Medical Tourism and Group Health
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Medical Tourism and Group Health
Two years after the Lowe's and Cleveland Clinic deal, employers are eager to try new ways to save money right here in the USA.
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GROUP HEALTH BENEFITS INSIGHTS with MICHAEL - November 15, 2011

GROUP HEALTH BENEFITS INSIGHTS with MICHAEL - November 15, 2011 | Medical Tourism and Group Health | Scoop.it

According to recently-released research* from Xerox companies ACS and Buck Consultants, nearly one third (31%) of those responding to the survey weren't able to put any money in their HSA this year. On another survey question, 21% reported that they through HSAs were not valuable to them for one reason or another, and a whopping 36% reported that their high-deductible health plan (HDHP) / health savings account (HSA) combination did not meet their family's needs.  That's disappointing, to say the least!

 

On the other hand, employers who responded reported that the cost of providing HSA-qualified plans is less than the cost of providing a standard Preferred Provider Organization (PPO). The average direct cost to provide an HDHP/HSA is $5,469 for individual coverage and $9,909 for family coverage.

 

In comparison, the average PPO cost is $7,158 for individuals and $10,691 for family. When coupled with a domestic health travel option for US-based employees those savings can quickly escalate into extra thousands of dollars saved simply by driving a few hours or hopping on a low-cost airline for a short flight to an alternative source of care for high-cost elective procedures.

 

"The key to the savings is to know where and how to look for them," says Michael Tarabay, VP of Business Development at Mercury Healthcare International (MHI). "In the past, folks have always simply assumed that they could only select their care from the list of nearby providers, even if those providers charge upwards of 60-80% more than the hospital 90-miles away."

 

When employers sign up with MHI, they get savings, convenience and choices. One quick call to our professional Care Navigators™ and plan participants and MHI consumer members can have access to transparent pricing and doctor credentials at over 800,000 providers in the USA and 92 other countries. So, no matter where they live or work, here in the states, or as expats, we can steer them to qualified, pre-screened and inspected providers who have stepped up to the plate and are ready to compete for their business with service, quality, access and price, Tarabay continues.

 

For anyone seeking more information on how we can save millions on group health benefits with a variety of cost saving solutions, please call me today at 800-727-4160.

 

I am committed to find ways to save your self-funded employee or union welfare benefit plan money and lower the out-of-pocket costs for your workforce and their dependents, without forcing you to cut benefits or reduce coverage.

 

*2011 Employer and Account Holder Surveys, ACS and Buck Consultants, November 10, 2011

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singletruth's comment, April 4, 2012 3:07 AM
Wow, sounds like you have none of your bases covered and then pretend we actually have a system that doesn't bankrupt people as a matter of course when they get seriously sick.

HSA are worse than ridiculous, they're insulting to a working persons intelligence, but thanks for passing along the corporate line.
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3 Things You Must Do to Improve Managed Care Profitability

3 Things You Must Do to Improve Managed Care Profitability | Medical Tourism and Group Health | Scoop.it

Download this helpful white paper I promised last week on the three things you must do to improve managed care revenues and profitability.

 

Inside, you'll learn how you can increase your contracted revenues, reduce your cost to collect and access powerful business information to round out your 2012 contracted revenue strategies for your hospital, your medical practice or your integrated health system /ACO.

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Dependent Eligibility Audit

Dependent Eligibility Audit | Medical Tourism and Group Health | Scoop.it

"Dependent eligibility audits," in which companies demand proof that spouses and children qualify for medical benefits, are swiftly becoming both fashionable and financially rewarding for companies frantic to curb the runaway costs of health coverage.

 

Companies such as Boeing (BA ), General Motors (GM ), and American Airlines (AMR ) have been asking workers to send in marriage licenses, birth certificates, student IDs, and tax returns. The goal: to cull the benefits rolls of ineligibles, which could include ex-spouses, stepchildren who live elsewhere, or 29-year-old college grads still being claimed as dependents.

 

In the last year, the number of benefit audits  has increased drastically. At best, the audits are a device that can save millions in an employer's health-care costs, keep premiums down for legitimate beneficiaries, and catch outright fraudsters.  Audits are finding up to 15% of those claimed as dependents aren't entitled to coverage. 

 

While a large company's audit might cost $20 to $30 per worker, the average annual health-care cost is about $3,000 per dependent.  Others have taken to using proprietary software that flags employees with with too many children too close in age, which could indicate ineligible nieces, nephews, or other children.

 

One of the benefit consulting services we offer at Mercury Healthcare is dependent eligibility audit, as part of a suite of services including case management, predictive modeling, disease management, second surgical opinion, and health travel.

 

For more information, please contact our business development department at 800-727-4160.

