As the steward of a self-funded plan, do not let perceived plan year restrictions limit the opportunity to improve a health plan. Self-funded plans are ideal for direct contract benefits that can be implemented at any time during the calendar year. This is especially impactful for musculoskeletal issues as orthopedic occurrences are not bound by a plan-year pattern. An employee that encounters an orthopedic issue needs to remedy their condition in that same plan year. For example, if an employee has a rotator cuff tear this January, they are going to need treatment now and should not have to wait until the next open enrollment period to be offered an alternative to surgery.
Employers need the right orthopedic care continuum in place for their employee’s best care without regard to the plan year process occurring annually. The benefit of a self-funded plan is the flexibility for employers to assemble benefit options and program designs outside of the constraints of a fully insured plan. It is short-sighted to restrict benefit additions that can help manage risk, reduce healthcare costs and bring value to employees all year round.
Employers are facing another increase in employee healthcare costs in 2020. The average cost per employee is predicted to increase 5%—from $14,642 in 2019 to $15,375. With this in mind, having a non-surgical care option in your health plan is a good fiscal strategy to manage rising costs, add to employee retention and boost employee satisfaction in the new year.
Half of all Regenexx clients add our procedures to their self-funded plans off-plan year.
Regenexx has made the process of incorporating into a self-funded plan easy, with no upfront cost and can be exercised as an immediate benefit to the plan. No upfront costs translates into employers saving as soon as an employee engages. Full onboarding takes as little as 30 days. Meaning, the employee with the January rotator cuff tear would immediately begin treatment with a non-surgical procedure first, followed by more aggressive modalities only if needed.