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City of San
  Angelo




                                              ©2012 ACAP Health Consulting
                                              Confidential-Not for Distribution
         ©2012 - Confidential-Not for Distribution
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
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
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

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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

  1. Dan gives high level overview on MV