The pain: As of January 2014, small group premiums are subject to community rating–meaning, no matter what your company’s medical history, your rates are essentially the same as all the other small businesses in your region. However, large employers’ group health premiums are still subject to “experience rating” by insurers–that is, the more healthcare your company uses, the higher your premiums. Likewise, the cost of a self-funded health plan–an increasingly popular option for medium-size companies–is impacted directly by how much, or how little, employees use costly medical services.
The fix: Get employees to go the doctor less. How? Sherpaa, a New York City-based startup, offers a sort of digital diversion service. For a monthly fee of $50 per employee, workers get 24/7 online or phone access to a team of on-call doctors. “By providing access to a doctor, we can resolve 60 to 70 percent of problems without sending you into the healthcare system,” says co-founder Jay Parkinson. “We can rule out scary stuff, make a decision on the best next step, prescribe medications, and follow up if necessary.” No office visit necessary. By helping keep health-care utilization low, Parkinson claims the service can save clients–who include Etsy and Tumblr–up to $4,000 per employee annually. Sherpaa also helps identify common billing errors, which can help reclaim money for employees; advocates on behalf of users with insurers; and provides clients with a yearly “bill of health” that can help when renewing or shopping for a new plan. Currently, Sherpaa is only available to companies in New York City, but the company aims to expand to other cities soon.
From Inc. Magazine’s Three Services to Ease Your Obamacare Pain