A Medicaid healthcare consulting firm with operations in 40 states had plateaued in its approach to providing employee benefits. They thought they were doing everything possible to control their medical spend, but were experiencing dramatic sticker shock over the annual price increases of their commercial PPO.
In search of what to do, they discovered self-funding and Medicare-like prices offered by a transparent solution composed of several self-funding pillars.
Given the scrutiny they’d likely face from their insurance-savvy workforce, moving to a new plan had major implications for employee satisfaction. Moving to a more flexible model allowed the group to implement cost reduction strategies with no adverse impact on the quality of care. Their solution includes:
- Rates closely aligned with Medicare pricing
- Eliminate both member and plan Rx cost
- Direct contracting and bundled payments
- Financial incentives to redirected members within PPO
How real customers feel about transparency
The generosity we received from your company health plan is without words. Our family could not have afforded the over 50 days of hospice care Jack received here in our home during his fight with COVID-19. I am not sure how we would have paid for the cost, but, because of you, we were able to spend time with Jack on his last days… at home. I only hope your other employees, and their family, appreciate you, and your plan, like we do. We will always be grateful.
Given we are on a high-deductible, it is great to know what I am going to pay before I get the service. The advocate always gives me options; I don’t mind driving a bit to save hundreds, even thousands… it’s my money!
Native American Casino
Just wanted to thank you for putting in this new plan. I have been needing this back procedure for over 3 years now but could not afford it. With our new plan, I was able to go to the same doctor I have been seeing and it was FREE. I am now pain free and able to spend more time with my grandkids. I can not tell you how much I appreciate working here!