New Year's Resolution: Don't Leave Money on the Table!

December 12, 2024

As we ring in the New Year, many organizations are setting goals to improve efficiency, cut unnecessary costs and maximize financial performance. For self-insured employers, third-party administrators (TPAs), insurers, reinsurers and managing general underwriters (MGUs) one resolution should take center stage: Don't leave money on the table when it comes to managing high-cost medical claims.

In the ever-evolving healthcare landscape, the pressure to control rising costs while maintaining quality and compliance has never been greater. With health plan premiums projected to rise by 6-8% in 2025, now is the time to rethink your approach to cost containment and ensure you're not being misled by hollow promises of savings.

The Cost of Overlooking Real Savings

Many vendors tout significant savings but as highlighted in recent industry analysis, their methodologies often rely on deceptive metrics like per-case reductions that don't account for increased utilization or hidden costs. For example:
A program may lower the per-case cost but increase the total number of cases, ultimately driving up overall expenses.

Savings estimates often assume that new cases will cost as much as existing ones, ignoring the fact that mild or unnecessary treatments inflate costs without improving outcomes.

This New Year, make it your mission to partner with a trusted expert like H.H.C. Group, whose transparent, data-driven approach ensures real, measurable savings for your organization.

Achieving Real Savings with H.H.C. Group

H.H.C. Group recognizes the challenges of controlling high-cost medical claims and the risks associated with misleading vendor promises. That's why H.H.C. focuses on delivering actionable, data-driven solutions that align with your financial goals while ensuring the highest standards of care and compliance.

Here's how H.H.C. Group's innovative services can help you make 2025 a year of measurable success:

1. Independent Reviews That Drive Accuracy

H.H.C.'s URAC-accredited independent reviews go beyond surface-level assessments, combining financial and clinical insights to:

• Confirm the necessity of medical services.
• Identify and address inaccuracies in billing.
• Ensure adherence to regulations.

This thorough approach eliminates unnecessary charges and equips your organization with the confidence to make informed financial decisions.

2. Strategic Claim Negotiation

H.H.C.'s expert negotiators work directly with healthcare providers to reduce excessive claim costs without compromising care quality. With a proven track record of success, H.H.C. helps clients achieve significant savings while fostering constructive relationships with providers.

3. Fast, Reliable Processing

Delays in claims management can be costly. H.H.C. Group ensures efficient claim reviews and repricing with a standard 5–7 day turnaround, keeping your operations smooth and cost-effective.

4. Proactive Fraud and Waste Elimination

Using advanced analytics and expert oversight, H.H.C. Group identifies and mitigates instances of fraud, waste and abuse in your claims. This proactive approach safeguards your financial resources and maximizes the value of your healthcare spending.

By partnering with H.H.C. Group, your organization gains a dedicated ally in reducing costs and improving outcomes. Let us help you take control of your healthcare expenditures and achieve tangible results in the year ahead.

Starting the Year Strong

The New Year is the perfect time to reassess your healthcare cost-containment strategies and ensure your organization is positioned for success. Don't let misleading savings metrics or outdated processes cost you more than necessary. With H.H.C. Group, you gain a partner dedicated to helping you achieve real savings, streamline operations and reduce unnecessary expenditures.

Let's make 2025 the year your organization takes control of high-cost claims and ensures every dollar is well spent. Contact H.H.C. Group today to learn how we can help you achieve your cost-containment resolutions and set your organization up for success in the year ahead.