Why US Healthcare Is Like OPEC And Why Networks May Disappear – with Mike Dendy
January 29, 2018
4 Steps to Implementing a Reference-Based Pricing Program
February 8, 2018

Healthcare Cost Breakdown

Every month, self-funded employers pay dearly for their employee healthcare plan. Do you know where and how these employer/employee dollars are actually being spent? AMPS has taken a closer look at how employer healthcare dollars are used, and how many employeesare actually using the majority of this money.

 

 

 

 

 

For the average employer, nearly half of its annual medical spend goes to hospital/facility costs. But how many members are actually contributing to this cost annually?

 

 

Only 8.5% of the average workforce are utilizing hospitals annually. This means that nearly half of an employer’s overall healthcare spend is used by only 8.5% of its employees.

 

 

 

 

 

 

62.6% of total hospital costs consist of claims $20,000 or over. So, large claims make up 62.6% of nearly half of an employer’s overall healthcare spend. This is an easy target for cost reductions.

 

How many claims make up this large portion of your hospital claims?

 

Only 6.3%.

 

 

That’s right… 62.6% of your total hospital spend comes from claims over $20,000, and this cost is coming from only 6.3% of your total hospital claims filed. Low hanging fruit for cost cutting.

 

 

 

 

 

 

With Medical Bill Review or Reference Based Pricing, AMPS can save any self-funded employer hundreds of thousands or millions of dollars on its hospital costs. This means huge savings potential on the largest portion of your healthcare spend.

 

Any potential employee disruption can be very minimal, affecting under 9% of employees and total claims. Employee disruption with Reference Based Pricing is a myth propagated by PPOs who want to maintain their very profitable status quo that is slowly bleeding employers and their employee’s budgets. Any employer can cut its largest concentrated cost by 30% with some minimal education required of the 8.5% who annually use a hospital or facility.

 

 

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