Our Approach

You work tirelessly to run a sensible, lean company.

 You don’t overspend on materials and resources you could get for a fraction of the cost. And yet, most companies quietly accept rapidly rising healthcare costs as fact.

Just as you do with everything else, you have the power to negotiate and institute systems that will improve healthcare at a reduced cost.

We can help!

Depending on your company’s unique needs and challenges, Captiva Benefit Solutions provides assistance via:

Key Components

Value-Based Primary Care

Nowadays, patients are hurried through appointments and referred to specialists or quickly prescribed medications. We’re advocating for doctors and networks where the primary care doctor is once again at the core of the healthcare process, by giving patients the time and attention needed to make the best decisions for them. This cuts down on costs in the long run, as patients benefit from well-educated decisions by the doctors who know them, rather than shoot-from-the-hip hurried hypotheses.

Concierge-Style Customer Service

By allowing employees to have access to professional, trusted healthcare guides, they can find the care options that make the most sense financially and health-wise in a complex, often confusing landscape.

Proactive Pharmacy Management

Pharmacy Benefit Firms are well-known for hidden fees, shell game pricing and taking drug manufacturers’ money to promote specific medications, at a price of anywhere from 50 to nearly 300 times what generic drugs would cost. We help you manage drug cost and quality by becoming aware of these firms’ arrangements, making formulary changes that have a large financial impact, and carefully managing specialty drug costs by shopping around.

Reference Based Pricing

We don’t take the PPOs’ massive markup pricing at face value; instead, we use Medicare’s much lower reimbursement rates as a reference point to secure the same care for a reduced price.

Transparent Medical Markets/Payment Integrity

In order to control costs, you have to have a clear expectation of what the providers will charge. A transparent price must include the full bundle of services that wrap around it. Having absolute assurance and agreement on what comes with the price, as well as tackling fraud and ensuring claims are paid correctly, is essential to keeping costs down.

Planning for Uncommon, but Predictable Large Claims

Know how to account for these situations, both budgetarily and logistically.

Major Specialties and Outliers

In health benefit plans today, about 6 to 8 percent of plan members are spending 80 percent of the plan dollars. Misdiagnosis spends an estimated 16 percent of plan dollars for medical conditions patients don’t actually have. Finding employee-sponsored centers of excellence is key to proper diagnoses and treatment.

Transparent Advisor Relationships

It’s almost unheard of for healthcare advisors to disclose their financial stake in their dealings, due to entanglements with lots of the big players. Trust is cultivated with total transparency, and the benefits purchasing process should be transparent, based on disclosure and aligned financial incentives.

Are You Ready?

take back the American Dream and turn healthcare on its head!

Contact Captiva Benefit Solutions today!