Provided the evidence and implementation support to 3,500 employee multi-state company that was performing in the top 5% of employer health plan performance; resulting in an 11% initial reduction in cost within months, with the existing broker and pharmacy benefits manager.
The founding and lead company of a regional employer health alliance, with 20 members, functioning at the Top 5% of best health plan performance; requested Greenspire’s review to verify performance and identify opportunities for plan cost & value going forward.
This member with 3,500 employs engaged Greenspire to evaluate three areas of concern:
- Improve ESOP employee engagement & utilization of Health Plan services
- Identify & recommend cost of care & outcomes improvement for top Chronic Health Conditions
Over a six-month period, utilizing medical specialists in Chronic Condition outcomes management, pharma benefits, predictive analytics, and employee health engagement firms from with the Greenspire Network; the Greenspire Team recommendations, resulted in an 11% initial reduction in cost within months.
Working with company leaders, benefit providers, broker and pharmacy benefits manager, the following management accepted recommended specific actions were accomplished jointly, without disrupting existing health plan relationships:
- Employee Engagement & Use – Initiated an employee health engagement-prevention insured program, individualized to each employee & family that demonstrated immediate savings while reducing actual claims cost by 2% per year. Revised employee use, access, and follow-up specific to special benefit offerings in the health plan design.
- Pharma Services – Corrected PBM Agreement rebate provisions to the employer along with new contract performance standards, implemented a physician-based clinical pharma cost savings program, and improved employee service ease & use knowledge.
- Chronic Condition Care Management – Provided RN based individualized coaching, remote services for employees that improved outcomes while reducing claims and pharma spend by 18%. Also initiated concurrent review process for hospitalized & high-risk enrollees and streamlined the Company’s predictive analytics and implemented actions process.