The Problem of Being Functionally Uninsured
In the complex, opaque, and increasingly expensive world that is the US health care and health insurance industries, we have a new category of patient: the functionally uninsured. Like those with no health insurance coverage, Americans with high-deductible health plans are faced with crippling health care costs. These costs are shown to lead to more debt, mental health challenges, and people choosing to forgo care.
In this national survey of 1637 respondents, approximately 1 in 3 adults enrolled in a high-deductible health plan did not have a health savings account. Among those with a health savings account, most had not contributed money into it in the last year.
In other studies, one-third of Americans report they cannot afford to contribute to their HSA. One in three people report having avoided important care because of costs: 35% having skipped or delayed specialist visits and 32% having skipped or delayed primary care visits.
For employers or benefits advisors, it’s time to rethink offering employees these high-deductible HSA plans that leave them functionally uninsured unless they are coupled with a strong $0 out of pocket plan design if the employee or plan members seeks out directly contracted providers.
Direct Contracts Solve the Problem of the Functionally Uninsured
Fortunately, there’s a way to deliver higher-quality healthcare in a way that benefits all three parties: employers, patients, and providers. It’s cost-effective, simple, transparent, and achieves better health outcomes. It’s called direct contracting and bundled surgery.
Employers can contract directly with providers who offer bundled pricing and have proven track records of superior outcomes. Not only does this save the health plan and plan member money but it also allows the provider to earn more with no pre-authorization or collections. In turn, the patient knows exactly what a health care service will cost beforehand and isn’t overburdened by medical expenses, not to mention the better health outcomes. It’s a win-win-win relationship.
High Performance Providers Helps You Find Direct Contracts
High Performance Providers uses this bundled payment model to connect self-funded health plans with high-quality healthcare providers. We operate in the areas of orthopedics and sports medicine, knee and hip replacement, bariatric and surgical weight loss, spine/musculoskeletal, and general surgery.
Contact us if you are a health plan or involved in the purchasing of surgical services and wish to save 40-60%.
If you are a high-performing provider looking to direct contract with self-funded health plans, removing the transactional friction that comes with pre-authorizations, denials, and other administrative inefficiencies, schedule a meeting with us.
If you are a self-funded health plan and want to learn more about direct contracting providers in your area, we would love to talk to you.