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The NetMinder Blog

Aaron Groffman

Recent Posts

What Is the Best Job of 2013? Dentist!

Posted by Aaron Groffman on Tue, Mar 19, 2013

Dentists have something to smile about. They have the best job in the country, according to a U.S. News & World Report study. The study ranked the top 100 jobs of 2013 based on the number of openings, the chance to advance and be professionally fulfilled, and the ability to meet financial obligations.

With an overall score of 8.4 out of 10 and an unemployment rate of just .7%, the dental profession outranked other top 10 jobs, including registered nurse, pharmacist and web developer.

Dentistry is a growing field with predicted employment growth of about 21% between 2010 and 2020, according to the U.S. Bureau of Labor Statistics. More than 27,000 job openings for dentists are expected during that time. And with a median salary of $142,740 (in 2011), it is one of the highest paying healthcare professions.

This is all great news for insurers and consumers who will benefit from more choices of dental providers and – as many will open private offices – more access points.

As of November 2012, there were more than 195,000 professionally active dentists in the U.S., as reported on statehealthfacts.org, a Kaiser Family Foundation project. A NetMinder data analysis of dental PPO trends shows that these providers are joining more insurance networks, and their number of reported practice locations is growing.

In March 2012, the average national dental PPO network contracted with more than 72,000 unique dentists, up 8.7% from the prior year. If the number of dentists in the U.S. continues to grow, they won’t be the only ones smiling; consumers and insurance companies will be glad to see more providers and more practice locations in their insurance networks.

Tags: dental network, dental providers, dental insurance

Is the Health Insurance Company a Good Friend?

Posted by Aaron Groffman on Fri, Mar 08, 2013

Medical 000005787159Medium(2)The next decade will be about bringing down the costs of health care in the U.S., says venture capitalist and blogger Todd Hixon, in a recent Forbes article titled “The Health Insurance Company Is Your Friend.” The biggest drivers of healthcare spending in the U.S. are the over-utilization of advanced medical care and the high earnings of the providers of that care, he says.

It’s payers versus providers, and health insurers are in the payers’ corner.

Hixon shares one of his own healthcare experiences in which “the insurance company paid about 30% of the face value of the bill, due to a combination of lower negotiated prices and striking off major billing errors and duplications.” 

The takeaway for insurers is that finding the right network providers is more important than ever. Insurance companies can help keep healthcare costs down by shifting away the high-end risk as well as building provider networks with good value for the cost, Hixon says in his follow-up article. Look for providers who offer good discounts, have a good utilization track record, and who participate with other networks so they know what’s expected. 

This is the right dynamic: how the insurance company becomes a better friend.

Tags: network providers, health insurance, Healthcare, dental insurance, health reform, health insurers, payers

Join Me at World Congress!

Posted by Aaron Groffman on Wed, Feb 20, 2013

World Congress logoHealth plans, insurance carriers and brokers will convene March 13-15, 2013, to learn how to leverage ancillary and voluntary products to increase their competitive edge and meet the needs of a consumer-driven market.

The World Congress 3rd Annual Leadership Summit on Ancillary Products and Voluntary Benefits will take place in Orlando and feature industry-leading speakers from CIGNA, United Healthcare, VSP Visioncare, Integrated Benefits Institute, Prudential, Blue Cross and Blue Shield, Health Plan Week and more. Session topics include meeting consumer needs, health reform, member acquisition, public and private healthcare exchanges, business innovations and other issues affecting the healthcare industry.

Join me on March 14th as I present “Using BIG Data to Get BIG Results in Ancillary Benefits.” We will explore the following ideas:

  • What’s big data? Does it apply to healthcare?
  • Learn how other carriers are using their big data to create competitive advantages.
  • Teach your sales and network teams to leverage big data to get big results.

If you'd like to attend the World Congress, be sure to register with promo code TAU676 and save $400 off of your attendance fee! (Discount is not valid toward government rates.)

I would love to see you in Orlando. Will you be attending the summit? 

Tags: dental insurance, Ancillary benefits, Vision insurance, Managed Care, Specialty Benefits, Ancillary Products, Voluntary Benefits, Benefit Design, Benefits Consultants, Insurance Brokers, Health plan, World Congress

Overwhelmed by big data?

Posted by Aaron Groffman on Tue, Jan 22, 2013

Netminder powerfuldataBig data was a hot topic for businesses in 2012, and according to a recent Forbes article, it will be even hotter this year when consumers really start to see its impact in everything from retail to healthcare.

