SIGNATURE HEALTHCARE
• Award-winning company in long-term care industry
• 100+ locations in 10 states with 5,500 covered employees
• Imagine360 client since 2019
The challenge
To manage risk under its self-funded insurance model, Signature HealthCARE contracted with a big-box carrier to provide claims administration, network access, utilization review, disease management and program management concepts. Eventually, Signature grew frustrated with the lack of transparency.
In 2016, due to a drastic increase in healthcare costs, Signature was forced to increase premiums and deductibles for employees. This hit to their benefits package had a negative impact on staffing, and made it more difficult to fill positions, especially nurses.
The solution
Porter’s research to contain costs led him to Imagine360’s reference-based pricing (RBP) solution, which is backed by 360-degree member and client support.
Imagine360’s model considers both the cost of service and the Medicare reimbursement rate to determine a payment that is fair and reasonable for employers, members and health systems.
Results
NET SAVINGS*
REDUCTIONS IN PREMIUMS/
DEDUCTIBLES
INCREASE IN BENEFIT SUPPORT STAFF
*Savings based on estimated PPO charges.
the experience
In 2019, when Signature HealthCARE gave their employees the option to choose RBP or a traditional PPO plan, more than 70% chose the more affordable RBP model. In 2020, they fully adopted RBP for all covered employees and family members.
“By moving away from big-box carriers, we are saving a ton of money — probably 40 or 50 percent in admin fees alone,” said Porter. “That’s in addition to the money we’re saving on claims.”
“Before reference-based pricing, we were scraping for pennies and trying to figure out how to do a presentation to a group of employees and have them leave with a smile even though we were increasing their premiums by 10 to 15%,” said Porter.
the bottom line
When it comes to choosing an RBP firm, he adds that he would hands-down recommend the solutions provided by Imagine360.
“If you’re going to do reference-based pricing, I don’t know that I trust anyone else to manage a program like this.”
