EBS’ Direct2Employer™ (DTE) strategy is established when a healthcare system “directly” contracts with self-funded employers down to two employees (available in most states) to supply healthcare services to members through a contractual arrangement using claims, clinical, Rx, and financial data to better target and address the healthcare needs of a population.
The financial incentives include gain sharing arrangement if an employer plan achieves a favorable claim cost variance to the budget. The DTE strategy incorporates plan designs to financially incent members to use the healthcare system’s medical providers and adhere to protocols intended to address gaps in care and to manage appropriate utilization.
The DTE platform is offered through a strategic partnership by Employer Benefit Solutions (EBS) and The Key Family (KEY) .
EBS provides strategic consulting services to healthcare systems that desire to develop a DTE health plan for its employees in a more cost-effective manner while expanding market share by partnering with small and medium-sized employers to utilize the healthcare system’s medical providers on the same DTE health plan platform.
KEY is one of the largest independent third-party administrator (TPA) in the United States. KEY has a proven and patented population health management system that has been tested and quantified over 15 years and with 4,000 employers and 2.8 million members to address the management of the chronically ill. The DTE program has demonstrated plan cost reductions of between 11% and 17% over a three-year period. This DTE program would be part of the healthcare system's value proposition.
The process is as follows:
1) Identify the sickest patients through a sophisticated predictive modeler
2) Set up a regimen of care for 27 chronic conditions and co-morbidities
3) Coach patients to obtain needed regimens of care from a healthcare system medical provider.
These two companies have partnered together to offer healthcare systems one of the most disruptive opportunities in the healthcare industry – the ability to market health plans directly to employers without the participation of an insurance company.
EBS is a strategic consulting practice which consists of executives with decades of experience working with multi-billion dollar healthcare systems and employers. As a result, EBS understands the financial pressures that healthcare system executives encounter in managing the millions of dollars that it spends in providing healthcare coverage for its employees.
Through a DTE healthcare platform, EBS is able to coordinate healthcare coverage in a more cost-effective manner not only with medical and surgical care but also dental, vision, critical illness, gap, short term disability, life, and proactive health management plans (PHMP) and all without the participation of an insurance company.
What’s different about EBS is that EBS will partner with health insurance brokers who are fully committed to its goals in providing healthcare coverage in a more cost-effective manner as well as ultimately expand market share for the healthcare systems. These brokers will initially target small and mid-sized businesses of 2 to 500 employees in a healthcare system’s market and who do not have the bargaining leverage with insurance companies, to significantly decrease their healthcare costs by utilizing the healthcare system’s medical providers through the same DTE narrow network model.
Craig Bollinger is principal of CJ Bollinger Consulting LLC and has over 34 years of progressive Risk Management experience for various industries including Transportation, Logistics, Healthcare, Manufacturing and Service.
From 2001 to 2018 Craig was Sr. Vice-President of Risk Management of NFI Industries. As NFI grew from $250 million to $2.0 billion in revenue during his tenure, Craig was responsible for all Risk Management, Treasury, Cash Management, and Investment functions including setting up and managing a Segregated Cell Bermuda Captive, Domestic Branch Captive (Vermont) with combined annual premiums in excess of $35 million. Craig reported to ownership and was instrumental in utilizing creative alternative risk financing techniques to foster growth while limiting downside risk. Craig continued to provide consulting services to NFI after creating his own company.
Prior to joining NFI, Craig was Vice-President, Risk Management of Burns International Services Corporation. In this capacity (from 1985-2001), he was responsible for the entire Risk Management function. This included setting up and managing a Domestic Captive (Illinois) insurance company with an annual cost of risk exceeding $90 million, with approximately $200 million in liabilities retained on balance sheet. Craig’s 16 years of experience with Burns/Borg-Warner Security/Borg Warner Corp/Baker Industries was one of constant growth and promotions within the Finance Group with titles including Director of Risk Management/Assistant Treasurer and Assistant to Vice President of Finance. Craig continued to act as a consultant after the spin-off of Borg Warner Automotive Group from Borg-Warner Corp. Craig developed a reputation for providing cutting edge analysis of cost of risk and alternative risk financing including creative solutions for run-off liabilities for divestitures and acquisitions.
Craig earned a Bachelor of Science degree from Stockton State College in Accounting and a Master of Business Administration in Finance from Seton Hall University. Craig also received an Associate in Risk Management (ARM) designation from the Insurance Institute of America. He was an appointed member of the Manufacturers Alliance Risk Management Council and was a member of the Risk Management and Insurance Society as well as serving a term on its Executive Council for the Chicago, IL Chapter. Craig resides in Bucks County, PA. with his wife, Sheila, and son, Charlie, and is an avid gentlemen farmer and restores antique tractors in his spare time.
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