Traditional health benefit management strategy is mostly reactive. Plans and programs are decided year in advance, employees are enrolled and after enrollment, they are left pretty much on their own to manage their health care based on their coverage. We hope that everything will turn out the way it was planned.
However, we have seen time and time again that costs have been going up. The cost burden has increasingly shifted to employees with high deductible plans.
The ever increasing healthcare costs dovetailing alongside a tight labor market —which is upping the ante for recruiting and retaining talent — are pushing companies to take charge and act proactively to manage budget and costs. However most companies lack the tools and resources required for proactive budget management.
Reactive to Proactive
Sprite health budgeting and cost control provides the estimation of costs, the setting of an agreed budget, and management of actual and forecast costs against that budget.
The dashboards provide real-time visibility into how actuals are lining up against the forecast and budgeted amount and flag specific areas that should be addressed to keep the projected expenses under budget.
The more precise control of budget makes it possible in to reallocate margins in accordance with the new and evolving needs of the population anytime of the year.
Service-Centric to Member-Centric
Benefit administrators can define multiple budget strategies for specific services, benefit programs or incentives and can define the budget scope for specific members, specific locations, zip codes or counties. The cumulative budget strategies define the baseline against which the actual expenditure and predicted eventual health spend is reported.
In addition to costs, the administrator can specify the reserves to cover things that could not have been foreseen, such as changes from predicted utilization.
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‘Proactive budgeting’ to drive better care at lower costs