A Fresh Approach | Innovative Products Advantages | Results

GET MORE BANG FOR YOUR HEALTH CARE BUCK WITH PATIENT CHOICE

Year after year you see your health care premium costs increase, while little changes in the overall health care marketplace.

Instead, cost increases continue, competition between plan offerings is reduced, employees are less engaged in decision-making and provider dissatisfaction is on the rise.

Patient Choice offers a whole new way to purchase health care. It’s a fresh approach that:

• Helps control cost
  
  
• Enhances consumer choice
  
  
• Obtains more value for your health care dollar
  
  
• Drives quality improvements and efficiencies in the health care system.
  
  

Patient Choice provides a proven health care alternative that's significantly different from traditional offerings. Our programs feature unique health care delivery networks that are tiered based on performance measures and emphasize informed choices for consumers, accountability for health care professionals and effective cost management for you—the employer.

Since 1997 Patient Choice has been the pioneer in advancing tiered network methodology. Our approach, which was co-developed with employers and health care providers, creates an opportunity for providers to prove their value to their patients and for employees to make informed health care decisions based on meaningful information about cost and quality.

How it works

Network providers are tiered based on cost, quality and efficiency measures. Employers offer employees incentives to use high quality, cost-effective providers. Employees choose providers based on factors that are important to them—factors such as cost, convenience, special expertise, etc. Those who obtain services from providers in a lower (or better) tier generally have lower premiums, copayments and/or coinsurance.

Patient Choice is quite literally healthy competition. It lets providers compete for patients based on the value they provide, while fostering a dialogue and strengthening accountability between providers and their patients.

Patient Choice currently serves employers in Minnesota, South Dakota and limited areas of North Dakota and western Wisconsin. Our innovative program offerings include:

Patient Choice Care System Program
Patient Choice Insights^SM

• Patient Choice Care System Program
  The Patient Choice Care System program features a network that tiers groups of health care providers and facilities called “Care Systems." These Care Systems are analyzed on measures of cost, quality and efficiency and placed into three tiers.
  
  Employers offer a choice of Care Systems, giving employees the option to contribute less toward their premium when selecting lower cost Care Systems. Employees review comparative information about Care System performance to help guide their choices. Once enrolled, employees obtain care from providers who are affiliated with their selected Care System to be eligible for in-network benefits.
  
  
  • Program specifications:
    Service area—Minnesota, South Dakota and limited areas of North Dakota and western Wisconsin.
    Funding options—Self-funded
    Plan Administrator Options—Corporate Benefit Services of America (CBSA) and Fiserv Health (formerly Wausau Benefits, Inc.)
    
    
  • More information:
    To view more information about the Patient Choice Care System programs in South Dakota and the upper Midwest, click here
  
  
  
• Patient Choice Insights^SM
  Patient Choice Insights is a next generation tiered network program. It helps employers manage their health care costs and offers employees freedom of choice, while assisting individuals in becoming better health care consumers.
  
  Patient Choice Insights uses an approach whereby individual health care providers and facilities are tiered according to cost and quality factors and employees are rewarded for using more efficient, high quality providers. Employees can access any provider in the network—in any tier, without a referral. Comparative data enables employees to gauge value and make informed choices based on their needs at the time of service
  
  In addition to the relative cost comparisons presented by the three tiers, your employees have access to our Hospital and Outpatient Surgery Facility Guide and Pricing Catalog. This insightful resource helps individuals evaluate the performance of hospitals and other facilities and allows them to find out the actual costs of 15 common inpatient and outpatient procedures at various participating hospitals and facilities.
  
  View the Hospital Guide and Pricing Catalog.
  
  
  • Program specifications:
    Service area—Minnesota, and limited areas of North Dakota and western Wisconsin.
    Funding options—Self-funded and Fully Insured.
    Plan Administrator Options—Medica and Fiserv Health (formerly Wausau Benefits, Inc.)
    
    
  • More information:
    For more information on Patient Choice Insights by Medica, click here
    
    To view more information about Patient Choice Insights, administered by Fiserv Health (formerly Wausau Benefits, Inc.), click here
  
  
  

Patient Choice programs provide employers with many advantages not available in other health plan offerings. For example:

• Patient Choice leverages informed consumer choice and provider competition to obtain greater value from the health care system.
  
  
• Consumers are equipped with the information they need to make wise choices about their care. Tier assignments allow them to easily identify those high quality providers who are more efficient and cost-effective.
  
  
• Employers and their employees benefit from cost savings when individuals armed with comparative information and incentives to choose wisely, select quality care at a lower cost.
  
  
• All providers that deliver high quality care are encouraged to participate—broadening choice and access. Network providers are ranked on cost and quality measures, so your health care dollars are not used to subsidize higher cost providers.
  
  

Our innovative health care benefit programs help control employer costs, deliver useful, actionable consumer information about care cost, quality and service, and return health care decisions back to those providing and receiving care.

Since 1997, the program has been successfully delivering results. Employer participants have benefited from lower overall medical costs and administrative fees when compared to market alternatives.

The program has also shown that:

• Consumers migrate to better performing, lower cost providers.
  
  
• Providers respond to informed consumer choice by improving pricing and efficiency.
  
  
• Employers have experienced reduced cost trends and administrative fees, while spurring quality improvements in the health care system.