Employees are distracted and less productive at work. Employees miss more work. Employees incur more costs
What is the Solution?
A Consumer Driven Health Insurance Plan with an Effective
“First Alternative”
A First Alternative is a low cost, high impact resource employees & their families can access before seeking a more
expensive healthcare solution.
What is CADR+
Telemedicine means using information and communications technologies for the delivery of
healthcare services.
is Telemedicine
Growth of Telemedicine
By 2015 Industry experts realistically foresee
100 million individuals/yearaccessing virtual care services like telemedicine.
This level of growth mirrors the development of the popular MinuteClinic model, which had less than
100,000 visits in 2006 and in late 2011 grew to more than
10 million visits/year
100+ Carriers across 26 states reimburse for telemedicine:
States with legislative mandates: California ColoradoGeorgia HawaiiKentucky LouisianaMaine New HampshireOklahoma OregonTexas VirginiaMaryland VermontMichigan And Growing…
PREDICTION- ALL MAJOR PLANS 50 STATES – 36 MONTHS
Trend: Rapid Growth of TelemedicineWidely reimbursable and becoming fully integrated into the delivery systems and benefit offerings of major health plans and self-funded groups.
Resource for Living
Telemedicine
Multiple Ways to ConsultTechnology and service platform which allows patients to consult with physicians via Telephone, Mobile APP, Video, On-line,Email & Text, on an immediate basis,24/7/365 AND receive a refill or prescription for their illness…ready when they are!
Give them a call and you will be connected within 90 seconds!
National Telemedicine Physician Network
Enterprise Platform PLUS CADR’s National Network of Primary Care Physicians
50 State PCP Provider Network U.S.-based, Board Certified/Eligible Credentialed to NCQA Standards 170 Languages Supported On-Demand (24/7) Via Secure Phone,
Web (Video/Email) or Mobile App Additional Specialties Now Online:
Pediatrics, Cardiology, OB/GYN Mental Health, Endocrinology
Patients triaged to alternative level of care when necessary.
Cold/Flu Sinus infections Upper Respiratory
Infections Allergies Headaches Urinary Tract
Infections (UTI)
Zithromax Z-Pak Amoxicillin Albuterol Augmentin Tessalon Perles Azithromycin Keflex Bactrim
Macrobid Pyridium Biaxin Allegra Bactrim Ibuprofen 800 Nasonex Lipitor
* NO DEA CONTROLLED SUBSTANCES
Less prescribing than office settings Doctor less pressured More convenient More accessible Less effort/ aggravation for patient
~40%
Cipro Lisinopril Tamiflu Prednisone Metformin Flonase Diflucan HCTZ Levaquin
Top 25 diagnosis
Top 50 diagnosis
Bronchitis Stomach Ache/Diarrhea Eye infections Ear Infections Rash/Skin Irritation Yeast Infection Other GYNE complaints
Conditions treated with Telemedicine
73%
Common Medications PrescribedCommon Medications PrescribedCommon ConditionsCommon Conditions
82%
Symptom CheckerInteractive questionnaires designed to narrow down condition or illness
Health Risk AssessmentInteractive health tools identify health risks and promote wellness.
Wellness Tool & Lab OrderingPromote prevention with discount wellness tests for at risk population.
ePrescribing to Choice Pharmacy Safer and faster way to get RX medication when necessary.
Interactive Health ToolsPrograms to help stop smoking, learn about diet, nutrition & more
Health Library The latest articles sorted by topics, most popular or key words
Mobile Phone: First Aid Medications Medical Tests / Labs Wellness Chronic Condition Management Challenges Rewards Support Groups
Features / BenefitsElectronic prescribing
Less errors SureScripts RX history Med2Med
interaction Decision support Evidence based
Pharmacy of choice By home, work,
hotel, school Less wait Formularies Insurance
Documented in EMRReported to PCP/Plan
ePrescriptions
Follow Up/ReferralPost Consult Benefits Follow up care
instructions Telemedicine
consultations In-person referrals Patient education Scheduled
messages/reminders Diagnostic labs Health tracking tools Health risk assessments Coding
CPT ICD-9
Presented by
WaveFront Brokerage Services
• Low-PEPM of $2 - $5 (Physician consult = $38/consult; Wellness consult = $27/consult)
• 2 - 12% utilization rate nationally (lowest in nation)
• Avg. Physician response time: up to 3 hrs.
