How can USI help our organization improve our PPO network cost efficiency and health outcomes?
Traditional PPO networks fail to steer members to the most efficient setting of care. USI identifies network steerage options to financially incentivize members to utilize the highest-quality, lowest-cost providers within the network.
USI evaluates tiered network solutions ranging from simple HRAs to comprehensive network incentive programs.
We’ve estimated the financial impact for you. Feel free to update the assumptions.
- Channeling healthcare delivery to more efficient settings may reduce costs by up to 10%
- Potential to offer richer benefits without increasing plan costs
- Allows for member "choice" but with some level of responsiblity, reducing out-of-pocket costs for employees
USI recommends that employers waive deductibles or reduce coinsurance and copays.
Yes, vendors offer mobile engagement tools that encourage members to think differently about where they access care. These online tools allow members to find treatment options ranked by cost of care and provider quality.
Suprisingly, studies show that there is no direct correlation between cost and quality in hospital care, yet hospitals bill vastly different amounts based on "brand." Vendors examine large data sets derived from CMS to identify high-quality providers within the network based on outcomes and total cost of care.
I’d like to learn more about USI ability to help our organization identify savings opportunities related to our health plan’s provider network.
To get started on identifying appropriate networks, we'll need detailed claims data (if available) and a large-claims report.