The already vast volumes of information that exist online continue to grow every day, presenting enormous opportunities for businesses. Collecting and analyzing these large data sets, aka big data, can help companies make better decisions, predict probable outcomes, cut costs, identify new business opportunities, close more deals and retain more clients.

But how can businesses access the immense amount of information that is available and harness it for effective business intelligence?

Businesses, especially smaller companies, encounter three main challenges when trying to tackle big data, according to a recent article in Inc. First, many don’t have access to big data. Second, they may not have the technology and relational databases needed to easily pull the data. Third, many businesses don’t have the expertise on staff to analyze the data (e.g. a data scientist and a team of analysts).

David Selinger, a founder, CEO and data scientist at RichRelevance who formerly managed data mining and site optimization at Amazon.com, offered some tips for handling big data in a recent article. He suggests that businesses find experts to help them manage and analyze data, take advantage of the cloud, protect privacy, and of course, execute, test and measure.

Do you have experts lined up to take advantage of your big data opportunities?

Tags: data management, business intelligence, big data, data analysis

Heard About HealthCare.gov? Your Customers May Already Be Using It.

Posted by Aaron Groffman on Wed, Jan 02, 2013

describe the imageIf you haven’t already been to HealthCare.gov, I suggest you visit. The U.S. Department of Health and Human Services (HHS) introduced the website as a way for consumers to shop for health insurance, and businesses are also using it to research group plan options for their employees.

HealthCare.gov includes information from hundreds of insurers about thousands of coverage plans in all 50 states. This tool can be especially useful for small businesses looking for cost and coverage estimates for small groups and options for in-network versus out-of-network benefits, deductibles and co-pays.

HHS launched the site about a year ago under the requirements of the Affordable Care Act. Users can submit basic information about the type of insurance coverage they need (for an individual or group of up to 50 employees) to generate a list of results with estimated costs and advanced filtering options.

What does this mean for brokers and payers? Consumers and business owners are hungry for information and they have the tools to start the research phase of the buying process on their own. However, as they move further down the sales funnel, they would benefit from the guidance of an experienced insurance professional who is knowledgeable about the available benefit options and able to provide more accurate pricing as well as a competitive network adequacy assessment.

So, have you been to HealthCare.gov? How do you think consumers and businesses will use it?

Tags: health insurance, Affordable Care Act, Healthcare, insurance broker, healthcare reform, health reform, Obamacare, employee benefits, benefits advisor

Affordable Care Act Makes Strategic Benefits Advisors More Important Than Ever

Posted by Aaron Groffman on Wed, Dec 12, 2012

I recently attended a presentation by Beverly Beattie, president and CEO of Selden Beattie Benefit Advisors, Inc. Beverly addressed an audience of entrepreneurs and small business owners and explained the impact of the Patient Protection and Affordable Care Act on the increasingly complex and competitive employee benefits marketplace.  While many in the industry assume that brokers will become marginalized as a result of healthcare reform, I came away from the presentation believing that a strategic benefits advisor is more important than ever.

Businesses have many decisions to make over the next 12-24 months as the healthcare reform law is implemented. For example, businesses with 50 or more employees have to decide if they will “pay or play.”  Will they opt out and pay penalties or offer employee health insurance when the new rules go into effect in 2014? Many employers who do not currently offer health insurance may decide to do so after performing a cost-benefit analysis – which, of course, is good news for insurers.

It’s important for health care companies to identify those brokers and advisors in their distribution channel who are truly strategic (versus transactional), because I believe these will be the best sources for the new business opportunities that are certain to result from the complexities and changes of healthcare reform.

Tags: Affordable Care Act, Healthcare, insurance broker, healthcare reform, health reform, Obamacare, benefits advisor

As Dental PPO Penetration Increases, Is Market Saturation Near?

Posted by Aaron Groffman on Fri, Nov 30, 2012

Our analysis of the top 15 dental PPO networks revealed another important trend: market penetration is growing, with room for more growth in the future.

Dental PPO market penetration (contracted providers as a percent of the available number of providers) continues to grow. As of March 2012, the average national PPO plan contracted with approximately 72,000 providers, representing 37.8% of available providers, up from 37.2% a year prior. By comparison, in 2008, market penetration was only 28.1%, with fewer than 50,000 providers contracted. The recent growth seems due in part to an increase in the number of networks dentists are joining.  Networks per provider increased from 5.9 in 2008 to 8.4 in March 2012.

