Meritain Health® - In the Booth: Recent Episodes
Meritain Health
As Advocates for Healthier Living, we’re improving clinical outcomes while reducing the Total Cost of Care. Learn more about Meritain Health.As a third party administrator, we’re proud to offer the flexibility and devoted service we’ve shared with our customers since 1983. Today, as an independent subsidiary of Aetna and CVS, we’re able to offer access to carrier-level nationwide networks, discounts and other valuable resources. Coupled with our in-house products and valued vendor partners, your customized plan includes everything you need to keep your unique employee population healthy.
Our newest episode of In the Booth is available now. This last episode in a four-part series exploring medical economics looks at captives and consortiums. Join Bridgette Cassety, as she sits down with Jeremy Hensel and Dan Day to get their thoughts.
How do captives and consortiums differ? And what advantages do these options have for employers interested in becoming self-funded? Our latest podcast dives into this and more.
Plus, find out what’s setting Meritain Health® apart in the captive space and consortium space. Don’t miss this highly anticipated episode.
Join us for the third episode in our four-part series exploring medical economics and its potential impact on plan sponsors. Join Bridgette Cassety, as she sits down with Dan Day, Chief Sales Officer at Meritain Health®.
Together, they’ll explore how self-funding offers plan sponsors the opportunity to retain more control over their money while increasing opportunities to save.
Listen here to learn more.
This is the second in a four-part series exploring medical economics and its potential impact on plan sponsors. Join Bridgette Cassety, as she sits down with Dan Day, Chief Sales Officer at Meritain Health® and Jenny Shanks, Head of Market Intelligence.
Together, they’ll take a closer look at rising costs for hospitals and the pressures this creates. Many community hospitals have been forced to close, consolidate or find ways to stand out.
But what does this challenging environment mean for plan sponsors? And how can members still receive the care they need?
Listen here to find the answers to these questions and more.
This special episode of In the Booth covers one of the hottest topics in health care today. Tune in to discover how, at Meritain Health®, we’re planning a shift toward more value-based care solutions over the next three years.
Our host, Bridgette Cassety, sits down with Nicole Bennett, Lead Director of Hospital Vertical and Network Strategy at Meritain Health. Nicole is passionate about value-based care and what it means for the future of health care. Hear about the benefits of value-based care and the rate solutions are expected to grow. Also, learn what plan sponsors, consumers and providers can expect to see as value-based contracts within network arrangements become more prevalent.
Join host Bridgette Cassety and guest Dan Day, Chief Sales Officer at Meritain Health®, as they discuss If a Dollar Were Still a Dollar.
In this episode, you’ll hear how medical inflation has outpaced general consumer inflation. You’ll also learn strategies you can employ to counteract its impact, such as:
· Alternative health plan options, such as SimplePay.
· Pricing transparency and engagement drivers like Healthcare Bluebook™ .
· Provider contracting options through value-based care.
In our latest In the Booth podcast, we are pleased to have Erica Manhardt, Marketing and Communications Director and Heather Horn, Manager, Population Health Management, from Meritain Health, discussing Healthy Merits and how it can be a beneficial program to make wellness fun.
In our latest In the Booth podcast, we are pleased to have Kelly Mesi from Meritain Health market development strategy and delivery, Ashley Loeb Blassingame, Lionrock Founder and Chief People Officer and AJ Black, Lionrock Director of Business Development discussing Lionrock and how it provides a new approach to the treatment of substance abuse disorders.
Join our host, Bridgette Cassety, as she speaks with Stacey Meade, Head of National Sales and Account Management, Dan Day, Head of Sales for Middle Market, and Shelly Wines, Navigation Partners Program Manager. to discuss the benefits leveraging navigation partners.
Join our host, Bridgette Cassety, as she speaks with Jeremy Wisniewski, head of Meritain Health Pharmacy Solutions to discuss the benefits of Meritain Health Pharmacy Solutions.
Join our host, Bridgette Cassety, as she speaks with Dan Day, head of Middle Market Sales and Stacey Meade, head of our National Sales and Account Management team as they discuss how this external study validates the savings created by partnering with Meritain Health.