 

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Jawbone Releases UP, A Wristband For Tracking Your Wellness | Co. Design

Jawbone Releases UP, A Wristband For Tracking Your Wellness | Co. Design | Medical Tourism and Group Health | Scoop.it

Wellness doesn't necessarily mean going to the gym anymore...

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Employers who want to add medical tourism benefits to their plan will need specialty help.

Employers who want to add medical tourism benefits to their plan will need specialty help. | Medical Tourism and Group Health | Scoop.it

Hi,

I'm Michael Tarabay, VP of Business Development for Mercury Healthcare International. I've been a benefits advisor for more than 30 years and I can help your plan save money without cutting benefits.

 

Once an employer has decided to add a domestic or international health travel benefit option to their ERISA self-funded, group health benefit plan, they'll need to design their benefit option and add the details of their unique program to their Summary Plan Description (SPD).

 

ERISA sets fiduciary standards that require employee benefit plan funds be handled prudently and in the best interests of the participants. It requires plans to inform participants of their rights under the plan and of the plan’s financial status, and it gives plan participants the right to sue in federal court to recover benefits that they have earned under the plan. To be qualified for tax preferences under the Internal Revenue Code (IRC), plans must meet requirements with respect to pension plan contributions, benefits, and distributions, and there are special rules for plans that primarily benefit highly compensated employees or business owners.

 

ERISA specifies what the SPD must contain.[1] The Summary Plan Description, or SPD, is the main vehicle for communicating Plan rights and obligations to Participants and Beneficiaries. As the name suggest, it is generally a summary of the material provisions of the Plan Document, which is understandable to the average Participant of the employer. However, in the context of Health & Welfare Benefit Plans, it is not uncommon for the SPD to be a combination of a complete description of the Plan's terms and conditions, such as a Certificate of Coverage, and the required ERISA disclosure language.

 

Under Section 104(b)(1), a plan administrator must provide a summary of any material modification (SMM) in the terms of the plan as well as any change in information required to be included in the SPD.[2] This summary must be provided, in most cases, within 210 days after the close of the plan year in which the modification was adopted, and also must be furnished to the Labor Department upon request.[3]

 

Similar to the SPD, the materials must be written in a manner that can be understood by the average plan participant. While ERISA does not define “material modification” and does not specifically cover what changes warrant an SMM,[4] courts have addressed this issue.[5] Courts have held plan amendments such as the establishment and elimination of benefits are material modifications. [6]However, as courts have also pointed out, not all plan amendments are material modifications. [7]

 

[1] Hicks v. Fleming Cos., 961 F.2d 537 (5th Cir. 1992).

[2] 29 U.S.C. § 1024(b)(1), ERISA § 102(a); 29 U.S.C. § 1022(a); 29 C.F.R. § 2520.104b-3.

[3] ERISA § 104(b)(1), 29 U.S.C. § 1024(b)(1); 29 C.F.R. § 2520.104a-8.

[4] However, regulations provide a special rule for health plans. Subject to an exception, an SMM shall be furnished if there is a “material reduction in covered services or benefits.” 29 C.F.R. § 2520.104b-3.

[5] EMPLOYEE BENEFITS LAW (Matthew Bender 2d ed.)(2000).

[6] See, e.g., Baker v. Lukens Steel Co., 793 F.2d 509 (3rd Cir. 1986)(elimination of an early

retirement benefit option was a material modification); American Fed’n of Grain Millers v.

International Multifoods Corp., 1996 U.S. Dist. LEXIS 9399 (W.D.N.Y. 1996) aff’d, 116

F.3d 976 (2d Cir. 1997) (amendment to a medical plan requiring retirees to pay a portion of

premiums considered a material modification).

[7] See, e.g., Hasty v. Central States, Southeast and Southwest Areas Health and Welfare

Fund, 851 F. Supp. 1250, 1256 (N.D. Ind. 1994) (amendments more specifically providing

for a trustee’s discretionary authority under an employee benefit plan were not a material

modification because the amendments “simply clarify a power”).

