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The Future of Healthcare is Digital — and It’s Being Fast-Tracked by COVID

The Future of Healthcare is Digital — and It’s Being Fast-Tracked by COVID 1200 600 Apostrophe Health

Virtual health care is meeting critical needs now, and will be essential to patient care during the national recovery and beyond.

There’s a constant hum around all the ways the healthcare industry needs to improve and shift. COVID-19 has been the catalyst needed to accelerate that change overnight. There’s no more waiting. The time to accept and embrace innovation is here.

Digital health care services, like telemedicine and virtual primary care, were thrust onto the frontlines of the pandemic battle. What has seen slow adoption in recent years is now gilded as essential, and will continue to play a critical role in the recovery of our overtaxed health systems.

“The social and medical practices that are happening in response to COVID-19 will remain in place when the crisis eventually subsides,” reported Eric Topol, MD, a highly regarded cardiologist and medical author. “Telemedicine will play the role of the first consultation, akin to the house-call of yore,” for a long time to come.

It will be impossible to return to normal once this has all resolved. Who would want to? The healthcare system is broken and hasn’t worked for far too long. The deficits have never been more conspicuous:

  • Trillions of dollars in overspending and unnecessary treatment
  • Out of control health care costs that increase annually, while benefits get worse
  • Complicated access to the right kind of care when it’s needed
  • A system designed to put the interests of legacy insurance companies first, not patients 

If it all seems too expensive now, wait until next year when we see the true economic fallout of the pandemic. In 2021, some are projecting as much as a 40% spike in premiums from legacy health insurance carriers. That’s a dire warning from California’s Affordable Care Act marketplace that also cautioned:

  • Increased out-of-pocket expenses for employees
  • Employers drop or reduce coverage
  • Employers shift more of the cost-share burden to employees

For as much as this is breaking our norms, finances and even spirits in the moment, employers who can embrace drastic change now are primed to fare far better on the other side.

Most companies admit that their health plan does not maximize value nor deliver truly modern benefits, per a 2019-2020 Benefit Trends Survey from via Willis Towers Watson. This is your chance to take decisive action with your company’s benefits plan and budget. 

The telehealth and virtual health care services popularized in this moment will be the saving grace of the entire industry when it’s time to repair itself. Hospitals, health systems and private practice providers will face a period of recovery.

Digital health services, as we describe below, will be:

  • Called upon to bridge the gap
  • More cost-effective, efficient and accessible
  • The new standard

TELEMEDICINE AND TELEHEALTH

“Out of every crisis, a new opportunity arises. For telehealth, it may be an opportunity whose time has finally come,” wrote Paddy Padmanabhan, author of The Big Unlock Harnessing Data and Growing Digital Health Businesses in a Value-based Care era. 

Adoption rates for telemedicine have been about 2% nationally, but Padmanabhan cited increases of 500% since coronavirus arrived.

Now that everyone’s gotten a crash course in this alternative to urgent care, we expect to see engagement continue to replace costly in-person visits.

Employers should champion this. One case study cited a company saved $6 for every $1 spent on telemedicine.

VIRTUAL PRIMARY CARE

Where telemedicine is a virtual replacement for urgent care, VPC virtually replaces the primary care office. The low or zero-dollar copays eliminate the barrier to entry, and reduce costs for employers and employees alike. For annual physicals, chronic care and disease management and self-care combined, VPC poses “an economic value of approximately $10 billion annually across the U.S. health system over the next few years.”

The on-demand availability by instant chat, video, or telephone eliminates days of waiting for appointments. Patients can see a doctor right now about any little or big concern they have. These physicians can diagnose and manage about 95% of conditions seen in-office, and can diagnose and treat about 70% of primary care health concerns (without an in-person referral).

We expect patient consumers to become much more familiar and comfortable with this method of care and standardize it going forward.

VIRTUAL PHYSICAL THERAPY

SHRM calls tele-rehab the sweet spot of telemedicine, and lauds it as a lower-cost, higher-satisfaction alternative to in-person physical therapy. Through technology as simple as Skype and as novel as 3D motion-capture, therapists can work with patients remotely and achieve positive results. 

A 2020 large employer healthcare survey found that 85% of employers ranked musculoskeletal issues as a top-three condition with the biggest impact on their costs. And a 2019 study by orthopaedic surgeons found that post-surgical tele-rehab services saved a minimum of $1,000 per patient.

