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City Council May 15, 2012 ACAP
The City of San Angelo was charged with lowering health care costs while maintaining benefits and funding levels for 2012. Their challenges included declining employee health risks and only marginal potential savings from insurance carriers. ACAP Health Consulting was engaged to help address these challenges. ACAP analyzed hospital contracts and was able to project 35% in facility cost savings. They also proposed addressing underlying health issues and building a more coordinated care pathway between providers to find additional savings opportunities. The City is now seeking approval to contract ACAP on a shared savings basis as over $250,000 has already been saved that year.
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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 - The2012 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 - The2012 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 Planis 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
- #2 Dan gives high level overview on MV