How We Are Managing Employee Benefits Better with an On-Staff Medical Director
Companies who work closely with an employee benefits broker to develop their benefits packages rely heavily on the expertise of these employee benefits advisors to help them meet their employees’ needs and comply with all state and federal requirements.
Not only that, employers depend on these benefit consultants to get them the best possible ROI for their benefits investment, and bend the cost curve downward wherever possible.
But not all brokers are created equal in terms of what they can offer to their clients in this regard. Among other factors to consider when deciding upon a broker, it is wise to choose a benefits broker with a Medical Director on staff.
Why is this so important? Healthcare today is an incredibly complicated field.
Achieving a high standard of patient care involves interdisciplinary communication and multi-organizational cooperation. If you have ever attempted to unravel an insurance claim issue on your own, you know the frustration of dealing with a somewhat fractured medical delivery system.
A Medical Director is experienced in the system and can cut through some of that red tape to ensure that your organization isn’t spending more than it needs to, while also helping your employees get the right care, in the most appropriate settings.
Unique Qualifications of Medical Directors
Medical Directors that come from a strong clinical background are uniquely qualified to navigate the troubled waters of healthcare today. As clinicians, they understand the complexities of patient care. As administrators, they understand the importance of minimizing financial risks while providing that care.
A Medical Director combines a strong understanding of medical issues with a firm grasp of financial and business considerations.
Commenting on how Medical Directors integrate medical expertise with management of strategic and operational responsibilities, Gregory Preston, MD, chief medical officer for Cook Children's Health Plan in Fort Worth, observes:
"Medical Directors need to keep abreast of the standards of practice and stay in touch with the physician community in order to manage the constant flood of new technology and the translation from evidence of clinical effectiveness to strategic medical policy."
Bridging the gap between corporate responsibility and high-quality patient care, Medical Directors act as “innovative change agents who drive continuous improvement” for benefits brokers, employers, and plan participants with whom they interact.
Medical Directors have a broad and deep understanding of health care delivery systems paired with a working knowledge of sales and marketing. To do their jobs effectively, Medical Directors keep a close watch on regulatory and accreditation standards, changes in health care law, and delivery system trends.
At The JP Griffin Group, we stack each of our accounts with a highly skilled, cross-functional team of high performance, subject matter experts including a Medical Director. Learn more about our Staffing Approach.
What's In It for You?
Having a Medical Director on staff enables a benefits broker to find effective ways to counter growing medical expense trends. Here are a few things that a Medical Director does regularly to make your benefit plan both cost-effective and truly beneficial to its participants:
- Using his or her clinical knowledge, a Medical Director provides analysis of claims’ histories and rate assumptions to underwriters and actuaries. This type of in-depth analysis with a real-world understanding of clinical matters can result in significantly lower renewal rates for you.
- Research indicates that 1 percent of the insured population incurs 40-50 percent of the total healthcare spend. A Medical Director looks for ways to promote effective case management for high-dollar cases, reducing overall spending. Additionally, a Medical Director can help with negotiations for more efficacious outcomes in group and individual cases.
- A Medical Director helps craft wellness initiatives that truly work. Using his or her analysis of health outcomes compared to program cost, he or she can suggest winning strategies for wellness programs that will see high returns.
- A Medical Director makes himself or herself available as a resource when plan members need help navigating a particular health issue. With a strong knowledge of the health care environment, he or she can manage complex situations with a view to easing communication between all parties.
- A Medical Director works with health plan and employer groups to ensure that all members receive the best care available in the most appropriate clinical setting.
Considering the specialized skill and insight these professionals can provide, it’s easy to see how choosing a benefits broker with a skilled Medical Director on staff will provide the best value for your company.
The JP Griffin Group is proud to have a highly qualified, skilled Medical Director on staff to assist you with your benefits program – a rarity among brokers of our size.
For more information about our Medical Director and other unique and invaluable support staff, schedule a complimentary benefits review for your firm. Our team is ready to work with you today for the health and well-being of your employees and your company.