Future Talk with BAI’s Jeff Miller

Jeff Miller is chief operating officer of Benefit Administrators Inc. (BAI), an administrator of employer-sponsored, self-insured health plans. Based in Columbia, South Carolina, the firm maintains a local focus but competes successfully with national carriers, healthcare management organizations and TPAs by combining traditional management strategies, integrated service applications and web-based reporting tools to provide comprehensive health plan management.

BAI was selected as a member of the TPAA for its excellent track record of service, leading-edge products and value-added technology. Jeff talked to Best Practice about what he sees happening in the industry and what TPAs must do to compete.

BP: The employee benefits field has gone through significant changes in the last few years. What has had the biggest impact and why?
JM: The advent of the Health Insurance Portability and Accountability Act (HIPAA) impacted the industry like nothing before it. While many initially viewed HIPAA as a vehicle primarily for effecting portability of coverage, as time went by, we had to come to grips with its rather onerous requirements for security, privacy and electronic data transmission.

BP: How can TPAs address those issues?
JM: We actually see a lot of opportunities for firms willing to meet the challenges. BAI utilizes technology that enables us to electronically receive claims, transmit reports and communicate with plans, providers and participants. We offer a full-service website at no extra charge so employees and HR staff can view claims and plan documents, submit questions via e-mail, access links to the plan’s PPO, print reports, etc.

BP: You’ve done a lot. Is it working?
JM: Yes, but we did something else that many firms overlook. We continue to have real people handling our customer service line to provide information to plan members, medical providers and human resources personnel. Our goal is to not only provide state-of-the-art claims technology, but superior customer service with the personal touch lacking in many aspects of today’s business world.

BP: What else do you see as important issues for TPAs?
JM: Wellness and disease management is one of the latest frontiers and we must be equipped to help our clients design and implement programs geared to specific employee groups’ needs. It is not, however, enough to gather information and produce fancy reports. It is imperative that employees are given the tools—through education, newsletters and especially individual coaching, to help them make changes necessary to improve and maintain their health. And it’s not only about employees with health issues; we must also provide encouragement and information to people in good health to help them maintain that status.

BP: What’s your take on consumer driven health plans?
JM: Consumer driven health plans (CDHPs) are proving to be viable alternatives to traditional benefit plans. More than just higher deductibles, when coupled with health savings accounts (HSAs) or health reimbursement accounts (HRAs), they really help bring a consumer attitude back into the purchase of medical care.

BP: How so?
JM: Healthcare has long been an industry where the buyer (patient) and seller (physician/hospital) never discuss price. While we certainly don’t want to equate this transaction to haggling over a used car, consumers wouldn’t dream of not learning about costs and comparing prices, and providers when spending their own money on everyday purchases the way they do with healthcare. Now, in addition to helping clients design plans to meet their needs, we must also help plan members understand how to use them to maximum advantage. The increasing transparency of costs and medical outcomes will only accelerate people’s ability to become better consumers. Our experience shows when these plans are properly implemented, employees and employers are almost assured of lower costs.

BP: So what’s the bottom line on the future for your company and other TPAs?
JM: BAI’s success has been built on personalized service for our clients and we retain business relationships once they’re established. We provide the technological and data analysis expertise required in today’s environment, but we also remain connected to our clients and are mindful to not let the technology get in the way. This allows us to provide the service and attention of a small firm, while having the technological muscle and resources of a larger player. TPAs who take this approach give their clients the best of both worlds.