Check out the full case study here!
Join our host, Bridgette Cassety, as she speaks with Jenny Shanks, head of Market Intelligence and Stacey Meade, head of our National Sales and Account Management team to discuss the value that point solutions offer, and the many purposes they serve.
Join our host, Bridgette Cassety as she speaks with Michael Ciarrocchi, Chief Market Development Officer and Claudia Winsett, Head of Product Strategy and how Meritain Connected Solutions connects the value for our customers.
Join our host, Bridgette Cassety as she interviews Michael Ciarrocchi, Chief Market Development Officer with Meritain Health. Hear his take on TCOC what to expect from Meritain Health in 2022 and beyond
In our latest In the Booth podcast discussing Medical Management, we are pleased to have Bridgette Cassety from Broker Engagement, and Tina Etzler, a senior strategic consultant from the product team.
In our second In the Booth podcast on Captive solutions, we are pleased to have Bridgette Cassety from Broker Engagement, Mark Morgan, Head of Underwriting and Business Analytics, and Dan Day, Head of Middle Market Sales discuss the financial advantages of Captive solutions.
In this In the Booth podcast, Bridgette Cassety from Broker Engagement, and Dan Day, Head of Middle Market Sales, discuss Captive solutions and how they can drive down total cost of care and create good outcomes for both brokers and clients by mitigating the risk of high-cost claims.
Self-insuring is routine for large employers, and a growing trend for smaller plans. Listen in as Mark Schmidt and Michael Ciarrocchi of Meritain explain some fundamentals to smart change management, the value of interchangeable point solutions, and where this TPA fits in the larger CVS Health and Aetna strategies.
•Meritain Health is always looking to bring industry-leading, OON solutions to the market.
•Options give people flexibility to provide the best choices to help them meet plan goals. These are set together with consultants, and designed to meet risk preference.
•Every option has a balance between noise and savings, and that's for each individual customer to decide.
•We can address high-dollar bill review in negotiations and audits through the processes we have in place.
Featuring Veronica Medina, Regional President; Rashundra Gamble, Account Manager; and Malea Mitchell, Underwriting Manager from Meritain Health. Hosted by Bridgette Cassety from the Broker Engagement department at Meritain Health.
Why does mentoring matter? Female leaders share their insights:
· Create your vision and spend some time on your career path. Dedicate time to determine your objectives.
· Grab opportunities when offered.
· As a mentor or a mentee, be willing to change.
· Have diversity of thought. Surround yourself with people with unique or different perspectives.
Featuring Emma Maurer, Vice President at Peerfit; Ashley Karpinski, Director of Behavioral Health Strategy and Innovation at Aetna; and Michelle Bledsoe, Head of Sales at Meritain Health. Hosted by Bridgette Cassety from the Broker Engagement department at Meritain Health.
How can we find ways to take care of our physical and mental health? Female leaders share their thoughts:
· Make time to acknowledge the importance of taking care of yourself.
· Try not to feel guilty about taking care of yourself; make it a priority.
· Consider making physical activity a social activity, instead of something that could isolate you.
· Set aside time, make a plan, have a strategy and be sure to have some fun.
Featuring Catherine Ratcliffe, Principal Vice President of Operations at Sullivan Benefits/One Digital; and Stacey Meade, Head of Sales from Meritain Health. Hosted by Bridgette Cassety from the Broker Engagement department at Meritain Health.
Looking to get into the industry? Female leaders share their advice, including:
•Taking risks and being fearless.
•Being intentional while developing your network.
•Not being too critical of yourself.
•Being yourself while also taking care of yourself.
The value that Meritain Health provides through Actionable Data.
Expertly reviewing your plan will help you maximize your utilization, for the most value and efficiency. We’ll use our data analysis tools to give you:
- Information and decision support.
- Integrated health care data across multiple platforms.
- Better patient outcomes.
- Improved financial performance.
- Quality and efficiency metrics.
- Industry benchmarks.
The value that Meritain Health helps provide through Access to Care
Gaining access to strong networks and pharmacy brings savings right to you. We’ll give you the pathway to:
- National value-based networks (Aetna and CVS).
