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MedBen Hospital, Municipality Roundtables Spotlight Client Cost Trends

03/25/18

  09:34:00 pm, by MedBen5   , 320 words,  
Categories: News, Prescription, Reporting, Cost savings, MedBen University, Self-funding, Trend

MedBen Hospital, Municipality Roundtables Spotlight Client Cost Trends

Brian Fargus

At two recent industry-specific MedBen University (MBU) roundtables, MedBen Vice President of Sales & Marketing Brian Fargus highlighted how the company's claims management solutions are keeping plan costs in check.

From 2013 through 2017, the 5-year net cost trend for MedBen's block of hospital clients was just 3.1%. Municipality clients also fared well during the same period, seeing average net cost trend of only 2.7%.

Hospitals are unique among the industries that MedBen serves in that they can help themselves keep health care spending down by incentivizing plan members to use their own facilities for medical care and prescription drugs. Through these and other cost containment tools, MedBen's hospital clients have managed to keep average cost increases below national trends.

Conversely, municipalities traditionally have higher costs per employee than private sector health plans, due to contractual obligations that usually produce more benefit-rich health plans that than those offered by other businesses. But through strategic use of cost controls, the 17% plan cost difference in 2013 between MedBen's municipality block and its overall block shrunk to just 7% in 2017.

Like other industries, hospital and municipality employers alike have experienced an increasing prevalence of higher medical and pharmacy claims in the past several years. Since health plans were required to drop lifetime maximums under Affordable Care Act rules in 2014, medical claims over $100,000 and pharmacy claims over $25,000 have become more commonplace.

"The challenge in controlling costs has only become more difficult since the ACA," Fargus said. "But through our clinical review and reporting systems, plus strategic use of plan language to reduce the financial risk of specific conditions, we can still manage large claims to keep overall cost increases in line with our current trend."

MedBen will be conducting additional MBU sessions in 2018 that examine claims and utilization trends, including our Annual Employer Benefits Roundtable in Newark, Ohio. Invitations for this event, which focuses on self-funded private sector businesses, have been mailed out, so keep an eye out for yours!

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