Challenges and Solutions in Cost Management
Healthcare costs are a topic of conversation among individuals and among insurance companies administering automobile no-fault claims in particular. Costs in general are rising and inflation continues to be a concern across industries as well, further contributing to financial concerns.
Improve cost management
When it comes to healthcare costs, the Centers for Medicare & Medicaid Services (CMS) reports that the United States observed an increase of 4.1 percent in this category in 2022, according to the National Health Expenditure Accounts (NHEA). That translates to a total spend of 4.5 trillion dollars, which works out to nearly $13,500 per person in the U.S. Put another way, this category amounts to 17.3 percent of the country’s Gross Domestic Product (GDP), which is clearly a significant number.
Proactively working on cost management is a necessity today. Rising healthcare costs mean an increase in the cost of auto no-fault claims administration. It is perhaps more critical than ever that your company considers working with a PBM if you haven’t already. An experienced PBM will work with your company on multiple cost management measures.
For instance, Northwood is a proven, highly qualified DMEPOS, pharmacy and ancillary service provider and PBM with over 30 years of experience within the insurance industry. Over those 30 years of experience, Northwood has developed numerous processes and procedures that assist insurance companies with cost management.
One way Northwood assists with your cost management is by offering your company access to its network of quality medical providers. Each provider is thoroughly credentialed before being admitted into the network, and all providers undergo a stringent re-credentialing process every three years. They are monitored to ensure they continue to offer high quality care for claimants. The providers offer contracted rates on physician prescribed services, which helps insurance companies with cost containment.
In addition, Northwood is unique in its approach to cost management within auto no-fault claims. Northwood employs pre-authorization to ensure every physician prescribed service is injury related, which directly impacts your company’s bottom line by reducing unnecessary costs for non-injury-related prescriptions. Other PBMs often rely on a formulary for prescription medications, which means a claimant’s non-injury-related prescription could inadvertently be approved for payment simply because it is listed on the formulary.
Though Northwood’s network and its use of pre-authorization translate to a reduction in costs, your company will experience additional benefits that are more indirect. Claimants receiving efficient, quality care through Northwood’s providers will be more satisfied with your company. Eventually, those higher satisfaction rates translate to increased retention rates and an improved bottom line for your company.
Increase your retention rates
Your insurance company stands to benefit in a variety of ways by partnering with Northwood. Please call Rosanne Brugnoni at 586-755-3830 ext. 3771 for an in-depth look at the many benefits of working with Northwood as your company’s PBM.