How we reduce waste
The lack of transparency in the US healthcare system has bred outrageous price discrepancies, unimaginable in any other industry.
Prices that are “in network” for routine care often vary by more than five times for identical procedures. This routine “commodity care” includes routine blood work, imaging, outpatient surgeries and chronic care prescriptions, that collectively makes up 50% of the total cost.
Lack of transparency also has looming legal implications for self-insured companies’ CFOs and HR executives needing to detect wasteful healthcare spending and provide the same level of fiduciary ‘rigor’ (from the DOL) that ERISA retirement plans have faced.
We leverage deep industry expertise with an analytics platform to assist reducing, on average, 30% of wasteful healthcare spending.
1. Waste Detection Phase
We upload our client’s de-identified medical and prescription claims from the past twelve months into Benjamin™’s price & quality transparency engine, powered by over 250 million records.
Benjamin™ analyzes costly, in-network price variations by comparing actual claims for identical, routine “commodity care” and displays actionable savings opportunities based upon the client’s own medical & Rx claims, not a generic benchmark report.
This waste detection also discovers billing irregularities in the paid claims, generally between 1% to 3% of total spending, that have the potential to be recovered in the short term.
The Benjamin Report™
The key deliverable of the Waste Detection and Spending Optimization Phases is The Benjamin Report™. This is fundamental for transforming organizations into efficient healthcare consumers.
Employee engagement is key. With Benjamin™ they will be able to search for price and quality information about in-network routine care facilities, specific to their area, regarding 600 types of medical care procedures, and cost saving identical prescription drugs reducing their out-of-pocket costs by avoiding over priced routine care facilities.
Within 30 days we will let you know how much money you can save.
INSIGHTS & RESOURCES