Let’s face it:
You didn’t plan to become an expert in the health insurance business.
Running your company is enough of a daily challenge. You and your staff simply don’t have the time, money, or energy to waste on unresponsive bureaucracies, higher costs, and lower levels of service.
That’s why we founded Continental Benefits – a smarter approach to health and health management designed specifically for the unique needs of businesses who self-fund their healthcare. Get the coverage you need with higher quality outcomes and proven value for each dollar invested. More importantly, let us help so that you can do what you do best – build your organization and look after your employees.
Self-Funded Insurance Delivers Results
Self-funded companies typically see cost reductions when they choose Continental Benefits as their third-party administrator (TPA). Our intense focus on your company’s reduction of unnecessary tests and treatments, supported by positive, easy-to-follow health management programs helps ensure valued employees stay well.
Flexibility
We’ve collected the right plans and programs for your organization, with configurability that no competitor can match.
Transparency
We’re happy to show you the data, the context, and the results behind our programs and our decisions – proof that you’re receiving the best value care for you and your employees’ expenditures.
Cost Containment
We do the hard work that unites the best providers and programs across hundreds of partners. This best-of-breed model means higher quality care because we don’t steer business to wholly owned subsidiaries like the major insurance companies do.
Advocacy
We aggressively challenge inappropriate claims and duplicate claims, reducing your risk exposure. We also intervene with hospitals, doctors, and partners on your behalf ensuring your employees receive the care they need
Population Health Programs
Unique population heath programs that no major carrier or TPA can match
We believe that healthcare begins long before one of our members becomes sick or hurt. Our advanced data analytics help make substantial improvements in health management. We use this information to support your employees through these programs.
TopCare connects members with the highest quality in-network providers and facilities, working with each member to ensure they receive the care and attention they deserve.
This value-driven guided service builds on the best data resources in the industry to generate recommendations based on five key criteria:
- Inpatient quality
- Patient Safety
- Complications
- Readmissions
- Mortality
We also monitor care transition, care goals, provider communication, staff responsiveness, and post-discharge information across providers, creating a concierge-style experience for members but with reasonable, carefully managed costs.
Continental Benefits’ clinical care programs reach across medical disciplines to provide a unified, integrated approach to care. Members receive targeted care from high-quality providers – and without unnecessary treatments or unwarranted expense.
CB Care Advocate – Our comprehensive care management solution increases health and wellbeing engagement throughout the workforce, with a particular focus on higher risk populations. This suite of services personalizes and improves the healthcare experience by typically engaging more than 90% of your population.
GI Thrive – Gastrointestinal issues represent one of the most common and most expensive areas of health management. They also represent one of the most straight-forward opportunities to promote a healthier lifestyle and generate rapid positive results. GI Thrive makes it happen for Continental Benefits members through intuitive, easily followed programs geared for each member’s individual needs.
Orthobiologics – Continental Benefits helps members recover faster from orthopedic procedures when the appropriate application of advanced orthobiologic therapies provide a clear, cost-effective benefit over more invasive approaches to healing.
CancerCare – Cancer affects more than just the patient. Continental Benefits helps members and employers with a holistic approach, treating not just the disease, but its extended impact, from diagnosis and economic impact through recovery.
Pharmaceutical costs represent a significant and rapidly growing proportion of healthcare costs. At the same time, managing those expenses increases in complexity every year. Continental Benefits helps reduce the burden on employers and members through:
- Best-in-class pharmacy pricing through Continental Benefits’ national reach and partnerships
- Data-driven analyses to ensure appropriate therapy and minimize risk from drug interactions
- Active pharmacy benefits manager (PBM) oversight to promote access, control costs, and direct appropriate discounts back to each employer or member
Continental Benefits works aggressively to assess and provide newly developed precision medicine for members, starting with pharmacogenomics that analyze how the individual genetic makeup of an individual affects their response to medications. This information provides insights that providers use to select the most appropriate drugs and dosages when treating challenging diagnoses while also minimizing costly adverse drug events.
Comprehensive Analytics
It’s your data – and we give you complete access to better understand how business and personal decisions impact both costs and results. We work with leading data and analytics providers to make sure that these comparisons operate consistently across providers and health systems. As a result, you’ll see how to:
- Gain early notification of unusual risks of budget impact
- Apply executive analytics to track plan performance and identify areas for improvement
- Monitor plan usage, provider quality, and performance benchmarks
- Quickly identify gaps in care and inappropriate care
We provide larger clients with their own data analyst for trend reporting and actionable information that improves outcomes while controlling costs.
Our Networks
We ally with national provider networks to give employers unmatched quality, flexibility, and value for each member.
We also provide reference-based pricing solutions for cost control, as well as customized networks and direct contracting for employers seeking those alternatives.
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