Taking care of business by taking control of costs.
- Founded in 1968
- 100+ covered lives
- Two senior living locations
Paying the price with a traditional health plan model.
Family-owned and operated, Oak Ridge Care Center provides assisted living, rehabilitation and skilled nursing care to the residents and families of Wisconsin. The organization’s flagship location is south of Milwaukee and a short drive from the shores of Lake Michigan. With 250 employees, Oak Ridge was traditionally fully insured for years, and paid the price for it.
“As a small group, we knew that if we had a good year, our increases would be in the mid to high single digits. A bad year would be in the high teens,” says Steve Kuranz, owner and executive director. Oak Ridge was looking for more insight and control over its healthcare expenses. It moved to a self-insured model, liked it, and credit its knowledgeable broker as the key to its success as they enter its fifth year.
“We felt we could manage our costs better if we had more control, and it’s been a terrific decision.”— Steve Kuranz, Owner and Executive Director, Oak Ridge Care Center
Taking it to the next level.
In 2021, Oak Ridge took the control and savings of its self-insured plan to the next level with the addition of the Imagine360 solution, which has reference-based pricing (RBP) built in. RBP provided the cost transparency that Oak Ridge was searching for.
“We haven’t had any really bad years, but we’re a pretty conservative group. We sock away the savings so if we do have a bad year, we’re prepared for it.”
“As a smaller organization, we felt that the risk of being fully insured was greater,” says Kuranz. This plan design has worked well for Oak Ridge, plus Kuranz adds that they’ve also had good fortune.
“We haven’t raised premiums, our coverage is better, and we know what’s happening.”
Now in the third year with Imagine360 and using RBP, Kuranz describes the experience as really good. Plus, Oak Ridge is enjoying its increased flexibility. “We’re able to tailor our benefits package to the needs of our team so, for example, we can cover a major portion of employee-only coverage. In the future, we hope to expand that to employees plus family.”
Oak Ridge has also put added resources into its wellness program, including onsite biometric screenings. In addition, incentives around preventive care have resulted in employees building a relationship with their primary care physicians, some for the first time.
Elevating the member experience.
Before Imagine360, Kuranz says lack of support had been an issue, but that’s all behind them now. “With our previous provider, when there were employee issues or concerns, we really didn’t have great support. But with Imagine360, the support has been great.”
Kuranz speaks from personal experience about calling the member experience line. “I say, ‘here is my problem’, and they take care of it. That doesn’t happen for me very often, and I delight in it.”
“When we need Imagine360, they’re there for us.”
Oak Ridge also makes educating employees a priority, and “the HR folks are great champions of our solution.” While Kuranz feels that being proactive is an important part of minimizing the bumps, he also believes noise exists for every type of insurance. In fact, he regards it as a positive. “Personally, I think noise is a good thing. You should understand and realize that healthcare does cost money. It takes effort, just like shopping for a car. You want to compare and look and search.”
A winning formula.
Kuranz is a firm believer that a reimbursement model based on cost, plus a fair profit margin, is the way it should be. Imagine360 leverages insightful predictive analytics and years of industry data and experience to understand costs and power its RBP model.
“I love RBP. From a moral and ethical perspective, it’s the right thing to do.”
Kuranz sums up healthcare reimbursements in a single sentence every business owner can relate to. “If you can’t make it on 120% of your costs, and sometimes even more than that, you’ve got a problem.” In keeping with this philosophy, he’s not a fan of the reimbursement formulas peddled by some of the large carriers.
“I’ve seen contracts where they’re giving 50% off, so you think you’re doing great. But the discount is really 200% of Medicare. I call that nonsense.” In addition to RBP, Kuranz says the combination of outstanding support, a strong PBM, and a dedicated brokerage is a well-coordinated and winning formula.
Using healthcare savings to recruit and retain nursing staff
