Exploring Self-Funded Healthcare Plans, with Christina Heckathorn

In this episode of The Healthy Savings Podcast, we are joined by guest Christina Heckathorn, an employee benefit advisor from Employee Benefit Associates, EBA. Together, we explore the journey towards sustainable healthcare solutions in Kentucky, shifting from annual cost increases to innovative self-funded and level-funded plans. Collaboration with industry leaders like Health Rosetta has been pivotal in navigating the complexities of self-funding successfully while maintaining transparency and educating clients about the benefits and risks involved. Strategic partnerships with entities such as milu Health ensure tailored solutions for clients, promoting long-term savings and operational efficiency.

Empowering employers with knowledge about self-funding and debunking myths surrounding traditional healthcare models is essential to revolutionizing the healthcare landscape for small to mid-sized businesses. Critical aspects like stop-loss contracts and choosing trustworthy partners are highlighted to mitigate risks effectively. Innovative programs like Thrive RN are discussed, showcasing how specialized support and cost-saving measures can enhance members' healthcare experiences.

The episode delves into a unique healthcare plan prioritizing employee well-being and affordability in rural Kentucky. Through partnerships with local pharmacies and inclusion in the Anthem network, substantial savings are offered without compromising on quality care. The focus on reducing co-pays, providing access to vital services, and enhancing employee experience through a nurse navigator program exemplifies the commitment to community support and cost-effective solutions.

Disparities in healthcare costs and the importance of providing alternative, cost-effective options are emphasized, alongside building trust with employees to ensure the plan's success. The hosts' anecdotes shed light on the challenges and successes in transforming the healthcare plan into a well-structured, employee-centric model. Continuous improvement, transparency, and patient-centric care remain at the core of reshaping healthcare provision.

Furthermore, we discuss managing employee health insurance plans, emphasizing the need for a reliable consultant, Third-Party Administrator (TPA), and Pharmacy Benefit Manager. Data-driven decisions, transparency in evaluating care quality, and tracking performance metrics for medical procedures are crucial for enhancing patient outcomes. Success stories of significant savings through self-funded plans and the value of client-oriented consulting firms over corporate-driven approaches are highlighted, showcasing a dedication to client outcomes and transparency.