Want a better health plan? Then break away from BUCA (Blues, United, Cigna, Aetna) and create a plan for your employees and your business. Here’s how to do it.
We recently conducted a Webinar “How An Ohio School District Saved $9.1M in 3 Years” with the former Superintendent of Ashtabula Schools presenting his Blueprint for success. We have a recording if you would like a copy.
Dr. Potts outlined the steps to create a successful plan that improves benefits for employees by waiving ALL out of pocket expenses, thus making health insurance affordable for everyone and at the same time creating considerable savings for the School District.
They had been with BUCA for years, they have a CBA with the teachers, and kept absorbing annual increases of 10-15% or more every year. There weren’t any options other than taking those increases, needing tax levies, and cost shifting to employees where/when they could.
Here is the formula:
+Third Party Administrator
+ Direct Contracting
+ Independent Pharmacy Benefit Manager
+ Nurse Navigation
+ Direct Primary Care
= Better Outcomes
= Huge Savings (District and Employees)
= Transparency and Access to your Data
Savings
- Year 1 -21% $2.4M
- Year 2 -18% $2.0M
- After 3 years over $9.1M
- With 385 employees, 1100 lives
Step 1: ‘Unbundle’ your plan and contract with an independent Third Party Administrator (TPA) that provides the same services as an insurance company.
Step 2: Contract directly with local providers at better discounts than what insurance companies offer.
Step 3: Contract with an independent Pharmacy Benefit Manager (PBM) that has “Zero Spread Pricing” and give you 100% of all rebates (this saved the School District >$400K per year).
Step 4: Implement effective Nurse Navigation to steer employees to the highest quality providers – not just In Network providers – AND eliminate ALL out-of-pocket expenses.
Step 5: Implement a FREE Direct Primary Care program which eliminates any barriers to care for members.
Like Dr. Potts, you weren’t necessarily trained, educated, and informed about all the innerworkings of health plans. They aren’t actually complicated, it’s just that that’s the historical way it’s been presented to you over the years by brokers, consultants, and insurance companies. There is a better way – think outside the proverbial box and change the paradigm.
At Strategic Healthplan Consulting LLC we act as a “General Contractor” and help employers build a better health plan for their employees and their businesses. It allows them to more easily attract and retain employees – it’s sustainable and affordable. Our client results speak for themselves.
