City Council May 15, 2012 ACAP
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City Council May 15, 2012 ACAP

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City Council May 15, 2012 ACAP City Council May 15, 2012 ACAP Presentation Transcript

  • City of San Angelo ©2012 ACAP Health Consulting Confidential-Not for Distribution ©2012 - Confidential-Not for Distribution
  • COSA’s - The 2012 Plan YearThe Charge:• Lower Overall Costs• Maintain Benefits• No Increase to the Employee/Employer Funding ©2012 ACAP Health Consulting ©2012 - Confidential-Not for Distribution Confidential-Not for Distribution
  • COSA’s - The 2012 Plan YearThe Challenge:• Health Risks of Employees Declining• Procurement Process Showed Marginal Savings – Insurance Carriers’ Network Discounts Similar at 58% – Administrative Costs Not Enough to Offset Projected Claim Cost Increase – No Administrator Able to Deliver Lower Costs ©2012 ACAP Health Consulting ©2012 - Confidential-Not for Distribution Confidential-Not for Distribution
  • ACAP Health Engaged• Former Insurance Executive with contracting knowledge• Data warehouse to assess physician/hospital performance• Based on the knowledge of the providers’ current costs: – First Step: Contacted hospitals’ CEOs on COSA’s objectives – Second Step: Requested fixed cost financial arrangement – Third Step: Analyzed the hospitals’ contracts – Finally: Resolved financial outliers to identify best financials ©2012 ACAP Health Consulting ©2012 - Confidential-Not for Distribution Confidential-Not for Distribution
  • ACAP Health Engaged• Selection of Community resulted in a projected 35% facility cost savings from current• ACAP’s paid on a results-based model - % of actual savings ©2012 ACAP Health Consulting ©2012 - Confidential-Not for Distribution Confidential-Not for Distribution
  • ACAP’s Next Steps• Must address underlying health risks of COSA’s population• Analyze claims and biometric data to identify the right interventions to avoid catastrophic claimants• Work with Community to build a more connected Care Pathway for the individual ©2012 ACAP Health Consulting ©2012 - Confidential-Not for Distribution Confidential-Not for Distribution
  • ACAP’s Next Steps• Create an Accountability Model for the physicians – Improve the Employees’ Health thru Wellness – Close Clinical Gaps in Care for the Employees – Better Connection with Specialists and the Hospital• Additional savings available through an accountable physician ©2012 ACAP Health Consulting ©2012 - Confidential-Not for Distribution Confidential-Not for Distribution
  • Request• Health Plan is realizing savings today• Year to date, we estimate the plan has saved over $250,000• The health fund reserves are healthy• Seeking approval to contract with ACAP for services rendered on a shared savings basis• Need assistance from ACAP to address additional shared savings opportunities ©2012 ACAP Health Consulting ©2012 - Confidential-Not for Distribution Confidential-Not for Distribution