Solutions

Healthcare Strategy

Today’s healthcare experience is frustrating: employers face the same options and rising costs year after year. Don’t let another year go by hearing, “The claims are the claims.”

Thousands of claims and millions of dollars reduced to one annual premium with no explanation-
no more.

  • Actionable strategies to reduce claim costs
  • Data-driven solutions, accounting to the penny for continuous improvement
  • Evolving strategies without disrupting members
Problem 1: Getting “Brokered”

“Show me the incentives, and I’ll show you the results.” — Charlie Munger

Getting brokered starts with not understanding how, when, and how much your broker is paid. If you don’t align pay incentives with the outcomes you want, insurance companies will set incentives that benefit them. (Hint: they want more money.)

Problem 2: Closed-Box Strategies

What’s a closed-box strategy? It’s distilling thousands of claims into a single column in a spreadsheet with one annual premium. Would this level of accounting be acceptable in other areas of your business?

We open the box, account for every penny, and then control costs while improving the supply
chain.

Problem 3: Zero Fiscal Controls

The big lie in healthcare: You can’t control the costs of your healthcare plan.

Switching carriers without any clear strategy for future improvement won’t solve the problem.
The only question is:

What’s being done to lower the frequency and severity of claims?

Administration

With experience working with hundreds of employers nationwide, we bring best practices to simplify administration and act as an extension of your team.

  • Benefits administration build, maintenance, and payroll integration
  • File feed support with in-house technical experts
  • Full Eligibility support
  • Full Benefits Compliance support
  • Comprehensive HR support platform
  • Interactive dashboard with all service and support items updated in real time
  • Custom Communications campaign year round
  • Ethos Experience bi-weekly calls with service team
  • Monthly Claims Reviews, Quarterly Fiduciary Committee Meetings
  • Fiduciary Liability Audit

    And much more…

Advocacy

We don’t send your employees to insurance company 800 numbers. True advocacy means
guiding employees through the complex challenges of healthcare delivery and finance.

  • Modern, two-way text messaging to engage and support members
  • Spouse & dependent engagement and support
  • 24/7 Access with online benefits guide and text portal
  • Assistance in choosing providers
  • Understanding costs before services
  • Billing review
  • Hospital Financial Assistance Support
  • Measured cost and quality reporting of providers

Ongoing Engagement

Our service team integrates seamlessly with yours, acting as an extension of your operations.  Comprising industry-leading professionals who are passionately committed to transforming healthcare for American workers, our team advocates tirelessly on behalf of you and your employees. Whether dealing with carriers, vendors, hospitals, or providers, we strive to ensure afair and positive healthcare experience.

  • Monthly Claims Analysis
  • Weekly or Bi-Weekly Ethos Experience Calls
  • High Claim Monitoring & Mitigation Strategies
  • Auditing & Vendor Coordination
  • Employee Claim Advocacy & Healthcare Navigation Support
  • Transparent Reporting of Open Service Tickets