Making managing healthcare expenses easier

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Presentation transcript:

Making managing healthcare expenses easier 2/24/17

Fulfilling our Mission Helping people increase well-being through better health and greater financial security

Problems faced by Healthcare Consumers Moving from Passive Patient to Active Consumer Paradigm Shift in Cost-sharing Consumers are confused They don’t know the total cost prior to, or at the time of, service Get multiple bills from several different entities. “What do I owe?” X 2.5 2015 $1,541 2005 $622 Avg. deductible more than doubled in last 10 years¹: X 1.3 2015 $48,099 2005 $36,953 Avg. employee wages over last 10 years2: ¹ Agency for Healthcare Research and Quality : Medical Expenditure Panel Survey-Insurance Component, private-sector establishments, July 2016. 2 Social Security Administration - National Average Wage Index

Consumerism causes Providers to DO MORE WITH LESS Billing patients is very expensive for Providers Patient payments are the most volatile and slow It costs 3X more1 to collect from Patients than from Employers – Expected to increase 62% by 20192 Providers typically write off 30-50%4 of Patient payments as bad debt – this will increase 23% by 20192 …and more staff is needed to support patient billing …and lower utilization due to patient cost 35% of calls3 to Admin Staff are regarding billing issues 58% of people report they’ve foregone or delayed medical care due to financial concerns5 While keeping patients satisfied 1. Improving self-pay at all points of service. McKesson/ RelayHealth white paper. September 2010. 4. The next wave of change for US health care payments,” McKinsey Quarterly, May 2010 2. Citi analysis, 2014, Emdeon Analysis 2015, based on 2011 data gathered by HHS and CMS. 3. NextGen, Revenue Cycle Management Survey 2015 5. Kaiser Family Foundation, “Health Security Watch.” June 2012.

How do we fix this? Plans shift cost to Consumers Consumers use less services Providers raise fees to counter lost income The same old “reactionary” approach can’t fix this – it only gets worse

An Innovative and Unique Solution A healthcare financial benefit exclusively for CoreSource clients A merger between the financial and healthcare industries Making managing healthcare expenses easier for employees

About Simplicity Simplicity is a healthcare financial benefit provided as part of the CoreSource benefits package. It offers financial protection from high out-of-pocket costs and is a safety net members can count on when they need it most.

How Simplicity Works Member goes to doctor 1 Patient makes one payment to SIMPLICITY 7 Doctor submits claim 2 SIMPLICITY sends statement to Patient 6 CoreSource sends benefit payment to SIMPLICITY 3 SIMPLICITY sends ONE complete payment to doctor 5 SIMPLICITY pre-funds patient payment responsibility 4

Simplicity Offers: Flexible payment options (debit, check, credit card, HSA/FSA card, or bank account) 12-months interest free payments for a financial safety net Up to 5% SimpleRewardsSM credits on payments made to Simplicity

SimpleRewardsSM Earn up to 5% SimpleRewardsSM credits on payments to Simplicity Accrue SimpleRewards credits during the current plan year Use SimpleRewards during next two plan years

Simplicity Value to Members Financial Protection – medical expenses can be overwhelming and possibly catastrophic. Simplicity is a safety net and offers protection from high out-of-pocket costs with 12-months interest free. Trust – members can be assured the balance bill confusion is removed. They can be confident the amounts they owe were clarified for them. Advocacy – members get support and education from industry experts to navigate the complexities of healthcare expenses. They benefit from someone helping them while they focus on their health.

Key Aspects of Simplicity Create a single, complete source of reimbursement for Providers Add Plan benefits to Patient obligations at the time of adjudication Send one, consolidated monthly statement to patients Combine all provider bills and services into a simple statement Give patients a single source of truth for what they owe by taking Providers out of the billing process - one amount due to one source A New Type of Provider Network Offer a consumer-focused payment network tied to the managed care environment

With Simplicity, Providers Can… Benefits to Providers Simplicity Offers Providers something they’ve wanted but never thought they could get: A system where Payers bill and collect all patient responsibilities – taking providers out of the process. Payments that finally work like other modern industries – one payment for one service A more complete and expedited payment with less effort than ever before – no startup investments, no internal process change With Simplicity, Providers Can… Increase Liquidity Receive Prompt, complete payments for services Reduce days in A/R Reduce administrative burden and Cost Eliminate bad debt Improve patient relationships

Benefits to Brokers and Consultants Differentiator for Broker working through CoreSource CoreSource is the only company leading the introduction of this benefit to the self-insured market Protect retention of client with value of retaining rewards No cost to client Funded via fee paid by provider No work on their behalf Can leverage communication opportunities to educate employees

Simplicity Value Proposition Trust and advocacy for the member Confused? We’re here to help! Simple bill payment process and rewards One bill for Simplicity users SimpleRewards Control and transparency Easy to understand statements & portal