VIRTUAL BEHAVIORAL HEALTH

Another sweet spot in telemedicine is virtual behavioral or mental health services. Patients use video conferencing tools from their own couch to speak with an on-demand therapist or to establish recurring therapy. Studies have found it to be just as effective as face-to-face meetings with lower attrition rates. 

Especially amongst millennials (now in their early 20s to late 30s), instances of anxiety, depression and other mental health issues have never been so high. As Americans cope with the current quarantine, and in time grapple with the emotional and economic ramifications, remote access to mental health may become the rule, not the exception.

Teletherapy apps, like that of our partner MeMD, have completely disrupted a decades-old practice in the best way. Virtual behavioral health will continue to improve access to and reduce the stigma of this necessary healthcare service.

ASK THE TOUGH QUESTIONS TO GET AHEAD

How much access do you and your employees have right now to this modern suite of healthcare services? Do you have any idea how much it would cost if you did?

Rising healthcare costs are one of the greatest challenges facing 80% of employers in the next 36 months. The yet-to-be-seen ramifications of COVID-19 can’t ease those concerns.

Ask your advisor: How much will my premiums increase, and benefits value decrease, in 2021?

Are you comfortable with the answer?

You can stand by and wait to see what’s going to happen to you later this year or next. Or, you can decide it’s time for your company to take control of the cost, experience and quality of your health benefits plan and demand better benefits for less money.

Apostrophe is already way ahead of that curve for plan sponsors. Our Intelligent Health Benefits:

  • Simplify and improve the member experience with white glove Member Care
  • Provide a curated suite of virtual health care solutions 
  • Collaborate with a robust roster of partners to provide telehealth and flexible payment options
  • Advocate on behalf of our members for low- and $0 treatment options with high-quality providers
  • Make price transparency the standard ahead of a federal mandate


This pandemic will impact all of us in ways we still can’t know for sure. It will not, however, eliminate your ability to transform the most expensive line in your ledger.

COVID-19 Exposes the Breaking Point in America’s Dysfunctional Healthcare System

COVID-19 Exposes the Breaking Point in America’s Dysfunctional Healthcare System 2083 1041 Apostrophe Health

The coronavirus pandemic poses a financial threat to American families, one the legacy insurance industry designed and will benefit from.

Half of American households don’t have as much as $4,500 in their bank accounts. Which is why “most Americans are a bad stubbed toe away from financial ruin,” according to David Chase, co-founder of Health Rosetta.

Or, just one case of coronavirus. High deductibles, excessive copays and surprise billing can devastate a family financially, especially in the face of an unexpected illness.

The coronavirus pandemic (officially known as COVID-19) is exposing just how fundamentally broken the American healthcare system really is. Under the most expensive healthcare system in the world, a family with little discretionary funds would be hit hard by the $3,270 bill for coronavirus treatment a Miami man received last week.  

While the CDC is not billing for testing (that’s right, you won’t be charged for COVID-19 lab tests), related treatment expenses from hospital stays and medications won’t necessarily get the same free pass.

On March 11, President Trump said “leaders of [the] health insurance industry…have agreed to waive all co-payments for coronavirus treatments, extend insurance coverage to these treatments and to prevent surprise medical billing.”

However, that same night, a spokesperson for the major insurance lobby America’s Health Insurance Plans’ made an important clarification to Politico. They will only waive co-pays “For testing. Not for treatment.” This rare sign of decency from traditional carriers won’t play out exactly as the president described. AHIP said even less in their public statement, and didn’t address cost at all.

The decades-long effect of outrageous billing schemes from these legacy insurance companies has dangerous effects, which includes avoidance of care when people need it most.

No one should avoid testing or treatment, for coronavirus or any other ailment or disease, because they fear the unknown and potential financial setback from medical bills.

This is the problem with America’s broken healthcare system

NOW IS THE TIME FOR INTELLIGENT HEALTH BENEFITS

Most insured Americans are flying blind at each doctor, hospital or ER visit. There aren’t published rates, there’s not much clarity around who’s in network, and you’re at the mercy of the provider to run any lab or scan they see fit. It gets unnecessarily expensive very quickly. 

