By Brant Couch, CIC

You might think reducing claim costs by approximately $3.9 million since 2008 would be the first thing a hospital CEO would mention when asked about the success of their employee health benefit plan.

Not so for Rebecca McCain, CEO of Electra Memorial Hospital who said, “It’s nice to save money, but when it’s better for the employee, it’s also usually better for the hospital. That goes without saying.”

The millions in savings since 2008 are a result of limiting the amount paid on claims exceeding $50,000 to the rate Medicare pays. Rebecca explains, “When we have a claim over $50,000, our plan says that we will pay the Medicare rate. Some facilities won’t accept it. Some will. But when they don’t, we now have a mechanism to negotiate with them on the balance of the claim.”

“We’ve also made other changes that have made a huge difference. For example, we no longer have deductibles. The employees absolutely loved it from the very beginning, because they said, ‘What do you mean I don’t have a deductible?’ We do have different levels of copays… but when they seek medical services, they know exactly what they will pay.”

Strength in numbers

Rebecca says membership in RHIA is where she and her colleagues are exposed to strategies like these; “One thing I think RHIA has done really well is bring everybody together and create a network of people that support each other.”

Her advice to a new CEO or a CEO whose hospital has just joined RHIA is two-fold, “Don’t be afraid to ask questions. Definitely meet with Dave Pearson, or somebody from RHIA, and ask what services they offer that other people are using. And then talk to other CEOs. I’ve done that since I started working here, even when I wasn’t the CEO. I constantly call people and ask, ‘What do you do about this?’”

Rebecca says the number one benefit from participating in RHIA is the collective strength it wields. “One small hospital is never a big player in any market. It’s nice to be able to have a forum for us to come together and become a larger group where we do have a voice.”

Risk and insurance

When asked how she would recommend a CEO can get the most out of what the RHIA team has to offer, she said, “I would start by using them as a resource. Even if you’re not their client, you should ask them questions because their entire team has always been really good about sharing information .”

Keeping you safely ahead of the game

RHIA’s mission is to help healthcare organizations prosper in the increasingly complex world of risk and insurance. Contact us today to get the answers you need.