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» Cost Containment 101

January 31, 2023

Employee Benefits, Human Resources, Primary Care, Wellness

While this article mostly applies to self-funded plans, some strategies listed can impact the fully insured marketplace. If you correctly steer and educate your employees, cost containment should lower your claims. Henceforth, whether you are fully insured, level funded, or self funded, it should lower your overall spend and decrease your renewal. However, in a fully insured marketplace that is not always the case so I recommend starting looking at self-insurance options.  With current increases in healthcare, 54% of employers expect their healthcare spending to be over budget next year. Below is a list of ways to control your spend.

  1. Prioritize Primary Care: By providing comprehensive and preventative care, primary care physicians can help identify and address health problems early on, reducing the need for more costly treatments or hospitalizations down the line. Additionally, primary care can help manage chronic conditions effectively, leading to fewer complications and emergency room visits. By emphasizing primary care in the healthcare system, it can improve overall health and reduce the financial burden on the healthcare system.
  2. Virtual Care: Virtual care, which includes telemedicine and remote patient monitoring, can play an important role in cost containment by offering a more convenient and cost-effective alternative to traditional in-person care. See this attached website on rankings of virtual care platforms ( The benefits of virtual care include:
    1. Improved access to care: Virtual care enables patients to receive care from the comfort of their own homes, reducing the need for travel and making healthcare more accessible to those in remote or underserved areas.
    2. Reduced healthcare costs: Virtual care can help lower costs by reducing the need for expensive in-person visits and reducing the likelihood of costly hospitalizations or emergency room visits.
    3. Improved health outcomes: Virtual care can allow for more frequent monitoring and communication between patients and their healthcare providers, leading to better management of chronic conditions and earlier detection of health problems.
    4. Increased patient satisfaction: Virtual care offers patients a more convenient and flexible option for accessing care, which can lead to higher levels of satisfaction with the healthcare experience.

In conclusion, virtual care can provide a cost-effective and accessible alternative to traditional in-person care, leading to improved health outcomes, reduced healthcare costs, and increased patient satisfaction, making it a valuable component of cost containment strategies in healthcare.

  1. Consider a second opinion service: it can improve medical decision-making, reduce healthcare costs, improve health outcomes, and increase patient satisfaction, making it a valuable component of any cost containment strategy.
  2. Partner with a center of excellence: Partnering with a center of excellence (COE) can be important for cost containment in healthcare because COEs are typically highly specialized medical facilities that offer expertise and advanced treatments in specific areas of medicine. By partnering with a COE, healthcare organizations and payers can benefit from the following:
    1. Access to high-quality, specialized care: COEs typically have experienced physicians, cutting-edge technologies and best-in-class processes that can lead to better patient outcomes.
    2. Reduced costs: By directing patients with complex medical conditions to COEs, healthcare organizations can reduce costs associated with less-efficient care delivery and lower quality outcomes.
    3. Improved patient satisfaction: Patients treated at a COE often receive more individualized and effective care, which can lead to higher levels of satisfaction and better health outcomes.

In summary, partnering with a COE can help improve patient outcomes, reduce healthcare costs and increase patient satisfaction, making it an important component of cost containment strategies in healthcare.

Overall, cost containment is part of a bigger solution to your health insurance plan. The solution is refinancing your plan to a self-insured product so you can receive the correct data and implement the above strategies.

For more information, please reach out!

  • Eleanor Schroeder

Posted by in Employee Benefits, Human Resources, Primary Care, Wellness