In late 2011, predictions for 2012 US health insurance premiums suggested a slower rate of increase than had been experienced in recent years. However encouraging that may have sounded to employers worried about managing their business costs, it suggested that relief over lower increases could be tempered by the knowledge that a reduction in premiums was not on the radar as far as future projections are concerned.
If health premiums are set to rise for the foreseeable future, that translates into increases in the cost of care becoming a facet of the modern way of life for the whole of the developed world. It doesn’t just apply to health care financed by insurance premiums either. Even schemes like the UK National Health Service, or the joint insurance and national health systems of France and Germany, are feeling the pressures of financing care. This is because the demographic consequence of increased longevity and improved long-term treatments for acute conditions offer successful but costly solutions to maintaining our quality of life.
How do employees and employers choose a health plan that offers a degree of security against increases in price or severe reductions in benefits and service to meet the bill? Derry Graham, General Manager of BritCay put it this way, “We now live in an era of unprecedented access to high quality health care. This has come about because we have asked for it and benefited from it. BritCay was the first company to offer overseas network care because our customers asked for it. Now it is commonplace to have a health insurance plan that offers local care, to the limit of local resources and expertise, and oversees care when it is needed for major courses of treatment. Finding a health plan that maintains choice, access to benefits and a degree of confidence in future premiums is paramount in having a health plan that allows businesses to budget accurately. Businesses can then take care of employees in a way that allows them to remain focused on the needs of the business without doubting their health plan on service or benefits. BritCay is in a very fortunate position in this respect.
“We have had a direct relationship with the same network provider since 1995 and benefit from the leverage of 50,000 members in securing discounts as high as 65 per cent to help keep costs under control. However, we have made several key investments in service to facilitate further controls on costs and provide more convenient access for local and international providers to manage the patient through treatment without unnecessary delays. We are now able to offer claims settlement in an average of 5-10 days with an accuracy rate that exceeds 98 per cent. We can confidently say that BritCay has not lost a client for reasons of poor service or lack of access to benefits, and we still maintain a market competitive premium”.
BritCay is a member of Colonial Group International, business partners since 1984, and the latest investment in service capability (2011) was a $1 million upgrade to online management capability. It allows any medical provider with Internet access to log onto the system and verify eligibility data and submit a claim in what is increasingly becoming a paperless management capability.
Graham explained the significance of this.
“Basically, if you are choosing a health plan, and you are worried about price increases or value for money, look first at the level of service and benefits you are likely to receive. If the service is fast and efficient, that indicates effective cost management and fewer errors. If providers can enjoy similar service efficiencies, it opens more doors for your employees when accessing benefits too. That also means you and your employees will have more choice over very personal issues, but it also means more providers can support the plan and the cost controls in place. Secondly, more freedom of choice for individuals when seeking care is a good indicator of accurate underwriting and effective negotiation of rates. Plans providing choice by permission of an employee of the insurance company (a gatekeeper), or by passing more costs on to employees, usually indicates how the insurance company is trying to control costs. Something has to give in that scenario, and we believe it is value for money. BritCay has not had to curtail benefits or choice to manage premiums.”
Healthcare costs are likely to continue to rise as hospitals and drug companies seek to recoup costs of new initiatives, technologies and improved treatment courses – something from which we all benefit. While there is no guarantee on future costs, make sure you fully understand how your health plan works and what you can receive in benefits before deciding on value for money.