DENVER--(BUSINESS WIRE)--BridgeHealth, a leading provider of high-quality, lower-cost, bundled surgical case rate benefit plans, says an innovative benefits solution can help employers avoid a “tsunami of millions of dollars of litigation” in their role as health plan sponsors. This is one finding of a white paper announced today by BridgeHealth.
Titled “How Self-Funded Health Plan Sponsors Can Avoid Litigation Around Fiduciary Responsibilities,” the white paper notes that more than 100 of Cigna’s self-insured clients and their plan administrators were named as defendants in a massive fraud lawsuit. The suit, one of several, alleged that employers failed to meet their fiduciary duties – for unmanaged health plan costs affecting their enterprises and employees.
“With many employers spending an estimated $2,000 to $5,000 more per employee for healthcare than necessary, businesses are taking steps now to correct course and avoid the lion’s den of litigation,” said Mark Stadler, BridgeHealth’s chief executive officer. “One step is to contract for specialized benefits that bundle the various charges for each costly major surgery into a single discounted price.”
According to BridgeHealth’s white paper, these bundle-priced benefit plans save 20 percent to 40 percent over PPOs on spinal fusions, hip replacements, angioplasties and coronary bypasses, among other common surgeries. For each hip replacement at one business, employer and employee paid $24,213 and $0, respectively, versus $42,153 and $2,500 under the company’s PPO plan. For a variety of bundle-priced surgeries, another employer saved $3.8 million in a single year.
“Recent lawsuits claiming a dereliction of financial duties signal that the intense scrutiny so commonplace for retirement benefits has come to self-insured health benefits,” Stadler said. “The good news is that bundled surgical case rate benefit plans can help employers stand up to this scrutiny.”
Self-funded employers obtain bundle-priced health benefits by contracting with specialized benefits management firms. The best of these firms identify top-performing hospitals and surgical centers based on nationally recognized quality ratings. The firms then negotiate with these centers of excellence, bringing the discounted episode-of-care prices to the employers.
To fulfill their fiduciary responsibility, BridgeHealth’s white paper also suggests employers shore up systems to meet standards of conduct of the Employee Retirement Income Security Act. The report recommends self-funding employee health benefits, targeting prescription drug costs and implementing workplace wellness and disease management programs.
Founded in 2007, BridgeHealth (www.bridgehealth.com) is a surgical benefits management company that offers a suite of products for self-insured group health plans to improve quality and outcomes of surgery, reduce costs and positively affect the rate of unnecessary surgery. Through decision support, a high-quality narrow network, care coordination and other strategies, clients get real savings in cost and high-quality outcomes while providing an outstanding patient experience through a facilitated process. Clients achieve very quantifiable results for themselves and their employee/plan members in a manner that integrates with their full suite of health plan benefits. BridgeHealth is headquartered in Denver, Colo.