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MedBen Beats Trend by Focusing on Claim Costs

11/05/17

  01:55:00 am, by MedBen5   , 220 words,  
Categories: Health Plan Management, Cost savings, Research, Third party administration, Trend, Claims management

MedBen Beats Trend by Focusing on Claim Costs

MedBen building

Medical plan trend has kept stable over the last few years. Even so, MedBen has consistently remained under national trend by emphasizing the highest driver of plan costs – claims.

According to the 2018 Segal Health Plan Cost Trend Survey, medical trend* for active employees and retirees under 65 for the years 2012 through 2016 averaged 6.5%. By contrast, the MedBen medical trend for the same four-year period was just 2.1%. Even if pharmacy costs (which have lately experienced much higher trend) are also considered, our overall trend rises to only 3.2%.

Because "all claims are not created equal," MedBen approaches them differently depending on the type and size of the claim. For example, while every claim gets a thorough examination to ensure that it meets medical necessity and billing standards, large claims receive even closer scrutiny, including review by certified medical specialists.

Pharmacy claims, too, merit a different kind of examination. The rise of expensive specialty drugs demands that such claims are reviewed to ensure that lower-cost medications aren't available or therapeutic alternatives haven't been overlooked.

More than ever, MedBen has the technical, analytic and personnel tools to keep client expenses in check and plan cost trend low. For additional insight into how we do it, contact Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

* Includes open-access preferred provider organization (PPO) and point-of-service (POS) plans.

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