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Similar to RBP, Centers of Excellence (e.g.,

offer a combination of quality service,

Mayo, Johns Hopkins) may be used by large

efficiency, consistent outcomes, health plan

employers for employees with complex health

cooperation, and cost-effective pricing.

problems. Recently, a Walmart truck driver visited multiple doctors who were unable to fix his neck bone spurs, resulting in high provider bills and fragmented care. Walmart took control of the situation by flying the employee to the University of Texas, where he had a successful surgery and returned to work. Walmart used their influence to pay a flat, bundled fee to the Texas Center of Excellence hospital for all services. RBP pricing isn't automatic and is best for organizations that are willing to take on more risk and negotiate directly or via a third party with healthcare providers. RBP lowers costs and prevents the employee from receiving a balance bill for unpaid charges. For organizations that are financially savvy

Employers can have high-value networks customized as part of their benefit plan offerings. Employees benefit by using highquality providers and are incentivized to use these networks by lowering out-ofpocket costs. In 2017, 11% of large employers included high-value networks in their plans and this is expected to increase to 50% in the next three to five years.

50%

Expected increase in use of high-value networks by 2023-2025 by large employers

and dedicated to controlling costs, an RBP approach can result in significant cost savings.

Strategy 2: High-Value Networks High-value networks offer top-quality providers through a PPO network, typically at a lower cost. According to a report from the American Health Insurance Plan (AHIP) by a leading actuarial firm, high-value networks are comprised of providers who

EMPLOYEE BENEFITS LOOKING AHEAD 2020 | WOODRUFF-SAWYER & CO.

The Puget Sound High-Value Network offers over 6,000 providers at 12 hospitals and over 1,000 clinics in the Seattle area and surrounding counties. This network helps participants evaluate all of their health care needs and works to make a plan to address illness or injury. In the San Francisco Bay Area, Canopy Health offers plans through UnitedHealthcare and Healthnet.

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Profile for Woodruff Sawyer

Looking Ahead: Employee Benefits Trends and Solutions in 2020  

Read our annual Looking Ahead Guide for insight into the 2020 employee benefits marketplace, including election impact, attracting and retai...

Looking Ahead: Employee Benefits Trends and Solutions in 2020  

Read our annual Looking Ahead Guide for insight into the 2020 employee benefits marketplace, including election impact, attracting and retai...

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