There’s enough panic around the outbreak without igniting fear over bankruptcy and financial ruin because someone in your family gets sick.  

Apostrophe’s direct-purchase model does away with the waste and helps self-insured employers control costs for better benefits for their team. We’re committed to:

  • Simplify the experience and billing process
  • Be transparent so members know what they’re spending and saving
  • Show our members love during the most routine or life-changing circumstances

This is how Apostrophe humanizes care for our members every day, especially now.

TELEMEDICINE AND VIRTUAL PRIMARY CARE

The CDC recommends avoiding crowds, limiting contact with those who are sick, and staying home as much as possible during the COVID-19 pandemic. They also recommend calling your doctor if you’re developing symptoms. This is exactly what telemedicine and VPC were designed for.

Apostrophe members get direct access to quality physician care without entering infected environments, protecting themselves and everyone else.

Using our 24/7 telemed partner MeMD or virtual primary care partner Sherpaa is especially beneficial for members in at-risk populations or with compromised immune systems. Avoid the waiting rooms altogether — they can assess symptoms, order lab work and call in prescriptions online or by phone.

PRESCRIPTIONS DELIVERED TO YOUR HOME

Groups using our pharmacy benefits have the advantage of having medications delivered to their door. Skip the lines — and potential crowds — at the corner drugstore.

NO NETWORK CONFUSION

Our members can see any provider who’s willing to accept Apostrophe. There are no confusing network rules and no out-of-network penalties.

WHITE GLOVE MEMBER CARE

If our members are feeling uncertain about the coronavirus situation, or have questions about COVID-19 treatment costs, they can always contact our market-leading Member Care team. Member Care will:

  • Help to navigate a bill and avoid overpaying
  • Explain what is covered under their health plan
  • Make sure they maximize their virtual care benefits 

We’ve known for a long time that the state of healthcare in America is at a breaking point, and the COVID-19 pandemic may push it to the limits. 

Especially during a global pandemic, we’re committed to putting our members first. We’d like to see the entire industry make necessary moves to do the same. 

Current Apostrophe Health members, Call Member Care at the number on your card for coverage questions.
Current and prospective self-insured employers, please visit our COVID-19 page for more information.

How Self-Insured Employers Should Use Telemedicine to Cut Healthcare Costs

How Self-Insured Employers Should Use Telemedicine to Cut Healthcare Costs 1004 591 Apostrophe Health

Understand why telemedicine participation is low and how to get your entire company on board with the plan.

Plan rates, premiums and deductibles have reached a fever pitch, and there’s no doubt those rates will climb again at renewals. Helping self-insured employers control those costs, and pass the savings on to employees, has been the heart of Apostrophe’s health plans since the start. Better benefits for less money is a promise that we help self-insured employers realize in more than just a monthly statement.

Telemedicine is one of the many ways we add value to our self-insured plans. This service gives members access to qualified doctors and nurses via phone or other digital channels, and it’s always free* to our members on non-HSA plans. For Apostrophe members, it’s as simple as a call to our telemedicine partner MeMD. Once connected, members can discuss symptoms and even share photos with the provider via a secure connection.

These professionals can identify and diagnose about 1,500 common conditions seen every day by primary care and emergency physicians. They can even fill or refill a prescription one time, just like going to an urgent care facility. Where urgent care costs about one-fifth of what a trip to the emergency room costs, telemedicine is free* to most Apostrophe members. And when 25% of ER visits could have been handled at urgent care, imagine how many of those could have been handled, at no cost, over the phone. 

Here’s the kicker: members who use telemedicine don’t have to go to urgent care. They don’t have to go to the emergency room. And they don’t have to visit their primary physician. One call to the telemedicine provider doesn’t cost them—or their employer—a dime (zero copay expenses*). Plus, they save time by not going into a medical facility and receive quick, quality attention to their illness or other concern.

For all of the advantages telemedicine presents, not nearly enough people are using it. SHRM reported in 2018 that 96% of the largest U.S. employers had made telemedicine services available to their employees, and 56% included behavioral health as part of that. Yet, the national average for participation is only about 2%. That’s a dismally low adoption rate for a service that, in one case, saved the company $6 for every $1 spent.

Here’s why: Both companies are buying the same insurance. The only difference is the funding mechanism on the back end. Of course they aren’t seeing a difference.

