For employees and employers alike, health insurance and health coverage don’t seem to be working. The cost of care and medicine is a major problem.
The cost of health insurance plans is going up while access to affordable coverage is going down. Employers and their employees are both at a cost tipping point in their budgets.
Traditional health insurance plans are no longer serving their purpose as an “employee benefit” for employees because, even though they offer “coverage”, many cannot afford to enroll in coverage for themselves, much less their dependents, because it all just costs too much.
Within traditional healthcare plan structures, we’ve noticed that most patients can’t afford the high deductibles and out-of-pocket exposures that come standard with their employer-provided insurance. As a result, most care is deferred, which creates new problems of its own.
Benefit Advisors find that legacy PPO networks and National TPA plan designs just keep getting more expensive and they shift more cost to patients. They are searching for better options and strategies they can bring to make healthcare affordable again but in the current system, the costs only get worse.
This is where high-performance healthcare plans are the answer to solve the problem that healthcare and (traditional) health insurance plans and strategies don’t solve the problem clients are facing.
High-performance Healthcare vs. Traditional Healthcare Coverage
High-performance health plans provide higher-quality care, lower costs for patients, and better financial performance for employers.
High-performance plans typically involve three key elements to change the outcomes above.
- Direct Contracting with providers and facilities
- Direct Primary Care
- Fully Transparent Pharmacy administration with an “acquisition cost” pricing formula.
When Employers move away from traditional healthcare constructs, they leverage healthcare pricing transparency, direct relationships with providers, and pay cash-level pricing, all of which remove 20-50% of the cost of traditional health plan deals.
In summary, high-performance healthcare changes how employers purchase and pay for healthcare. The middle layers of traditional health plan costs are removed and patients see the same providers for far less cost.
This fundamental shift, with no middleman layers, allows employers to reduce what employees pay for coverage and care. In most cases, everyday care and medicine are at no cost to employees. When more extensive care is needed, the direct arrangements allow for very low or no out-of-pocket costs when directly contracted providers are seen. These are the very same doctors and hospitals in the community today. The cost simply changes, a lot.
What Employers Are Looking For
Employers who place their employees at the forefront of their organization understand that healthcare coverage is important. Everyone needs medical help or care at one point or another and Smith Medical steps in to provide a trusted and high-quality surgical-focused healthcare option directly to Employers.
For patients, finding a surgeon that accepts employer-specific insurance takes time when you are a patient looking for a serious injury or procedure like surgery. When Employers contract with Smith Medical, they now have a high-performance option that delivers care they can afford.
Employers are looking for options that will keep costs low while providing their staff with awesome benefits they value when they join the team.
Many ask, how can this all work, does paying less mean we are getting less value? The answer is no. Providers actually make more when they are paid directly. They get paid faster than insurance companies, and much of the red tape and complexity of traditional healthcare is removed. It sounds too good to be true but it’s not.
Smith Medical Surgical Coverage Made Easy
Direct surgical care at your employee’s disposal. Removing the third-party cost layers of traditional insurance makes things better for all involved.. here’s how we are helping:
At Smith Medical, we are dedicated to providing premier patient care at an affordable price for everyone. Our state-of-the-art multispecialty facilities are operated by only the most talented of surgeons in your communities. The care provided at Smith Medical elevates the standard of typical surgical care. We take pride in our upfront, transparent, competitive pricing.
Smith Medical is ideal for:
- Individuals with no coverage, or high out-of-pocket costs, or share plans
- Businesses with high deductibles
- Businesses who are self-insured and want to pay less, and get more value from their plan.
- Businesses who are tired of paying so much and getting so little.
Cost transparency and High Quality are the priorities at Smith Medical. This is why we have chosen to work with businesses and organizations that are looking to provide a better care model for their employees.
We understand that providing health plans that are valued and a benefit to employees can be a game changer for a business that needs to retain and attract top talent.
Affordable health coverage and care is gold when you need to land that next high-performing employee.
How Coverage Works
In contrast to traditional health insurance, Smith Medical direct pay specialty care offers you and your employees unique and individually tailored packages to suit the needs of you and your employees while keeping costs down for employers and employees.
As a medical practice, Smith Medical is committed to transparency, ensuring that patients and employers are aware of all costs upfront. The fees for all services are combined in our package pricing so that everyone has a clear understanding of what the costs are from the very first introduction to Smith Medical.
Whether they are looking for an orthopedic procedure, a minimally invasive surgery, women’s or men’s health procedure, or anything in between, our price is direct and easy to find using our pricing tool on our website.
Partnering with Smith Medical is easy:
- Contact us directly to learn more about enrollment.
- Whether you are an individual or Employer, we will answer questions, refer you to providers, and guide employers to contract with Smith Medical.
- Choose a plan that delivers high-performance healthcare that will meet the needs of your team.
Everything changes when you or your team can afford the care you need. Call us to get started on changing healthcare.