Tandem Increases Incentives; Adds Concierge Nursing Care

Tandem Increases Incentives; Adds Concierge Nursing Care

Tuesday, January 21, 2014

Harvard Pilgrim subscribers have been eligible for cash rewards when using Tandem Care to compare the cost of medical services before treatment since the program was launched in January 2012.  As of Jan. 1, 2014, those rewards have been increased.

If you’re not familiar with Tandem Care, it’s a personal health care shopping service that compares medical fees and offers cash rewards to eligible UNH employees who opt to use a lower cost provider for qualifying tests or procedures.

Employees are not obligated to use the lower cost provider; the choice is up to them. But if they do, they receive a cash reward based on the amount of the savings. There is even a reward ($20) if it is determined that the existing provider offers the less expensive care.

“The university was pleased that Tandem was so well utilized considering it was the first year of implementation and we wanted to build on that success.  We took the opportunity to ‘tweak’ the incentive levels to demonstrate our appreciation of growing employee awareness and the initiative they are taking when calling the nurses at Tandem and choosing a lower cost provider,” says Amy Schwartz, assistant clinical professor and director of health care cost containment.

“We know it’s not easy to change how we do things, especially with something as personal as health care. We have had employees switch high cost elective surgeries and wanted to be able to offer an improved reward structure as a thank you. It’s asking a lot to have someone switch a procedure such as a surgery and as such, we want to share more of the savings in these cases.”

The new reward structure is as follows:

  • $20 if already using a low-cost provider

  • $40 when saving between $100 and $249 (the range used to start at $150)

  • $75 when saving between $250 and $449

  • $100 when saving between $450 and $649

  • $150 when saving between $650 and $999

In addition to lowering the starting range to include tests and procedures that cost less than $150, Tandem has added to its higher-end savings range:

  • $200 when saving between $1,000 and $1,999

  • $300 when saving between $2,000 and $3,999

  • 20 percent (up to a maximum reward of $3,000) when saving more than $4,000

Also new for 2014 is the concierge nursing services and care coordination for outpatient surgery. If the procedure qualifies, a Tandem nurse will assist with scheduling and confirming the appointment; getting patient records transferred; coordinating a second opinion, if appropriate; implementing the discharge; and scheduling any necessary therapies and follow-up care, as required.

The assigned Tandem nurse will be available to the employee, authorized caregivers and relevant providers for clinical consultation and care management throughout the process. 

The patient will receive information relevant to the surgical procedure, including clinical information and links to appropriate resources; contact information for the assigned Tandem nurse; a list of suggested pre and post-op questions for the physician and a form for recording the answers to allow for review after their appointments.

Savings generated through the care coordination program will be reviewed and the subscriber will receive a cash reward based on the category the amount falls under.

Read more information on Tandem Care here.