Telemedicine opens access to care and controls cost in a way no other healthcare development has been able to achieve. And still, very few people use it.

“For telemedicine to be able to move the needle on access to care for overall health spending, more enrollees will need to take up their services,” concluded a Peterson-KFF 2018 Employer Health Benefits Survey. 

In other words, employee education is key. It is the crux of ensuring your employees dial into telemedicine for common aches, pains, illnesses and other non-life threatening concerns that send them to urgent care and the ER. 

For self-insured employers who want to continue cutting costs and managing healthcare expenses, it’s imperative to get employees on board.

What’s Keeping Employees from Participating

Low telemedicine participation starts with a lack of awareness that the program even exists. And if it does, questions abound over the costs and possible reimbursements. (With Apostrophe, access to MeMD is always free* to our members with non-HSA plans.) As with anything new, some patients struggle with trust. There can also be a desire to simply connect with a provider one-on-one, in person.

How Can Employers Encourage Participation

Ultimately, it’s up to your company to determine how you’ll promote telemedicine to your workforce. Josh Luke, an HR futurist, suggested to SHRM that companies create a room or space within their office where employees can privately access telemedicine while on the job. Here are seven more ways you can drive more employees to dial into telemedicine. 

  1. Talk openly about the service and promote it frequently.
  2. Make sure your employees know that access is free*, and that it prevents expensive out-of-pocket ER and urgent care fees.
  3. Let them share ownership in the value by communicating the substantial cost savings for both themselves and the company as a whole. 
  4. Emphasize the credentials of the providers, and that these physicians supplement not replace their PCP.
  5. Celebrate that telemedicine creates a healthier labor force with less absenteeism. 
  6. Talk up the convenience of making a call from home or work, instead of commuting to the doctor’s office. 
  7. Share how telemedicine increases access to care (key for people with chronic illnesses) and improves quality of care. 

For current Apostrophe Health members, it’s free* and easy to access telemedicine:

Call Member Care at the number on your card and press 1 to connect with a nurse or doctor.

*Access to telemedicine services is free except for Members with HSA plans. 

Self-Insured Employers Can Save on Healthcare When They Abandon Legacy Insurance Carriers

Self-Insured Employers Can Save on Healthcare When They Abandon Legacy Insurance Carriers 1004 591 Apostrophe Health

Controlling health plan costs shouldn’t be a luxury reserved for the largest companies in America.

It’s been argued that neither self-insured nor fully-insured companies do a better job of controlling healthcare costs. That’s accurate when the self-insured company continues to purchase the same contracts, meager discounts and broken model sold by legacy providers. 

Here’s why: Both companies are buying the same insurance. The only difference is the funding mechanism on the back end. Of course they aren’t seeing a difference.

Self-insured employers have to change how they purchase their company’s health plan in the first place. Only then will they realize the greater savings and cost control that’s seemingly been out of reach, reserved exclusively for the largest employers in America. That accessibility shouldn’t be limited to the top few. All companies should have access to this proven model.

Apostrophe’s Intelligent Health Benefits were informed by the direct purchase model optimized by major corporate players (think Lowe’s, Boeing and Walmart) and designed to be accessible by mid-size, self-insured employers. By working outside of the fundamentally broken system that props up traditional insurance carriers, we’re able to provide employers and their employees with better benefits for less money and never sacrifice quality of care or experience.

Each year, employers of every size are faced with average rate increases of 12%, increases that come despite cutting corners on providers and coverage. Self-insured employers aren’t immune to increases, but at an average 4-6% per year, it’s substantially less than the standard market rate. 

“Until employers engage in a different way, we are stuck,” warned Ethan Merk, Vice President of Sales for Apostrophe (and a former broker himself). He says we’re out of road and out of options. “We’re at a tipping point. Businesses are at risk because they don’t treat health benefits as a major spend or a top-three line item even though that’s exactly what it is. Until they do, they’re in trouble.”

The market has been trained to keep buying a lack of transparency and unknown rates. It’s hard to see a better way when the status quo is all that’s presented during renewals. At Apostrophe, we’re telling benefits brokers and self-insured employers that it no longer has to be this way. They no longer have to accept these broken plans at face value. They have options. 

