How It Works
First Step: Transparency and Awareness
Providing transparency to plan participants drives awareness of the cost elements behind their monthly premiums. Once aware of the causes of health care cost increases, the employees are empowered to make wise decisions and can take advantage of the Adjudica GSM to control costs while still receiving the care they desire. Reports available:Group Spending
- Spending by care categories.
- Procedures that drive costs.
- Projected impact to monthly premiums for next plan period.
- Reimbursements to each care provider – total and average.
- Compare actual spending to projected spending year-to-date.
- Identify cost overruns as they are happening.
- List specific categories of care that are over budget.
- Highlight most expensive procedures within each category.
Individual Spending
- Total Costs
- Out of Pocket costs
- Cost by care categories (pharmacy, primary care, specialist, hospital)
- Comparison to average regional costs
- Impact to monthly premium.