- Accountable Care Organizations (ACOs), and similar groups.
- Multiple network configurations.
- Centers of excellence and institutes of quality
- Integrated pharmacy solutions.
- Innovative point solutions.
- Walk-in services (Minute Clinic® and HealthHub™).
The value that Meritain Health provides for Payment Integrity.
Careful review of your claims and bills while maximizing discounts puts more money in your pocket. We’ll zero in on things like:
- High-dollar claims review.
- Hospital bill audit.
- Facility claim cost reduction.
- Out-of-network claim discounts
- Individual claim negotiations.
- Claims editing.
- Fraud, waste or abuse recognition.
- Subrogation recovery.
The value that Meritain Health provides though Cost Avoidance and Prevention.
The right tools and resources let you lend the right health guidance and support to your employees and members. This includes things like:
- Cost and quality transparency.
- Employee wellness programs.
- Standard and specialized case management.
- Disease management tools.
- Telemedicine options.
- Pre-admission and post-discharge.
Preparing for a COVID-19 Vaccine Podcast with
•Dr. Sree Chaguturu, SVP and Chief Medical Officer , CVS Health
•Stacey Meade, Regional President for National Accounts, Meritain Health
The Meritain Pharmacy Solutions team discusses:
- The pricing strength we deliver as being part of CVS.
- That we have the integration that brings a real powerhouse of data that we can leverage.
- We have innovative programs like CARE that will minimize total cost of care and allow us to fulfill our mission as Advocates for Healthier Living.
We are pleased to share a new podcast discussing Meritain Health’s response to COVID-19 and how pharmacy is impacted.
Key points include:
Utilization Patterns – We are tracking the utilization patterns of pharmacy as a result of COVID-19 from a holistic perspective around total cost of care.
Refill Too Soon edit relax – Members with active eligibility may obtain an early refill of their prescription medications if they have refills remaining on file at a participating retail or mail-order pharmacy. The refill obtained will stay consistent with the standard days’ supply previously filled by the member as allowed by their plan.
Prior Authorization (PA) Extension – extending PAs that are set to expire on or before June 30th for 90 days. This will apply to Formulary Exception and Clinical PA records; including Specialty. This will ensure continuation of critical drug therapies and eliminate the need for members to go to their prescribing physicians for prior authorization renewals.
Quantity limits – To address potential stockpiling, ensure proper utilization and to help address potential supply chain shortages, we have worked with our PBM partners to implement quantity limits on certain drugs. Quantity limits are designed to address safety and to ensure that the correct amounts of medications are dispensed.
Support– Meritain Pharmacy Solutions Service Management, Strategic Account Executive and Clinical Teams are on the front line and accessible to address any/all escalated issues related to member prescription issues.
Key points include:
- Meritain Health’s preparedness and response to the COVID-19 pandemic and an update about what's new and what is in the works.
- We are continuously responding to the federal legislation updates.
- How Meritain Health is proactively trying to help our customers manage risk.
- Meritain Health’s Preferred Stop Loss partners and how our relationships with them benefits our customers.
- Continue to talk with your Meritain Health client management team or your Meritain contact.
- Our business continuity plan has allowed Meritain Health to keep business as usual, with all employees working from home.
Meritain Health is committed to being Advocates for Healthier Living, helping our customers be and stay healthy.
- Meritain Health is proactively bringing strategies and options to our plan sponsors to provide solutions for our customers to enable their employees to access care and help prevent the spread of Covid-19.
- Meritain Health has “fast tracked” several plan enhancements that customers can put into place quickly. However, clients have the flexibility to make other enhancements to their plans that Meritain Health will support.
- Meritain Health is able to continue operations during this time and will continue monitoring best practices to share with our customers and brokers ideas they may wish to consider to help employees prevent illness and access care.
Learn more about the Health Imagination & Transformation (HIT) Program including:
- The value of the HIT program for clients & for brokers
- Why we developed the HIT program
- A overview of some the solutions currently offered via HIT
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Learn how SmartSelect reduces the total cost of care for the member and the plan sponsor without reducing any type of quality, or creating risk.