Apostrophe’s Intelligent Health Benefits are driven by simplicity, transparency and love. Can you name one insurance company that can offer any one of those, much less all? We work cooperatively with providers and employers alike, not combatively. And the discounts we receive are passed directly to our members saving them thousands every year. 

The contracted rate employers are forced to accept each year during plan renewals is not the best case scenario. In our world, it’s a low bar for doing no worse. As a self-insured employer, your rates can, and should, be a lot better than you’re paying now.

If you’re not saving any more than you were under a fully-funded health insurance company, it’s time to change everything. 

Let’s connect.



How Benefits Advisors Can Give Better Health Plans to Self-Insured Employers

How Benefits Advisors Can Give Better Health Plans to Self-Insured Employers 1004 591 Apostrophe Health

Legacy insurance plans are working against American workers, and it’s costing them trillions.

As a health benefits advisor, we don’t have to tell you how broken the U.S. healthcare system is. You’re deep in this world just like us. You can see the costly pain points affecting your clients and their employees every single day. You have to know they’re sick of it all. 

Aren’t you?

Premiums and deductibles keep increasing (more than 250% since 2006) and yet, wages are stagnant. Employers rightfully anticipate double-digit increases to their benefit plans every single year; benefits for their employees that just keep getting worse. And overall, the U.S. healthcare industry wastes a trillion dollars every year. That’s $1,000,000,000,000 on unnecessary treatment, low-value care, pricing failures, fraud and abuse. 

It all stems from the legacy insurance plans that brokers keep selling and employers keep buying because they don’t know how much control they actually have in this situation. You can give them back that control.

Take 2 minutes to watch Sick of it All to understand:

  • How it all got to be so one sided
  • Where we see the opportunity to fix healthcare in America
  • Why we should work together to provide better benefits for less money to your clients

As you see, the legacy insurance industry isn’t designed to benefit consumers. It’s setup to make sure the carriers get paid and brokers get a healthy commission for selling through the same broken plans time and again. At Apostrophe, we believe in humanizing healthcare, putting people back at the center of cost, quality and experience where they belong.

That’s why we designed our health plans after the direct-purchase model that works for power players like Boeing, Lowe’s and Walmart. We made it accessible to mid-sized self-insured employers, which allows them to offer their staff benefits that actually feel like benefits. Working together with your clients, Apostrophe Intelligent Health Benefits can can give them greater savings than their current legacy provider. Doesn’t that sound a lot better than the rate increase for worse benefits you were going to share at renewals?

If so, let’s talk now and prepare you to take an entirely different health plan to your renewal meetings. 



This is How Americans Waste $1 Trillion a Year on Healthcare

This is How Americans Waste $1 Trillion a Year on Healthcare 1004 591 Apostrophe Health

Learn how the U.S. healthcare system got this bad, and how we’re fixing it for self-insured employers.

The American healthcare system wastes $1 trillion dollars every year. One Trillion. That means $1 of every $4 spent on healthcare in the U.S. could have stayed in someone’s wallet.  That someone includes your employees.

Between 2006-15, employee deductibles increased 255%. Their wages did not.

And each year, health plans increase an average of 12% for coverage that only gets worse. 

We are sick of it all. Aren’t you? 

In this 2-minute video, we explain how the system became so broken that this has become acceptable reality. In Sick of it All, you’ll learn:

  • 4 glaring problems with the current healthcare system
  • Why that puts an unfair burden on American consumers
  • How YOU can save 20% or more on your health plan in year one

There’s this sort of cycle that self-insured employers and benefits advisors find themselves stuck in, and it only perpetuates the problem:

  • Employers need great benefits for their employees that won’t tank the bottom line.

  • Advisors keep showing up with the same broken legacy carrier model designed to put the insurance company first (and employees bearing the financial burden).

  • Employers don’t feel that they have any other options, so they sign the dotted line on the renewal form.

  • Advisors have an opportunity to do the right thing: take the commission for closing the sale, or give your employees benefits that actually feel like a benefit.

  • If you return to renewals next year facing the same increases, you’ll know which your advisor chose.

Self-insured employers have more control over price, quality and experience than they think they do. That’s where Apostrophe’s Intelligent Health Benefits come in and stop this tired system in its tracks. Working together with advisors and employers, Apostrophe provides Better Benefits for Less Money. We’ve made that possible by making accessible the self-insured model used by big players like Boeing, Lowe’s and Walmart. 

