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LIFESTYLE PERx Presentation

  1. An Innovative and Transformative Strategy to Reduce Healthcare Costs
  2. Managing Healthcare Costs • Employers continue to seek creative solutions to reduce healthcare costs, decrease absenteeism and increase productivity • They have been forced to restructure their benefit plans, often reducing benefits and raising deductibles and co-pays • This leaves some gaps in coverage and more exposure for employees • This also leaves some strategic opportunities
  3. Managing Healthcare Costs • One creative solution is the HEALTH PERX™ Card, which offers a range of affordable healthcare benefits. • These benefits offer the entire family thousands of dollars in savings. • At the same time it offers the employer those creative solutions they seek
  4. Disclosures • This plan is NOT insurance. • This plan provides discounts at certain healthcare providers for medical services. • This plan does not make payments directly to the providers of medical services. • The plan member is obligated to pay for all healthcare services but will receive a discount from those healthcare providers who have contracted with the discount plan organization. • This discount card program contains a 30 day cancellation period. • Member shall receive a full refund of membership fees, excluding registration fee, if membership is cancelled within the first 30 days after the effective date. • The range of discounts for medical or ancillary services provided under the plan will vary depending on the type of provider and medical or ancillary service received.
  5. Benefit Choices Health Benefits Pharmacy Savings Card Telemedicine Vision Care Dental Care Hearing Care Lab, X-ray & Imaging Complete benefit information, provider locators, FAQs and links to Rx price finder and Lab discounts can be found by visiting
  6. Health Care Reform  20-30 million consumers entering the system  A shortage of primary care physicians What Will Happen?  Individuals will ignore symptoms and delay treatment which can lead to more serious medical complications  Individuals will leave work for minor issues which results in loss of productivity and unnecessary costs  Individuals will overuse Urgent Care and ERs Telemedicine can eliminate most of these problems
  7. Health Care Reform and Telemedicine Access Points for Healthcare Medical Offices—physician assistants and nurse practitioners Walk-in Clinics–-Grocery Stores and Pharmacies Urgent Care and ER Clinics Telemedicine—Doctors by phone or secure email Telemedicine can provide immediate access to healthcare to every individual wherever they are, whenever they need it. The most efficient and cost effective method to deliver telemedicine is by phone.
  8. National Center for Policy Analysis “Telemedicine has the potential for restructuring medical care in ways that can solve many of the problems, while reducing costs and improving quality of care.” National Center for Policy Analysis Convenient Care and Telemedicine White Paper, November 2007
  9. Studies Show Physician telephone consults … have been proven to replace 45%-64% of doctor office visits and 15%-35% of hospital ER visits. Source: TelaDoc 2007 Survey and Consult A Doctor Survey Results 2010 Costs can be reduced as the healthcare system moves from in-person physical exams to virtual visits. The average ER visit is $1024 and primary care office visit is $140. Source: BCBS 2007: Health Cost Estimator Patient satisfaction with telemedicine is high…due to convenience, comfort , privacy…and the security of having 24-hour access. Source: Us Department of Commerce, Office of Technology The Challenge: Most telemedicine services require a co-pay. This represents a significant barrier resulting in low usage rates. We have eliminated that barrier.
  10. Telemedicine We partner with a network of licensed, board certified physicians, available 24/7/365 by phone or secure email, who can diagnose and treat non-emergency, routine medical conditions. They can prescribe medications when appropriate.  Call :  Survey Results • When your physician is not available • For non-emergent medical conditions or • Patient calls are diagnosed and treated questions successfully more than 94% of the time (the other 6% cannot be treated by phone) with 98% • After normal business hours, nights, satisfaction rating. weekends • When on vacation or in the field • 64% of callers would have gone to physician and 15% to the ER—a significant savings of time and • Requesting prescriptions or refills money. Disclosures: Physicians do not prescribe controlled medications. Telemedicine is not insurance. Telemedicine does not replace your primary care physician. Proprietary and Confidential
  11. Facts Physicians:  Experienced in Primary Care, Internal Medicine or Emergency Room practices  Fully credentialed by the NCQA Common Conditions Treated:  Cold/flu  Sore Throat  Bronchitis  Allergies  Sinus and Respiratory Infections  Headaches and Migraines  Stomach aches and Diarrhea  Urinary tract Infections  Minor Burns  Sprains  Insect Bites  Prescription Refills  Second Opinions
  12. Return on Investment Based on typical investment in this benefit program (results vary according to number of variables) With 25% participation: Receive $1.86 for every $1 invested With 33% participation: Receive $3.07 for every $1 invested With 50% participation: Receive $4.65 for every $1 invested Imagine if every corporation strongly encouraged a “call first” policy Telemedicine is a game-changer! Disclosures: Office and ER visits taken from CDC Nat’l. Center for Health Statistics. Costs per office and ER visit based on BCBS negotiated rates. Reductions in office and ER visits based on actual survey results.