Of course, there’s still plenty of room for growth. With nearly 120,000 providers, on average, not yet participating, we expect dental PPO market penetration to continue to increase.

 DentalPPOTrends MarketPenetration Netminder1 resized 600

Tags: network growth, dental, dental insurance, dental PPO networks, dental benefits, dental insurer, dentists, dental provider

Is Growth of Dental PPO Networks Sustainable?

Posted by Aaron Groffman on Fri, Nov 16, 2012

We recently analyzed the top 15 dental PPO networks and discovered several important trends in the dental PPO market. One of the most notable trends is that, so far, dental PPO networks continue to grow.

More dentists are contracting each year. In March 2012, the average national dental PPO network[1] contracted with more than 72,000 unique dentists, up 8.7% from the prior year. Additionally, reported access points increased 22%, much faster than the growth in unique dentists. Based on these two factors, on average, the number of locations a dentist practiced at grew from just over 2 in 2011 to 2.25 in 2012.

We’ve heard concerns that some network directories might be overstating access, so we dug deeper into the claims data provided by many of our clients.  We found that, of the average 2.25 locations per dentist that directories claim, we were able to confirm an average of 1.34 practicing locations.  A practicing location is one where there was confirmed claims activity for the dentist during the last twelve months.  As we receive more and more claims data from clients, the number of practicing locations will most likely increase.

With all this growth of dental PPO networks in recent years, we have to ask: is it sustainable?


[1] The average of the top 15 national dental PPO networks.

Tags: network growth, dental, dental insurance, dental benefits, dental insurer, dentists, dental provider

States Must Act Fast on Health Insurance Exchanges. Is There Enough Time?

Posted by Aaron Groffman on Fri, Nov 09, 2012

States have just one more week to decide if they will run their own health insurance exchanges. With the election over, state officials who waited to implement some aspects of the 2010 Affordable Care Act are under pressure to make decisions very quickly … and, arguably, with little guidance. If they don't act, the federal government will take over, potentially putting us one step closer to single payer nationalized healthcare.

With the November 16th deadline looming for states to submit their plans, the majority of states are still undecided, and some of specifics of the law are still unclear. States are waiting for more clarity from the federal government regarding "Essential Health Benefits," the required minimum benefits for every plan offered on the exchange.

California, Nevada, West Virginia and Maryland are among the states that have already chosen to implement exchanges. Texas, Louisiana, South Carolina and Alaska are among those that will let the federal government run the show. Some states will adopt a third option: a "partnership" model in which the state and federal government jointly manage the insurance marketplace.

Which model will ultimately prove best for consumers? Which is best for insurers? It may be too early to tell. 

Tags: health insurance, Affordable Care Act, Healthcare, healthcare reform

Consumers Seek Real Data Online for Health Decisions

Posted by Aaron Groffman on Wed, Oct 31, 2012

Healthcare reform is not only changing the way individuals buy health insurance, it is also changing the way insurance companies will have to market their products. Many insurers are starting to experiment with direct-to-consumer marketing, hoping to reel in Medicare beneficiaries as well as those in the under-65 crowd who will soon be entering the market for individual policies. Developing a strong sales strategy backed by solid data will help you edge out competitors and win customers who are looking to make informed decisions.

Under the Affordable Care Act, individuals without medical insurance will pay an annual penalty starting at $95 in 2014 and increasing to $750 in 2016. That means millions of uninsured Americans will flood the health insurance market, and competition among insurers will continue to intensify.

How will you reach these potential customers? Start by providing the information they are looking for. About 60% of U.S. adults (80% of Internet users) look online for health information, according to a 2010 study by the Pew Research Center. A more recent study by Cybercitizen Health suggests that number may now be as high as 73%. You can influence and empower potential customers by arming them with comprehensive network comparison data that demonstrates the strength of your products.

Savvy consumers expect choices, and they want to make educated decisions about their healthcare. Although some insurance products are complex and difficult to explain online, using the internet and other direct sales channels strategically can boost your business.

State and federal health insurance exchanges will make it even easier for individuals to research and compare plans online before deciding on the best medical, dental and vision options for their needs. What kind of information are you providing to these potential customers, and which sales tools will you use to capture leads?

Tags: health insurance, Affordable Care Act, Healthcare, healthcare reform, consumer choice

 

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