The Expion Health team left the Self-Insurance Institute of America, Inc. 2023 Conference energized and inspired. We had insightful conversations with over 40 different organizations and immersed ourselves in thought-provoking speaker sessions.
🔑 The key takeaway: Self-insured groups and administrators are assessing their current approach to managing medical claims costs, leading them to reevaluate their network and reimbursement strategies.
▶ The Evolution of Healthcare Cost Management: We observed a significant trend among self-insured groups and administrators. Many are transitioning from the traditional PPO model to Referenced Based Pricing (RBP) methods. However, traditional RBP solutions often fall short on their promises, particularly in post-pay support on appeals and member assistance.
▶ Network and Reimbursement Strategies Under Scrutiny: Self-insured groups sticking with PPO models for In-Network and Wrap Networks for Out-of-Network (OON) coverage are realizing the limitations of these strategies. Wrap Networks don’t always provide optimal discounts and often come with misaligned incentives in Shared-Savings pricing models.
▶ The Common Thread: Regardless of the chosen path, one thing is clear – everyone is seeking greater transparency into the management of their medical expenditures. They also value solution partners who can introduce cutting-edge innovation, including real Artificial Intelligence, to enhance financial outcomes, automation, and efficiency.
At Expion Health, we’re at the forefront of modernizing healthcare cost containment through technology-driven solutions. Our Intelligent Allowable represents the next generation in RBP, featuring a comprehensive, adaptive, and configurable AI-driven pricing model.
Unlock the Future with Expion
If you’re ready to unlock the future of healthcare cost management and explore how our innovative solutions can transform your approach, we invite you to get in touch with us: [email protected]