This legacy carrier system that is bankrupting Americans may have become the status quo, but it doesn’t have to stay that way. If you’re sick of it all and ready for a change, let’s get to work

Humanizing Healthcare: Health Benefits That Actually Feel Like a Benefit

Humanizing Healthcare: Health Benefits That Actually Feel Like a Benefit 6286 4480 Apostrophe Health

For self-insured employers, it is possible to provide your staff with better benefits for less money. Just treat people…like humans

America’s healthcare system is broken. And the hard-working people you employ are the ones paying for it. From where we sit, people were removed from the healthcare equation and replaced by third-party payers and misaligned incentives. What we got in return were ill-informed consumers going broke to pay for healthcare that keeps getting worse. It all contributes to nearly 20% of the United State’s GDP, and racked up a $556 million healthcare lobbying bill in 2018. 

This serves no one. The lobbyists are winning. Legacy health insurance companies are winning. Where are you and your employees supposed to come out ahead in all of this? If you maintain the way things have been…you don’t.

THE COST OF INACTION
We know that changing health plans is scary. The cost of doing nothing is far scarier than upgrading to benefits that actually feel like benefits. Under Apostrophe’s Intelligent Health Benefits, employers see substantial savings your company will see in its bottom line, and your employees will notice in their bank accounts. Those numbers are hard to ignore when you consider most health plans increase by an average of 10-12% each year.

BETTER BENEFITS FOR LESS MONEY

We’ve seen this come to light for so many of our members. One, in particular, stands out. 

Last year, a Wisconsin member was earning $7.50 per hour, and had been paying full out-of-pocket expenses for her family’s healthcare needs for years. Then the company switched its health plan to Apostrophe, giving her access to our Member Care team. By working together to make smart choices, we helped her reduce out-of-pocket expenses to $0 for the year! She walked into the CEO’s office…and hugged him! Because of the thousands of dollars she saved, her family was able to take their first vacation. 

HUMANIZING HEALTHCARE

Apostrophe Health took on this mismanaged healthcare system by putting simplicity, transparency and love at the center of everything we do. It’s a hard departure from the established rules legacy health insurance providers use to take advantage of their own customers. 

Our members access quality care, market-leading support from the Member Care team and realize tremendous savings through smart shopper options, all at a price that is often less than they paid under the legacy model.

Apostrophe Intelligent Health Benefits were informed by the best practices of the direct-purchase model refined by big players like Boeing, Walmart and Lowe’s. We’ve made this model accessible to self-insured employers who are ready to take back control of cost, experience and quality.

Watch our short Humanizing Healthcare video and then ask your broker about Apostrophe. You’ll learn a little more about how we simplified billing, why it’s important to treat humans like humans and hear a few more Member Care success stories. 

The Benefits Advisor Survival Guide for Renewal Season

The Benefits Advisor Survival Guide for Renewal Season 1004 591 Apostrophe Health

How to avoid burnout in the insurance advisor industry when your work never stops.

When 72% of sales directors work evenings and weekends, and 72% of salespeople want more time off, it’s clear we’re working against our own best interests. Insurance advisors used to have two big renewal cycles each year, and could really coast the rest of the time. Now it feels like we’re running an endless sprint that, frankly, can’t be sustained. We’re burning out, and we need to make it stop by making ourselves a higher priority. 

In this webinar, hosted by Apostrophe’s Director of Sales Ethan Merk, we talk about tactics for working smarter, not harder as we prepare for another round of back-to-back renewal cycles. 

In less than 10 minutes, we’ll cover:

  • Self-care tips like actually sleeping, which affects every aspect of our lives
  • Work-life balance that allows us to be present when it matters most
  • Using technology to work smarter, and put all of this tech to work for us
  • Apostrophe’s PowerPlan, which delivers big for clients with less hands-on time from you

Commit to even some of these tips and you’ll be more apt to bring your A-game to every situation you’re in, and maintain the stamina to show-up for your self-insured employer clients no matter what time of year it is. 

For more information about how Apostrophe’s PowerPlan can better serve you and your clients, contact Ethan Merk. 

Price Transparency to Become the Standard in American Healthcare

Price Transparency to Become the Standard in American Healthcare 1004 591 Apostrophe Health

With Apostrophe’s smart shopper, our members already enjoy the cost-saving benefits of price transparency without waiting on a new federal law.