  13. Pharmacy Savings Card Wellness Health Solutions has direct contracts for discounts on both brand- name and generic drugs at more than 67,000 pharmacies. Savings of 11% to 75% with an average of 53% off the retail price of most Rx purchases.
  14. Pharmacy Savings Card Even though some individuals may have a pharmacy benefit, many prescriptions aren’t covered. Ex: cosmetic drugs, appetite suppressants, smoking cessation prescriptions, prenatal vitamins or nutritional supplies, inject-able supplies, contraceptive devices, immunizations and vaccines and many more Our card covers them all.
  15. Pharmacy Savings Card Other Features that promote consumerism: • RxPrice Retriever. • Generic Navigator Proprietary and Confidential The Pharmacy Savings Card is NOT Insurance.
  16. Pharmacy Savings Card Drug Selected LIPITOR 40 MG Tablet QTY 30 =$133.18 (discounted price) Generic Alternative GENERIC PRODUCT NOT AVAILABLE N/A Optional Drugs within this Therapeutic Class Speak to your Physician about a therapeutic alternative. SIMVASTATIN 40 MG Tablet QTY 30 =$10.66 PRAVASTATIN SODIUM 40 MG QTY 30 =$13.67 LOVASTATIN 40 MG Tablet QTY 30 =$26.76 LESCOL 40 MG Capsule QTY 30 =$90.81 MEVACOR 40 MG Tablet QTY 30 =$124.02 CRESTOR 40 MG Tablet QTY 30 =$127.01 Proprietary and Confidential
  17. The Rebate Program The only Pharmacy Savings Card in the country to offer rebates from over 30 pharmaceutical manufacturers on over 1000 branded drugs. When consumer purchases a drug on rebate list, they will receive a preloaded MasterCard in the mail with their rebate amount. Many drugs offer $12-$20 rebates. Subsequent rebates will be loaded onto that same card. Every time a rebate is processed, card holder will be notified by email. Proprietary and Confidential The Pharmacy Savings Card is NOT Insurance.
  18. Additional Benefits Mail Order Price Guarantee Our Clients are eligible for additional programs: • Smoking Cessation programs at big savings • Diagnostic Lab, X-ray and Imaging Discounts • Access to ―Health & Wellness Focus‖ portal
  19. Additional Benefits Smoking Cessation Program Present Pharmacy Savings Card and receive significant discount on Chantix™ prescription After 90 day program, receive additional $30 via Rebate Card Take advantage of educational materials and complete support program available through Pfizer ―The Get Quit‖ Plan
  20. Additional Benefits Diagnostic Lab, X-Ray and Imaging Affordable: Deeply Discounted Rates – 10-60%. Convenient: Choose the lab location that's best for you Quality: Federally and state certified clinics. Over 2900 radiology centers Easy Laboratory Testing: Order your tests online or call us. Results within 48 - 72 hours. It's that easy. No co-pays No deductibles Confidential: Results sent only to you.
  21. Additional Benefits
  22. Who Can Benefit  People who do not currently have medication coverage  Many drugs on PBM plan cost more than discount card  People who are taking a drug not covered by their medication coverage  Those with a high co-pay or deductible  Those using another discount card There are 33,000 prescriptions below $7
  23. SUMMARY • We own our own network—over 65,000 pharmacies • We offer excellent discounts to the consumer (11-75%) • We offer cash rebates on many brand drugs • We provide smoking cessation discounts and educational tools • We provide discounts on Lab, X-ray and Imaging • We provide a comprehensive, user friendly, wellness portal • Everything can be branded
  24. This can be a stand-alone benefit Generate Revenue with a Free Pharmacy Savings Card This card is now being offered to Associations, Non-profits, Municipalities and other groups for distribution to their members and communities. Every time a prescription is filled, they earn revenue We can design website tools for pharmacy cards online or print cards for our distribution partners. Proprietary and Confidential The Pharmacy Savings Card is NOT Insurance.
