4 strategies to better manage practice health insurance costs

When it comes to nonclinical management challenges, today’s medical practices struggle to balance the effects of continuing staffing shortages against intensifying financial pressures that, among other things, can hinder successful recruitment efforts.

Like other businesses, for example, they’re getting squeezed by rising operating costs. Medical supplies and necessary technology are among the expenses it’s hard to keep up with, especially as supply chains and pricing undergo significant disruption in a volatile political and economic environment.

As medical costs continue to rise, health insurance rates rise in tandem, and physician groups pay the price like everyone else. Pay is important for attracting and keeping both clinical and office professionals. But so are great benefits, and health insurance tops the list.

Medical practices are no different than any other small or midsize business when it comes to budget busters: Health insurance accounts for between 30% and 40% of their total compensation costs.

One common cost-saving strategy has been to shift to high-deductible health plans, transferring more of the cost burden to employees. But it’s not an ideal solution during a worker shortage and, in fact, may discourage existing employees to shortchange themselves on wellness for financial reasons.

A smarter approach is to take the long view with more sophisticated strategies for effectively navigating a difficult environment. Four of the best options include the following:

1. Dig deep into your health claims data. This information is now available to employers of every size. Experienced brokerage partners are key to leveraging this data to gain insights on which health conditions are driving costs and what solutions will address them.
2. Pair analytics with clinical informatics. If data analytics uncover where health care costs are rising, clinical informatics tell you why and give you a path for fixing the issues. Between data analytics and clinical informatics, employers gain a critical edge for a plan that’s sustainable, affordable and efficient.
3. Ensure contract compliance. Undertaking such reviews for discrepancies and unmet financial guarantees is worth the investment. In one review of a pharmacy benefits manager contract, the reviewer found and renegotiated a poorly designed financial guarantee stipulation. The client received a $750,000 payout in the contract’s first year.
4. Consider alternatives. There’s more to health insurance than traditional plans, such as self-funded plans and group captives, to name just two. These may reduce expenses and improve employee health outcomes. Your broker can walk you through what would work best for your organization.

The rollercoaster ride of today’s environment for health care costs may never even out. However, experienced partners can help employers smooth out the ride and create a benefits plan that is effective and sustainable for the long term.

Pete Reilly is the practice leader and chief sales officer of global insurance brokerage Hub International’s North American health care practice.