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Similar to City Council May 15, 2012 ACAP
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City Council May 15, 2012 ACAP
- 1. City of San
Angelo
©2012 ACAP Health Consulting
Confidential-Not for Distribution
©2012 - Confidential-Not for Distribution
- 2. COSA’s - The 2012 Plan Year
The 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
- 3. COSA’s - The 2012 Plan Year
The 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
- 4. 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
- 5. 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
- 6. 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
- 7. 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
- 8. 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
Editor's Notes
- Dan gives high level overview on MV