Employee benefit adviser Maestro Health is betting that negotiating health prices with hospitals, doctor and other healthcare providers before an employee needs medical care could help employers see Medicare-like savings.

To help employers cut their health spend and boost employees' healthcare consumerism skills, officially launched its new benefits platform last week, although it has been available to select Maestro Health clients since last fall. Those early users are seeing healthcare savings in the range of 20% to 30%, according to Maestro Health CEO Rob Butler. None of the early customers were available to comment.

The Maestro Health platform is aimed at employers with 250 to 10,000 employees and offers access to hospitals and doctors across the country. The platform features a tool called “Shop by Doc” that allows users to check if their doctor is in a network.

Bloomberg/file photo

Employers can choose from several different plans, which offer different levels of coverage at different price points. Some are strictly based on an in-network model, while others allow use of out-of-network doctors and hospitals.

Egregious costs

“We are creating a health plan management offering that directly addresses some of the egregious medical costs that you and I and our families are facing,” says Butler. “Depending upon which statistics you read, most hospitals charge one price for Medicare and then they have an exorbitant price for non-Medicare services that’s sometimes 500% to 700% more.”

This, he says, is especially likely to hurt employees with more limited knowledge of the healthcare system. Unaware that other options, such as other nearby MRI facilities, are available, they are more likely to pay a hospital’s inflated price for the services they receive.

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“Essentially,” Butler explains, “we’re trying to get more transparency and pre-negotiate that pricing.”

Negotiating healthcare costs remains a major challenge for employers and the benefit advisers who service them.

“Employers are going to continue to work with brokers to see how their offerings were used in previous years and how they can update their plans next year,” says Chatrane Birbal, senior adviser for the Society of Human Resource Management, an HR trade group. Once they have a better understanding of how their workforce utilizes the benefits that they offer, she says employers will recalibrate their slate of offerings for the following year.

With this in mind, Maestro Health also offers a medical audit service to monitor billing accuracy, verify employee dependent eligibility and check for fraud and abuse.

“Given that over 80% of medical bills have an error, the company audits every facility bill to make sure it is fair, accurate and appropriate to the member’s care,” the company states.

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