In the U.S., the global coronavirus has claimed nearly 100,000 lives and 30 million jobs. Consequently, what COVID-19 has brought to light is the strength of our country’s health care infrastructure, begging the decades-old question of how we perceive medicine, doctors, hospitals, insurance companies, and pharmaceutical manufacturers.
With video conferencing platforms such as Zoom making it possible for doctors to treat patients remotely, using telemedicine, the global pandemic could (finally) bring an end to the American tradition of forcing health insurance into employment plans.
Back in May, there were approximately 21 million people in the U.S. unemployed (more than 13% of the U.S. labor force), with more than half the U.S. adult population dependent upon their employer or a family member’s employer for their health insurance.
Yet here we are in July 2020, where a key concern remains as to those who have recently become unemployed, have also lost their health benefits (in addition to their jobs). And if that isn’t scary enough, federal survey data probably won’t be available for some time to assess COVID-19’s impact on health insurance coverage.
Perhaps our healthcare system is heading into a complete transformation, in favor of telehealth. Telehealth, according to the Human Resources Services Administration, is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. This includes technologies such as videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.
For years, healthcare providers in the U.S. have been slowly inching towards telehealth services, but now it’s safe to assume that COVID-19 has pushed this telemedicine revolution forward years, if not at least a decade. Unlike telehealth, telemedicine is less broad in terms of the scope of remote healthcare services. Telemedicine refers specifically to remote clinical services.
One such technology that is already revolutionizing health insurance is IncentiCare, a group health insurance plan from TPA administrator, BeniComp Health Solutions. BeniComp, an InsureTech company and 58-year-old startup in Tampa, has radically been transforming healthcare by saving employers millions of dollars while providing smart solutions that improve the health of populations. Applying COVID-19’s horrific impact on our nation, BeniComp has announced its newest health plan, IncentiCare, that has quickly become a proof-of-concept for reformation of the nation’s healthcare system.
We spoke with Doug Short, CEO of BeniComp, who took over the business in 1980 from his father, Don, who started the company back in 1962. Originally located in Fort Wayne, Indiana, BeniComp relocated its headquarters to Tampa in 2014 with Doug taking the reins.
When Short first took over the business, he quickly experienced the pain points of the industry and the legacy systems it continued (and continues) to offer. He was determined to be a solution for the industry as a whole, developing the nation’s leading Executive Medical Reimbursement product in 1980, which has continued to be the primary revenue driver for BeniComp today.
In 2000, Short launched the first revolutionary concept of IncentiCare (formerly known at the time as BeniComp Advantage), wanting to empower people to take control over their health and be proactive (rather than reactive).
“I saw the issue of chronic disease plaguing the nation and I took a visionary stance in solving this problem,” Short explained to us, adding that he eventually built a team around him to accomplish this.
IncentiCare, according to Short, is a group health insurance plan for self-funded employers that allows them to control their healthcare expenses.
In 2019, BeniComp reintroduced IncentiCare as it is known today, alongside the company’s proprietary insurance platform, Pulse, to bring technology and data into the preventive model and have a greater impact on the health of populations.
“It brings data, technology, and preventative health management together to improve the health of populations and drastically strip out costs,” Short expanded. “IncentiCare identifies the risks and opportunities in the data of a company’s current health plan and implements transparent cost-containment services to eliminate wasteful spending and enable member access to high-quality and low cost of care.”
The plan’s differentiator, according to Short, is that it “motivates 96% participation in annual health screenings by allowing participants to earn $3,000+ towards their healthcare expenses, based on the outcomes of their screening.”
When we asked Short to elaborate, he told us that IncentiCare aims to prevent and reverse chronic disease by incentivizing the five-key biomarkers: blood pressure, blood glucose, cholesterol, body mass index, and tobacco usage) that are directly linked to chronic conditions.
“Each biomarker is linked to a specific deductible reward/incentive.”
Specifically, IncentiCare also includes services (which couldn’t be more timely) such as: mental health services, surprise billing defense, medical management, telemedicine, RBP/open-networks, pharmacy benefits management, specialty drug management, member advocacy, and legal support.
“With the help of [BeniComp’s] clinical team of functional medicine doctors and health coaches, [they can] identify and prioritize health risks in the population and proactively reach out to participants to help them bring their biomarkers back into a healthy range and prevent/reverse chronic conditions through lifestyle modifications.”
Why COVID-19 Has Predicted This Type of Health Insurance Transformation
COVID-19 has had everybody asking the question, “what is the new normal”, including employers. But where do employers go from there once they’ve asked the question?
From what Short has observed, two scenarios have stuck out to him:
First, employers want to protect their workforce by providing healthcare and insurance options. “Oftentimes, these options can be very reactive. The coronavirus continues to show us how important it is to be proactive in maintaining control over our health, as opposed to being reactive. For instance, individuals with chronic diseases are at much higher risks, but especially during this time when COVID-19 is linked to a greater likelihood of fatality and increased severity.”
With this in mind, employers want to take care of their employees and provide them healthcare that helps them be their best selves, stay healthy, and also that looks out for the well-being of their finances.
Second, employers have had to get ‘skinny’, adapt their business models, and cut costs.
“Health insurance is either the largest or second largest expense for companies, and each year the cost to provide health care increases,” Short shared. “Health insurance is either the largest or second largest expense for companies, and each year the cost to provide health care increases. Because of this, employers are forced to pass along expense increases to their employees, especially if they cannot absorb the increases. When this occurs, they can no longer ignore healthcare and continue to accept the same renewal increases over and over.”
We are no strangers to the hidden fees, non-transparent profits, wasteful expenses, and cost-steering mechanisms involved in traditional health-insurance plans that make health insurance more expensive than it needs to be. And with COVID-19 still at large, it’s time our healthcare leaders recognize that and help policyholders and consumers as they proclaim to.
As for the Tampa community, BeniComp and its IncentiCare plan doesn’t wait for people to be sick for it to “kick-in”.
“It is proactive and preventative in nature, addressing 75% of healthcare expenses by impacting chronic disease. Widespread adoption of this model empowers individuals to have autonomy over their health and health data and reduce the appetite for healthcare. This impacts healthcare from the inside out.”
Short gave us a quick insight into one employer group they quoted with 2,000 employees, projecting to save them $10 million in the first year alone. “This doesn’t account for the money that will be saved as time goes on and employees improve their health and are empowered with services such as member advocacy and defense support.”
Think with the money saved on healthcare expenses, employers (and potentially other entities) can increase cash flow and reinvest into their workforce, business, and health innovation.
The company’s Executive Medical Reimbursement product allows BeniComp to continue growing from, allowing it to receive profits to reinvest in its growth, team, and technology development.
“The future of health insurance is a health solution.”