Everything we do at Apostrophe is guided by simplicity, transparency, and love. We place the highest value on transparency, believing that every patient should know what they’re spending and what they’re saving.

That’s why we’re encouraged to see price transparency requirements issued by the Trump administration. Healthcare in America needs to be fixed, and this is a place to start that benefits every single patient. This historic effort aims to increase competition and lower costs for all Americans. 

The Health and Human Services Secretary Alex Azar says our current system deserves an F, but that after this takes effect, the president has promised an A+. This will be “a more significant change to American healthcare markets than any other single thing we’ve done, by shining light on the costs of our shadowy system and finally putting the American patient in control,” he said.

According to CMS, the executive order for Improving Price and Quality Transparency in American Healthcare outlines two rules designed to empower patients, and will take effect January 1, 2021. 

  • Price Transparency Requirements for Hospitals to Make Standard Charges Public, Final Rule

    All hospitals operating in the U.S. will “establish, update, and make public a list of their standard charges for items and services they provide.”

  • Transparency in Coverage, Proposed Rule

    Real-time access to cost information, including estimate of patients’ cost-share liability, through an online tool in order to shop and compare costs before care.

    It also requires that providers disclose, on a public website, the negotiated rates for 300 common, shoppable services (like x-rays, outpatient services, lab work, or bundled services like knee replacement or a c-section). This would include:
  • Full price before any discounts
  • Cash discounted price
  • Price negotiated with payers
  • The minimum/maximum with all payers

These disclosures are required under the ACA to some extent, but the data is hardly accessible, often too detailed and complicated. This new price transparency ruling aims to fix that by requiring accessibility and clarity by way of prominent publication and use of plain language.

This is what Apostrophe has offered its members all along through our smart shopper program. By selecting smart shopper options, which include high quality, low-cost providers, our members save enough money to result in $0 cost to them. We help them find the best possible rate from quality providers; it’s the difference between paying $2900 for a head CT, or $480 for the same service with the same (or better) results. We’re rewarding our members for making smart healthcare decisions.

That’s exactly what this price transparency ruling aims to do universally. This is a net-positive for employers who want to take control of healthcare costs (which, we imagine, is all of them!). For self-insured employers, this gives you power to help employees put published pricing information to work for both of you.

When price and quality data are available side by side, patients are more likely to opt for lower-cost care from highly-rated providers. In fact, they’re 94 percent more likely to choose the lower-priced option, according to SHRM. This can dramatically reduce healthcare costs for both employers and employees. Communicating the value of this information, and educating on how to use it, falls to the employers. 

Self-insured employers don’t have to wait for a transparency ruling to start saving their company and employees money, though. Contact us to learn more about Apostrophe.

4 Questions Self-Insured Employers Should Ask Their Insurance Advisors

4 Questions Self-Insured Employers Should Ask Their Insurance Advisors 1819 1021 Apostrophe Health

As you prepare for renewal season, learn how to take control of the cost and experience of your health plan to gain better benefits for less money.

Before you dive head-long into renewal season, stop and assess the current relationship between your company, your insurance advisor, and your legacy insurance carrier. How’s that working out for you? 

Watch this 1-minute video if you are a self-insured employer who is:

  • bracing for another rate increase
  • confident you won’t see any savings
  • certain your benefits will be worse than where you started.

Take these four simple questions to your next advisor meeting to show that you hold the power over your health plan’s cost and experience:

1: Do you run a transparent business model? 

2: Do you work exclusively with any carriers? 

3: Is your commission tied directly to my insurance rates? Or do you earn a flat rate?

4: Will you sign a document disclosing your sources of revenue on my account?

For most of the self-insured employers we speak with, the number one goal for their health plans is: “I just don’t want my rate to go up anymore.” 

That’s a sad reality.

The expectation isn’t to save money, or to get better health benefits at the same bloated rate

The goal is simply to avoid yet another rate increase. 

This is the broken thinking Apostrophe Health if fixing. Better health plan options exist for you right now, and you don’t have to lose healthcare coverage to get them. 

Learn more by downloading our eBook Sick Of It All: How American Healthcare Got This Bad and Why You Don’t Have to Accept It, or read how our Intelligent Health Benefits are Good for Your Business.

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