 

 

For more information, please call me at 800-727-4160

 

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American Council on Exercise Cites Increased Obesity Awareness and Whole-Life Training Among Leading 2012 Fitness Trends

American Council on Exercise Cites Increased Obesity Awareness and Whole-Life Training Among Leading 2012 Fitness Trends | Medical Tourism and Group Health | Scoop.it

The following is an overview of ACE’s 2012 Fitness Trends to Watch:

 -Obesity Awareness

 -While Life Training

 -Behavior Modification

 -Community Collaboration

 -Technology Influence

 -Senior and Youth Specialities

 -Workplace Support

 -Advanced Certified Athletic Trainer Education

 -Zumba and other popular workouts

 

 

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Self-funding, Wellness Among Public Employer Saving Strategies

Self-funding, Wellness Among Public Employer Saving Strategies | Medical Tourism and Group Health | Scoop.it
MedBen Blog: Self-funding, Wellness Among Public Employer Saving Strategies http://t.co/mrwxj9cO...
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Healthcare business statistics, charts, lists, rankings and survey results from Modern Healthcare

Healthcare business statistics, charts, lists, rankings and survey results from Modern Healthcare | Medical Tourism and Group Health | Scoop.it
50 Top Cardiovascular Hospitals: 2011

A list of the nation's top 50 cardiovascular hospitals for 2012 as ranked by Thomson Reuters. Source: Thomson Reuters. Published Nov. 14, 2011, p. 30.

 

 

AND ALL OF THEM ARE IN OUR PROVIDER NETWORK!!!

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US medical tourism network agrees four new deals

US medical tourism network agrees four new deals | Medical Tourism and Group Health | Scoop.it

MHI's network includes over 6,000 pre-screened and inspected hospitals, more than 4,300 of which are in the USA, along with over 750,000 vetted doctors, clinics, dialysis centres, physical therapy and rehab centres, labs, imaging and hearing centres, plus substance abuse and mental health clinics.

 

MHI operates several offices worldwide where staff work to operate a health travel and medical tourism logistics hub, conduct patient safety reviews and use medical records to conduct extended outcomes measurements for health travel and medical tourism patients seeking care in a location other than their home town.

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Medical Tourism is creating competition right here in American healthcare

Medical Tourism is creating competition right here in American healthcare | Medical Tourism and Group Health | Scoop.it

Medical tourism is now creating competition – true competition – and that is spilling over causing health care all over the world to respond. Add to that some of the changes in both the European and the U.S. health care systems and we are approaching a tipping point.

 

Prices will come down and quality of care will go up.  It's already happening within our network. Providers are asking if they can renegotiate "lower" prices.

 

To learn more, call our sales department at 800-727-4160. We can give solid examples and full pricing transparency on a hospital by-hospital basis for over 6000 hospitals in the USA and abroad.

 

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Health travel industry advances continuity of care across borders

Health travel industry advances continuity of care across borders | Medical Tourism and Group Health | Scoop.it

Company improves integration of electronic health records.
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Healthy employees boost a company’s bottom line - often up to 7x ROI per dollar invested

Healthy employees boost a company’s bottom line - often up to 7x ROI per dollar invested | Medical Tourism and Group Health | Scoop.it

It should come as no surprise that healthy employees boost a company’s bottom line. They experience less sick time, take fewer disability days and suffer lesser risk of premature deaths.

 

According to the Centers for Disease Control, more than 75% of employers' health care costs and productivity losses are related to employee lifestyle choices. Self-funded health plans who couple a voluntary wellness program with their self-funded health benefit plan are currently experiencing a return on investment (ROI) of up to 7x for every dollar invested in the traditional local health delivery setting.

 

Coupled with a health travel program that includes a comprehensive physical and age-gender appropriate screening exams, and case management campaigns for high-cost chronic disease management and surgical interventions, that program option can easily bring in excess of quadruple those savings.

 

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ERISA Self-funded health benefit plans are getting smaller and smaller

ERISA Self-funded health benefit plans are getting smaller and smaller | Medical Tourism and Group Health | Scoop.it

While most of these companies include Fortune 1000 companies, there is a growing trend by small to medium businesses (SMBs) of 2-100 employees to move away from high-cost renewals charged by traditional insurance plans. 

 

Plan administrators are converting their plans to an ERISA self-funded health benefit plan coupled with a leased network of providers with negotiated rates and hired services of third-party administrators to re-price and process their claims, cost containment firms to negotiate out of network prices with providers, and case managers to monitor and manage high-cost and complex cases.

 

Added to this, many are kicking the tiers on health travel as an option to take advantage of price arbitrage whether the lower cost provider is across town, or several states away.

 

To add the program and ensure its use, professional logistics teams to coordinate care in alternative locations away from the plan participants' home town. When coupled with an affordable reinsurance policy, self-funded plans hold the risk of a limited exposure on the cost of claims, and only pay out plan benefit dollars when a claim is incurred. This saves millions of dollars per company over traditional risk-transfer insurance policies where premiums are paid monthly regardless if claims are incurred or not.

 

Mercury Healthcare offers such a team and their services are included in the monthly network access fee that includes access to PHCS and MultiPlan PPOs in addition to the largest health travel and medical tourism provider network in the world.

 

For more information on how you can start saving money and maintaining nationwide access and choice for your employees, call us at 800-727-4160

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