The Power of Choice
The perception has been that a consolidated claims/care management program is streamlined to provide greater efficiencies and outcomes, with one company providing an all-in-one solution.
There is another school of thinking, however, that this type of program presents opportunities for hidden fees and decreased accountability. It requires that you — as Andrew Carnegie famously said — “put all your eggs in one basket, and watch that basket.”
While the ‘convenience’ of a consolidated program can appear appetizing, inspection of the individual components is required for optimal gain.
Zebrah Jahnke, AVP of Business Development at EK Health, believes that selecting partners based on their core competencies presents the ideal choice to offer clients control.
“We’ve experienced firsthand how choosing specialized service delivery provides risk managers full access to program data and enables each program partner to thrive in their respective areas, leveraging their unique expertise to define strategies, goals and objectives,” Jahnke said.
Including multiple program partners provides an extra level of assurance and confidence, because a number of expert vendors are not only evaluating their own outcomes, but also the outcomes of others with whom they now interact.
This natural ‘check and balance’ safeguard provides a fresh set of eyes to consistently analyze data and evaluate outcomes from all angles.
“Empowered by the full picture of program performance, clients can hold all parties accountable to their respective areas and gain superior outcomes,” Jahnke explained.
Many consolidated programs lack transparency in the areas of service billing and reporting fees against savings outcomes of the related service.
Charges for individual services or specific fees, such as negotiated rates or PPO fees, can be used to offset costs of other services, or buried deep within the structure without direct correlation. Revenue sharing may also exist between entities, a factor sometimes hidden from the client.
With a specialized program structure, the risk of revenue sharing is diminished, while the level of transparency and accountability is greatly increased. The costs are clear and inclusive, preventing the “sticker shock” that comes when someone shines a light on hidden costs.
While revenue sharing may exist, it’s the client’s right to have knowledge of where and how the revenue is shared. The client should have all the information to make an informed decision.
“Choosing distinct partners does not have to complicate a program,” Jahnke said. This program design builds a strong team of partners working toward a common goal with the customer.”
Key advantages of working with a specialized managed care partner include improvements in workflow, transparency and program performance, leveraging independent core competencies based on knowledge and expertise. Added benefits include:
- Diversity of expert partners, all working in their respective areas of expertise and knowledge
- Greater level of flexibility and customization of intelligent workflow processes
- Informed clarity in the billing and savings of each service
- Expanded scope of data acquisition and reporting to elevate understanding
- Enhanced knowledge of individual program elements, for a greater sense of confidence and control
Ultimately, the benefits translate into one thing: the power of choice.
“As the customer, you have the right to know exactly what you’re paying for so you can make informed decisions,” said Jahnke.
- Look at the whole picture and discover the full story
- Recognize the common practices and common abuses
- Ask questions
The team at EK Health offers unparalleled expertise in all of its service areas, expertly specializing in care management solutions for a seamless and optimal program design.
“Our goals are transparency, flexibility, customization and absolute excellence,” Jahnke said.
Connect with EK Health today to see how their care management components of a workers’ compensation program can work for you.
To learn more, visit: https://www.ekhealth.com/.
This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with EK Health Services, Inc. The editorial staff of Risk & Insurance had no role in its preparation.