Employer-Funded Insurance: Does Evidence Play a Role in Its Success?

Posted by Silvana Schneider, Director Payer Services on May 31, 2017
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self funded_1200.jpgThe quagmire that is the American healthcare system continues to leave payers, providers, and patients wringing their hands with the uncertainty of what lies ahead. Tired of waiting for the other shoe to drop and unwilling to leave their valuable employees without the coverage they need for themselves and their families, some companies have gone the self-funded, self-insured route. This path, while innovative and admirable, is not without complications and is not entirely immune from the current issues swirling around healthcare reform.

What exactly is self-insurance? Simply put, instead of paying an insurance company to take on the risk of the healthcare of its employees, a company will directly pay for the medical bills of its employees. This allows said companies to realize some cost-savings while allowing for some flexibility in designing plans that meet the needs of their personnel. According to the Employee Benefit Research Institute, the number of self-insured companies has increased from 28.5% in 1996 to 39% in 2015, with the greatest increase coming from companies with fewer than 1,000 employees.

“In choosing to self-insure with a goal of reducing cost, companies must also consider the use of unbiased evidence assessments in determining their coverage policies.”

employee wellness_1200.jpgIt is these small(er) companies that stand to feel the greatest impact from the tumult caused by the push to reform the Patient Protection and Affordable Care Act (ACA). The expected rise in premiums has caused these smaller companies to pursue self-funded options to help control costs while continuing to provide quality healthcare options for their workforce.

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In choosing to self-insure with a goal of reducing cost, companies must also consider the use of unbiased evidence assessments in determining their coverage policies. By utilizing health technology assessments (HTAs) performed with scientific rigor by an independent third party, companies can ensure that they are covering drugs, procedures, devices, or biologics that are proven to be safe, efficacious, and cost-effective by a critical appraisal of the peer-reviewed, published literature.

Are you a self-insured workplace? You owe it to yourself to see what the Hayes evidence solution can do for you. Click on the button below to view a sample Medical Technology Directory report, one of the thousands in our Knowledge Center. After you’ve done that, schedule a demo and one of our representatives will contact you directly.

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Topics: Health Technologies, Payers, Hayes Blog, Health Technology Assessments,

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