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Learn how SCIOinspire's subrogation services helped a not-for-profit insurance company achieve an overall decrease in member attorney fees by 5% over a period of 12 months, and total savings of $400,000.
As nonprofit organizations, BlueCross/BlueShield plans are especially committed to managing costs in order to support their overarching objective of improving clinical outcomes and, thereby, their members health.
SCIOinspire has significant experience with BlueCross/BlueShield plans and understands their priorities:
- Increasing access to healthcare, as the BlueCross BlueShield Associations (BCBSA) "Health Trends in America" report shows that more than 45 million Americans are uninsured.
- Keeping healthcare affordable, recognizing that the U.S. spends more on healthcare than any other nation and that premium increases outpace the consumer price index.
- Promoting quality and safety, based on studies showing that variations in care, which can be reduced by adherence to evidence-based-medicine, account for more than $10 billion in avoidable hospital costs and lost worker productivity.
- Improving consumer health, reporting that 5% of the U.S. population accounts for nearly 50% of total healthcare expenditures.
- Changing care delivery models, in order to maximize potential cost savings from patient centered medical homes, accompanied by increasing use of telemedicine, e-prescribing, and electronic medical records.
Even more important than our offerings, however, is the commitment to client service that backs them. We are not interested in a one-off relationship with clients. We seek to develop partnerships that allow us to blend our resources with each clients strengths to conquer challenging business concerns.
Pain Points
BC/BS plans must combat:
- Ineffective targeting of care management efforts
- Poorly designed programs that fail to effect meaningful behavior change
- Third party liability, which may total 1-1.5% of claims costs; COB may equal 2-4% of claims costs
- Inefficient data management and processes
- Lack of time and intellectual capital to design necessary process improvements
SCIOinspire Value Proposition
SCIOinspire provides capabilities to:
- Target potential candidates for care management services more effectively
- Deploy tools designed to better manage individuals enrolled in care management programs
- Evaluate programs continually, so improvements can be made for increased efficacy
- Increase recovery dollars through better identification and investigation techniques
- Coordinate benefits more efficiently
- Use data strategically to improve outcomes, optimize performance and better understand insured populations
- Augment and optimize internal resources by offering as-needed outsourcing services