• Consultations available by telephone only after going online prior.
• No recording of consultations
• SureScripts Access – No.
• Secure Email Consultations – No.
• Very modest physician network (reason physician response time slowest)
• Employee + Family $30/month (Unlimited usage; no fees)
• 18 % utilization rate
• Average Physician response time: 24 minutes
• Consultations available by telephone, internet and video.
• Record consultations and post to personal health record.
• SureScripts Access – No.
• Secure Email Consultations – No.
• 2,000 GP Physician network (not enough physicians to handle current rate of enrollments)
• Employee + Family $10/month (Unlimited usage; no fees)
• 26+% utilization rate
• Avg. Physician response time: 90 seconds.
• Consultations available by telephone, internet, video, smart phone app, secure email, chat, and text msg.
• Record consultations and post to personal health record.
• SureScripts Access – Yes.
• SecureEmail Consultations – Yes.
• Nation’s largest physician network; includes specialists (ONLY Physician Network equipped to handle current rate of enrollments).
Resources for LivingAetna Resources For Living provides the resources you
need to help you handle life’s challenges, whether that
be emotional, financial or legal. They’re your partner in
achieving resiliency.
THE STRESS EFFECT Over 1/2 of Americans self-report that they are “struggling” with
life today and 1/3 state their average stress level as “extreme”. 75 – 90% of doctor visit are considered to be stress-related. Stress is linked to all of the leading causes of death including
heart disease, cancer, accidents and suicide. The World Health Organization estimates that the equivalent of
7.1 productive days are lost per employee each year due to stress-related factors.
25 million Americans will have an episode of major depression this year alone.
WHAT IS AETNA RESOURCES FOR LIVING? A no cost, confidential telephone consultation and referral service for
employees and their household members. 24/7 online access to targeted resources.
Members can speak with a counselor any time — 365 days per year — from the comfort and privacy of home or anywhere else they choose.
Members engage instantly with a clinician — with no limit on the time it takes to help resolve their issues.
Legal/Financial , ID Theft, Crisis counseling Patient Advocacy Personalized assistance with child care, elder care, pet care and everyday needs Coaching or counseling to help members achieve worklife balance Access to the online Discount Center, your one stop resource for every day
savings on electronics, travel, movie tickets and more.
Resources For Living
How it Works: Give it a TRY!
Phone Number1-877-856-1788
Websitewww.mylifevalues.comLogin: CADRPdemoPassword: demo
The lowest cost, highest impact soluction to many of the issues plaguing the healthcare system today.Simply put…
The lowest cost, highest impact solution to many of the issues plaguing all Employers, Employees and the
healthcare system.
Benefits ofReduces health insurance claims.Reduces premium costs and premium increases.Reduces costs for employers & employees.Reduces the need for employees to take off work.Reduces distractions at work.Increases productivity.Turnkey Implementation.
Families & Individuals
Unlimited, 24/7 Access
Individual Enrollment
Credit Card or Bank Payment
Up to 6 Family Members
$19.95/month
Group Voluntary
Unlimited, 24/7 Access
Multiple Groups
Opt-In Enrollment/Payroll Deduct
Up to 6 Family Members
$14.95/month
Group Sponsored
Unlimited, 24/7 Access
Multiple Groups
Whole Group Enrollment
Up to 6 Family Members
$10/month
NO Underwriting, ALL Qualify – Pre-existing Conditions Included
Pick Your Plan
You’re in Good Company
The lowest cost, highest impact soluction to many of the issues plaguing the healthcare system today.
Partner: Pepsi Bottling Ventures
Covers 26 locations in 7 States
• - ROI: 413% based on actual usage• - 99% satisfaction rate• - 16 minute average response time• - 80% of people who used the platform would • have gone to a higher cost setting• - 48% would have taken time off work, but didn’t
Case Study…
Good Referrals for me are: Self Insured Employers Employers that don’t offer Health Insurance Employers with high deductible health plans Companies with Hourly Wage Employees Health Insurance Brokers Human Resource Professionals Third Party Administrators Doctors who want to expand their practice Hospitals Administrators Public Health Departments Colleges & Universities
Presented by
WaveFront Brokerage Services
Thank you for viewing this presentation!
Presented by:
Mike Sweeney847-340-8291