Understanding Healthcare Basics and Future Trends Presented By: Blanca Abbud, MBA Senior Consultant, TriNet Welcome and Intro Draft Confidential
Blanca Abbud- Bio UT El Paso, BS in Biology and Chemistry, 2006 Born and raised in El Paso Texas UT El Paso, BS in Biology and Chemistry, 2006 Texas A&M, MBA concentration in Healthcare, 2016 Resident of San Antonio since 2007 TriNet, Senior Risk and Benefits Advisor, 2013 Ranked Top 10 reps in the nation Associations: UTEP Alumni Association, Board Member, 2014 San Antonio Manufacturers Association, Committee Member, 2014 Medical Group Management Association, Member 2015 Business Professionals of San Antonio, Board Member, 2017
Agenda Vocabulary Terminology Plan Designs Benefit Comparisons Strategy Future Trends in Healthcare
Vocabulary Deductible - (in an insurance policy) a specified amount of money that the insured must pay before an insurance company will pay a claim. Coinsurance - The percentage of costs of a covered health care service you pay (20%, for example) after you've paid your deductible. Let's say your health insurance plan's allowed amount for an office visit is $100 and your coinsurance is 20%. Copay - A copayment or copay is a fixed amount for a covered service, paid by a patient to the doctors office before patient receives service from physician. In the United States, copayment is a payment defined in an insurance policy and paid by an insured person each time a medical service is accessed. Premium - The amount you pay for your health insurance every month. In addition to your premium, you usually have to pay other costs for your health care, including a deductible, copayments, and coinsurance. Plan Design – Also called the Schedule of Benefits, gives a summary and description of all the benefits covered in the plan. Out of Packet Max (OPP)- An out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services. Once you've reached your out-of- pocket maximum, your plan begins to pay 100 percent of the allowed amount for covered services.
Terminology Networks Hybrid Networks – POS, HNO, OA, MC, HSA HMO – Health Maintenance Organization PPO - Preferred Provider Organization EPO – Exclusive Provider Organization ACO – Accountable Care Organization Hybrid Networks – POS, HNO, OA, MC, HSA Insurance Providers Grandfathered vs. Non-Grandfathered Self insured vs. Fully Insured
Health Plan Designs
Benefits Comparison
Healthcare Strategy Solutions Options Tools Continuing Education Contribution Classes Base and Buy Up Options Network coverages Tools Not going to the ER or Urgent care Lower utilization Wellness Programs Continuing Education Best Practices
Top Healthcare Trends in 2017 Financial Pinch Technology Financial Viability Risk Management Population Health Management Improved Outcomes Increased Collaboration References: https://www.clearpointstrategy.com/top-healthcare-strategy-trends-2017/ https://www.healthcatalyst.com/top-healthcare-trends-challenges
Takeaways Use visuals and stories to covey our message during meetings How to have PEO high level discussions What words to stay away from Understanding that people learn differently and what way to seel to each learning style Draft Confidential
Q&A Contact Information: Blanca.Abbud@trinet.com 210-643-9431 5 minutes Everyone can take turns answering questions as they are asked. Draft Confidential