The Achieve Health Plan
The Achieve Health Plan
One of the main reasons your clients switch to self-funded healthcare plans, is to take control of their spent and have the flexibility to act. They hire you as an expert to have the entire healthcare supply chain unbundles giving everyone a clear view of the healthcare spend.
In an ideal world, you put together the Master Plan and choose the Third-Party Administrator that manages all the processes for you, so you can focus on sales and growth of your business. Your clients are happy, you can see all the numbers and results any time you like, all claims are controlled and proceeded on time and every element of this structure works in collaboration with one another. Like a clockwork.
Those of you who have years of experience on this market probably grinned while reading this. You already know there's no ideal world in this business.
However, this is exactly how most of vendors describe your future cooperation, before signing the contract. The "Yes, we can do it, it's not a problem" attitude and other marketing promises they make, that put your business under a great danger.
It's a common practice for the constantly growing market, to have participants that are just interested in reselling. Literally, some of them sold phone cases couple of years ago (because that was trendy) - and now they switched to healthcare plans, since the profits are higher. The problem is, just because their primary focus is to get you and your client, they would agree to anything. You assume that somehow it's integrated - and then you're dealing with the fact that those companies are just outsourcing, and nothing is done in-house with them.
As a result, none of the initial healthcare plan goals are accomplished. You lose control over your client's budget, the "elements" of your Master Plan do not communicate with each other, you learn about the problems when it's already too late, and nobody has any idea where do all the money go.
All you've left to do in this case is just "hope for the best", because even one single claim can destroy your client's healthcare plan - which happens more often on this market, than you think.
The saddest part is when you believe promises given by the vendor, you ensure your client in the exact same thing. And when it doesn't go the way it was supposed to, you are responsible for it.
Imagine you invited your client in a wonderful, shiny and bright restaurant that claims to have a 5-star kitchen. You sit at the table, order Steamed Maine Lobster with Black Truffle included in the menu, and the waiter promises you a wonderful and tasteful experience. In 30 minutes you finally get your meal - but it's not what you ordered. In fact, they just brought you the raw lobster and expect you to get along with that. On all your complaints the waiter states, that the restaurant has fulfilled conditions given in the menu (they did bring you the lobster, right?).
To save the day you, as the person responsible for your promises to your client, have to either explain him why you both have to eat raw lobsters, or put on the chef's hat, go to the kitchen and try to cook the lobsters by yourself (which is not even your job, and you have no experience in it). In both cases, the lunch is ruined. And your client will probably never accept your invitation again.
This happens to your healthcare brokerage business and your clients, when you look at the shopfront instead of the kitchen itself. It's extremely important to separate marketing promises from the reality before you get in.
"The Achieve Health Plan" webinar is your first step towards the new ideal world, where the promises given are the promises kept.
John Sbrocco and Craig Lack teach you how to get deeper into each element of your Master Plan, ask the right questions and learn about the bumps on the road at its very start.
After years of negative experience with the vendors, The Achieve Alliance Team has put together a structure to identify and avoid fraud on healthcare market. This structure will save you and your clients from the mistakes that can cost you money and your business.
On this webinar, you'll learn about the full-stack health plan:
- The Chef (TPA) - Important elements to consider when selecting a Third-Party Administrator
- Stop Loss Quoting - Lessons that will make the vendor tell you the truth;
- Captives - How to avoid financial risks and increase control over the program;
- Proactive RBP - The smart calculation strategies that match with providers' costs;
- Direct Contracting - "Adding new fish in a tank", or the criteria for choosing new providers;
- RX Watchdog - How to apply clinical data to your day to day administration;
- Family Monthly Deductible - Giving Ems the dignity of medical insurance they can afford;
- Care Management - Integrated and in-house to insure prompt and timely execution;
- Claims Auditing - The criteria for defining errors, review of documentation and other.
To a better you!
John Sbrocco & Craig Lack
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