Self-Funded Health Plans: Cost-Containment Strategies

Introduction

1. Introduction to Cost Containment
2. Plan Sponsors and Employers
3. Plan Participants and Beneficiaries
4. Premiums

Estimated Time to Complete: 5 minutes

Using Data to Improve Cost-Effectiveness of Health Care Benefits

1. Data Analytics: Goals and Processes
2. Types of Data
3. Predictive Modeling
4. Artificial Intelligence (AI)
5. Practical Uses
6. Predictive Modeling Example
7. Steps for Implementing a Data Analytics and Predictive Modeling Initiative
8. Four Steps to Take

Estimated Time to Complete: 25 minutes

Health Plan Design and Provider Networks

1. Common Plan Designs
2. Preferred Provider Organization (PPO)
3. Health Maintenance Organization (HMO)
4. Point-of-Service Plan (POS)
5. High-Deductible Health Plan (HDHP)
6. Percentage of Firms that Offer Specific Plan Types by Firm Size
7. Balance Billing
8. Other Cost-Containment Strategies Related to Health Care Providers
9. Prescription Drug Benefits

Estimated Time to Complete: 25 minutes

Health Plan Features and Rules

1. Health Plan Features and Rules
2. Utilization Management
3. Cost Sharing
4. Limits
5. Dependent Eligibility Audits
6. Care Management

Estimated Time to Complete: 25 minutes

Employee Premium Contribution Strategies

1. Employee Contribution Amounts
2. Wellness Participation Incentives
3. Tobacco or Nicotine Surcharges
4. Spousal Surcharges and Exclusions (Carve-Outs)
5. Surcharges
6. Exclusions
7. Pros and Cons of Spousal Surcharges or Exclusions

Estimated Time to Complete: 20 minutes

Health Care Education and Communication

1. What Is Health Literacy?
2. Improving Health Literacy in General
3. Improving Health Literacy Specific to the Plan
4. Communicating with Health Plan Participants

Estimated Time to Complete: 20 minutes

NOTE: The estimated time to complete each lesson is based on word count and assumes uninterrupted consumption of the course. Actual time to complete each lesson can vary widely based on familiarity with the topics and other factors. Time required to complete the course final exam is not counted in these estimates.