Hines invites you to stress less with our full suite of financial solutions for rising healthcare costs!
April is recognized as National Stress Awareness month, so we at Hines would like to highlight a few of our key financial solutions to save you, your clients and their employees time and money, in order to allow them to stress less!
According to The Peter G. Peterson Foundation “The United States has one of the highest costs of healthcare in the world. In 2022, U.S. healthcare spending reached $4.5 trillion, which averages to $13,493 per person”
Navigating an individual’s healthcare journey can be daunting, and while other companies may do a part of what we do, only Hines offers full service, end-to-end solutions. We offer high touch member-centric care, cost and risk management solutions so employees don’t have to stress about their quality of care. All prices are signed off and guaranteed, so your clients and members can rest easy knowing they’ll never see a surprise bill after the fact!
Here are just a few of our cutting edge financial solutions:
Utilization Management
Key to both patient satisfaction and responsible cost-control, Hines’ trusted Utilization Management services ensure all medical services meet the highest industry standards:
- Complete range of UM services, including: Preadmission, Concurrent and Retrospective Reviews, Discharge Planning Support, Directional Channeling and Large Case Management
- Inpatient medical, surgical, behavioral health and substance abuse stays
- Outpatient services, surgeries and procedures
- Second Medical Opinion Assistance
- Gatekeeper Service for direct provider access, Exclusive Provider Organizations (EPO) or Narrow Networks
- Reference-based Pricing Partner Coordination
- 24/7/365 Nurse Line
Directional Care
Whether your patients need to access quality healthcare around the world – or across the street – our Directional Care program makes sure they get the right care, at the right time, for the right cost:
- StandbyMD™: An innovative AI-driven platform used to direct members to the Right Care at the Right Time in the Right Location and at the Right Cost
- Encompasses telemedicine, visiting physicians, steerage into clinics and urgent care centers
- Guiding members to quality, cost effective providers, including providers who offer competitive reimbursement agreements
- Triggers effective cost management with upfront negotiations and bundled payments
- Accessed through our 24/7 call center, through the StandbyMD™ app or embedded in your member app with proven APIs
- Available worldwide
Specialized Case Management
Case Management can be challenging. Hines proudly offers one of the most comprehensive services on the market:
- Pro-actively working with patients, their families, and their physicians, to coordinate the delivery of cost-effective quality care
- Can be bundled with Hines’ UM services or implemented as a standalone solution
- Specialty Complex Case Management, including oncology, transplant, renal/dialysis, high risk obstetrics, neonatal, and behavioral health
- Chronic Condition Management including, Hepatitis C, Crohn’s, Hemophilia, MS and other large dollar or complex diagnoses
- Specialty Pharmacy Management
- Transplant Management
- Upfront Negotiations
Negotiations
Hines’ multi-level support, developed through decades of success, offer better savings – with less hassle:
- 40 professional full-time negotiators that leads the market in successfully negotiating in-network and out-of-network claims
- With an average individual tenure of 12+ years, our fee negotiation team is well equipped with the experience, expertise and data required to conduct successful negotiations with provider signoff for greater savings and minimal noise
We offer three levels of negotiation support:
- Our FLN negotiators support a highly automated process for lower dollar claims
- Our second level of negotiation support focuses on inpatient and outpatient claims
- Complex Claims Unit (CCU) composes our third level of support
Wellness, Prevention and Chronic Condition Management
Hines’ Healthy Tomorrows™ – a comprehensive program which includes:
- Disease Management
- A customizable solution for many conditions, including asthma, coronary artery disease, COPD, congestive heart failure, diabetes and rheumatoid arthritis
- Wellness
- Smoking cessation, health lessons, meal plans and our “connect to a coach” personalized service
- Diabetic Management
- Metabolic Syndrome and Pre-diabetes together with weight management program linked to our wellness services
- Biometric Screening
- Biometric / Lab Screenings available on-site or through your member’s Primary Care Physician
- Health Risk Assessments
- Either in conjunction with our Wellness program or as a stand-alone service
To learn more about Healthy Tomorrows™ by Hines, please click here.
Hines is also member focused, what’s more stressful for an employee than navigating the world of health care alone? Hines is their guide, offering high touch, personalized support:
The Hines Difference:
- Member-Centered Approach: We put members at the heart of everything we do. Their voice matters, and we actively involve them in decision-making.
- Informed Choices: Our team equips members with knowledge about treatment options, risks, and benefits. Together, we make informed decisions tailored to their unique needs.
- Cost-Effective Care: We understand the importance of affordability. Our strategies focus on delivering quality care without unnecessary expenses.
- Holistic Support: Beyond medical treatment, we address emotional well-being, lifestyle changes, and preventive measures.
What You Can Expect:
- Collaboration: We work as a team—patients, caregivers, and providers—to achieve the best outcomes.
- Education: Understand members’ conditions, treatment options, and self-care techniques.
- Empowerment: Take charge of your members’ personal health with interactive tools and resources.
- Transparency: Clear communication about costs, benefits, and alternatives.
Only Hines offers comprehensive financial solutions for your clients, allowing everyone involved, from administrator to member, to stress less!
For questions or to set up a meeting with a member of our team, please email Bob Marcoux at bmarcoux@hinesassoc.com
