AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT...
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Transcript of AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT...
AGENDA
HEALTH PLAN
•Customizable benefit design
•Funding options
•Comprehensive network options
CLIENT SERVICES
•Customer service
•Core administrative services
•Reporting
CARE DELIVERY
•Patient-centered care
•Care management
•Wellness Solution
•Occupational Health Services
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Contain your total cost of care byintegrating a customized health planwith our unique care delivery systemand exceptional client services.
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Achieve optimal coverage for your companywith our flexible options.
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Customize your benefits to meet the needs of your employees.
• Defined network
• Point-of-service plans (POS)
• Preferred provider organizations (PPO)
• Consumer-directed health plans (CDHP)
– Health savings account (HSA)
– Health reimbursement arrangement (HRA)
– Integrated HSA and HRA administration through HealthEquity®
– High deductible health plans (HDHP)
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Manage your risk with our full-spectrum of funding options.
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Your employees can get the care they need wherever they live.
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Care at Group Health Medical Centers
• It offers our greatest
competitive advantage.
• It’s where care and coverage
work together to create more
value for patients and employers.
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Empower your employees to improve their health and the result can be a more productive workforce and lower overallhealth care costs.
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No one else brings it all together in one package like we do.
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Experience something different with patient-centered care at Group Health Medical Centers.
• Patients can spend more time with their doctors*
• Doctors with Group Health Physicians partner with patients
in health care decisions
• Primary and specialty care physicians can focus
more attention on patient care
• Each clinic features a variety of services, including doctor visits,
X-rays, lab, and pharmacy services
* Group Health Research Institute study published in Health Advisor, Vol. 29, May 2010. * Group Health Research Institute is the research division of Group Health Cooperative.
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Employees can save time and money with online services at ghc.org.*
• Appointment scheduling
• Prescription refill ordering
• Electronic medical records, including lab and test results
• Secure e-mail exchanges with their doctor
• An award-winning** app for iPhone® and AndroidTM
smartphones to access care on the go
** Some services only available with care at Group Health Medical Centers** Source: Best Mobile App of 2011, TechFlash Newsmakers Award
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Manage your medication costs with our safe, competitive pharmacy solution.
• Extensive pharmacy network includes 25 Group Health
pharmacies, contracted network pharmacies, and the
MedImpact pharmacy network.*
• 2013 Medicare 5-star quality rating for prescription drug coverage
for Group Health Cooperative Clear Care® (HMO) plans.
• Market leader in prescribing generic drugs.
• Competitive formulary based on rigorous review of
new drugs for safety and effectiveness.
• Online and mail-order refills.
* Available for some plans 15
Care management beyond the exam room helps patients get the care they need, and reduces unnecessary services.
• 24/7 Consulting Nurse Service
• Complex case management
• Transition management between care settings
• Utilization review
• Disease management coaching
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Keep employees healthier with our Wellness Solution.
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Make wellness an integral part of the workplace.
We provide wellness consulting to help you build multi-year
programs and for an additional fee, we offer:
•Wellness challenges
•Worksite biometric screening events
•Worksite flu shot events
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For help with workplace injury care and safety, there’s our Occupational Health Services.
• Injured worker care at Group Health Medical Centers
• For an additional fee, we offer the following:
– Industry-specific physicals and employment exams
– Screening
– Drug and alcohol testing
– Prevention services
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Published research demonstrates that our model of care boosts quality and curbs costs.
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You don’t just get a plan.You get advice every step of the way.
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Exceptional customer service you can rely on.
• Local designated account management
and customer service teams
• Win-win relationships where everyone benefits—
employees, employers, and providers
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Core administrative services
• Claims administration
– Subrogation
– Coordination of benefits
• Eligibility maintenance
• Appeals
• Summary of benefits
and coverage
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Ongoing data-driven consultation helps you understand both health plan and care delivery cost and utilization.
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Let’s talk about how your company canbenefit from the Group Health difference.
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