  25. Other Health Benefits Dental Care  Members save 15% to 50% on everything from general dentistry and cleanings to root canals, crowns and cosmetic dentistry where available.  Over 92,500 dental practice locations.  Save on specialty care, orthodontics, endodontics and periodontics where available. *Actual costs and savings vary by provider and geographical area.  No limit on number of visits ** According to the Aetna Enterprise Provider Database as of October 1, 2008. . Dental Discounts not available to Vermont residents
  26. Other Health Benefits Vision Care  Save an average of 20%-60% on prescription eyeglasses, frames, lenses, tints, coatings, UV protection and specialty items  Savings on eye exams and 40-50% off the national average on LASIK surgery and PRK (where available)  Savings of 10%-30% on contacts  More than 12,000 locations including national chains and independent providers Pearle •Sears • JC Penny •Target • LensCrafters • Sterling •EyeMasters• QualSight LASIK
  27. Other Health Benefits Hearing Care- Beltone Hearing Centers—1350 locations  Free hearing screening and substantial discounts on hearing aids and other products and services. Newport Audiology Centers  35% discount off hearing aid prices at over 2,000 locations  100% Service Satisfaction during the first 60 days Mail Order Hearing Aids  Save 40% to 60% off average National Retail Pricing on over 100 models of name brand hearing instruments. Receive the lowest price available. 45-day in-home trial period and 1year factory warranty Proprietary and Confidential
  28. Other Benefits Lifestyle Benefits Emergency Roadside Assistance Identity Theft Protection Legal Services Direct Pet Care Fitness Club Discounts Complete benefit information, provider locators and FAQs can be found by visiting Proprietary and Confidential
  29. Lifestyle Benefits Emergency Roadside Assistance –  Up to 15 miles towing (up to $80 retail value) per occurrence maximum for covered charges.  Flat tire assistance, fuel, oil, fluid and water delivery service, lock-out assistance, battery assistance, & collision assistance. LifeLock ID Theft Protection * (for member only—family is extra)  Identity Alert™ System – provides early notification whenever they detect your personal information being used to apply for many forms of credit or services  WalletLock™ helps cancel and replace the contents of a lost or stolen wallet  eRecon™ patrols the web and notifies you of illegal selling or trading of your information  TrueAddress™ notifies you when a change of address is requested in your name  Free annual credit reports from the three major credit-reporting agencies  24-hour customer service  $1 million total service guarantee –if you become a victim of identity theft because of a failure in their service, they will help you fix it at their expense, up to $1,000,000
  30. Lifestyle Benefits Legal Services Direct Nine free services which include:  Unlimited initial phone consultations for new legal matters  Initial one-on-one consultations for new legal matters  Document review (6 pages or less)  Letters written on the member’s behalf  Phone calls made on member’s behalf  Assistance with governmental programs  Assistance with small claims court representation  Free simple will with free annual updates  Free living will—state specific Eight commonly used legal services deeply discounted, such as traffic ticket defense, name change, simple divorce, simple trust and more. Plan attorneys will either charge $125.00 per hour, or 40% off their usual and customary hourly rate, whichever is greater.
  31. Lifestyle Benefits Pet Care- Receive 25% off all services at participating vets. Free pet tag and 24/7 location service. Receive 10-30% off at participating providers on pet services, such as boarding, doggie day care, training, pet sitting and grooming. Fitness Club Discounts-International Fitness Club Network-- Guaranteed lowest rates at over 8,500 quality fitness centers nationwide. Introductory Free Week Trial to all clubs. All meet ACSM guidelines.
  32. Other Features  List-bill capabilities  Fulfillment Kit and Membership Cards  Website Access to benefits and provider locators  Onsite member services call center staffed with English and Spanish speaking representatives who can help with enrollment, verify discounts and assist with customer service issues.  Compliance Department monitoring state legislative requirements  Marketing assistance and brochures  Money Back Guarantee  All benefits are good for the entire family* *LifeLock benefit covers cardholder only
  33. Target Applications  Self-funded corporations  Fully insured companies with high deductible plans  Limited-liability plans  Schools, Government, Associations These low cost benefits complement any insurance plan by offering innovative strategies for reducing absenteeism, increasing productivity, and decreasing overall healthcare costs for the employer while encouraging employees to take more responsibility for their healthcare costs.
  34. Value Proposition Employers Employees • Ability to add a benefit with a high perceived • Access to medical consultations 24/7 as well as value savings on pharmacy, vision, dental, hearing and more • A program that will decrease absenteeism, increase productivity and reduce overall • A benefit that can fill in many gaps in insurance healthcare costs coverage, particularly with high-deductible and consumer-driven healthcare plans • Ability to ensure that every employee has access to healthcare when they need it • A program that eliminates unnecessary visits to wherever they are the doctor or ER • Ability to promote health and wellness and • A benefit that can save the family thousands of encourage personal responsibility dollars a year • A program that can help with acquisition and • Lifestyle benefits that can save the family retention of employees additional money on everyday needs
  35. Our Standard Packages
  36. Packages and Pricing Voluntary Benefits Select benefits to include and we will develop wholesale pricing. Involuntary or Embedded Benefits Based upon group size and projections or guarantees, we will develop involuntary pricing package. Fulfillment Kits can be provided by client and reduce cost.
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Notes de l'éditeur

  1. Good place to ask questions and tell stories