Business Owner's Guide to Fighting Healthcare

This means primary care, physical medicine & injury care, rehabilitation (including chiropractic), and basic labs, x-rays and immunizations. It would also include preventive services.

Making these services easily and affordably available is necessary to avoid the high costs of healthcare.

But don’t be tricked. The reason for having no co-pays is to help keep your people away from hospital services whenever possible. Don’t be fooled – This ‘no co-pay’ tactic can just as easily be used as a ‘lost leader’ to guide your people toward the more expensive hospital services.

• Real Insurance for Non-routine Services (the “Other 10%”) For the more expensive and less predictable “Other 10%” (i.e. hospital services, specialists and brand name prescriptions), this is where you will want the right kind of stop-loss insurance that lets you own your employees’ data. You don’t have to analyze the data yourself, but, as explained below, you do want to control who can do it for you. The “Routine 90%” represents only about 10% of your total health plan claims costs.

Insuring it, especially with the wrong type of insurance, is not wise if value is your goal. Self-insuring this part will almost always make the most sense.

• Plan Design that Guides and Rewards Wise incentivization matters. Your people really have no reasonable way to know or remember how to use 53