Medicare Cost Plus plans result in annual claims savings of around $150,000 – $200,000 per 100 employees for employers.”
Self-insured medical plan groups are becoming very prevalent – however, they are still experiencing increases in per capita medical costs that greatly exceed Consumer Price Index. A Medicare Cost Plus (MCP) plan may be a solution that fits your company’s needs in order to combat the rising costs of healthcare.
An MCP is a progressive healthcare plan that uses a Medicare pricing model for claims reimbursement. On average, these plans will pay 120% of the cost of Medicare pricing for certain doctor visits and procedures as opposed to the 150 – 250% of traditional PPOs.
Administrative costs under an MCP should be lower due to the lack of network access fees. In addition, employers should see stop loss premium savings because of the lower level of allowed charges which in turn reduces the insurance carrier’s liability.
Employee education is key in implementing an effective MCP. The issue lies in the fact that without pre-negotiated provider reimbursements or discounts, some providers are unwilling to accept the plan reimbursement for the full balance of services provided. The result – members can be balance billed after a claim is adjudicated.
Axion’s consultants have a combined experience of over 65 years, including extensive background in working with Medicare Cost Plus plans. If you would like to learn more, contact us today!