Butler Advantage S t e p h a n i e H e a r n | E x e c u t i v e - - PowerPoint PPT Presentation
Butler Advantage S t e p h a n i e H e a r n | E x e c u t i v e D i r e c t o r | B u t l e r H e a l t h P l a n R a n d y B e r t r a m | T r e a s u r e r | M i d d l e t o w n C i t y S c h o o l s E d w a r d W. S c h w a r
S t e p h a n i e H e a r n | E x e c u t i v e D i r e c t o r | B u t l e r H e a l t h P l a n R a n d y B e r t r a m | T r e a s u r e r | M i d d l e t o w n C i t y S c h o o l s E d w a r d W. S c h w a r t z , M D | C a r e H e r e | C h i e f M e d i c a l O f f i c e r
Stephanie Hearn is the Executive Director of the Butler Health Plan. As Executive Director, Stephanie and her team are committed to providing her division members with quality health care and responsive service. Stephanie has over 25 years of health care management experience; with emphasis on self-funded plan management since 2007. Stephanie holds a Masters in Healthcare Administration from Xavier University and completed her undergraduate work at Miami University in Business Administration. Randy Bertram is the Treasurer/CFO for Middletown City Schools in Ohio. Prior to MCSD Randy had been the Treasurer/CFO for Northwest Local Schools, Lebanon City Schools, Edgewood City Schools, and served as an Assistant Treasurer for Hamilton and Xenia Schools. Randy's other work experiences include sales, management and the United State Air Force. Randy has degrees in Finance and Business Management.
Our Guest Speakers
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Butler Health Plan
ü The Butler Health Plan is a not-for-profit health plan, currently self-funding medical and dental coverage for the benefit of 13 school districts and Lane Libraries.
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ü The mission is to provide employees and their families the most competitive and cost effective benefits possible. ü As a self-funded trust, the member groups have owned and operated these benefit plans for over 35 years.
Butler Health Plan Participating Employers
ü Beavercreek City Schools (effective 1/1/2020) ü Butler County Educational Service Center ü Butler Technology & Career Development Centers ü Fairfield City School District ü Great Oaks Career Campuses ü Hamilton City School District ü Lane Libraries ü Madison local School District ü Middletown City School District ü Monroe Local School District ü New Miami Local School District ü Ross Local School District ü Sycamore Community School District ü Talawanda City School District
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I-275 I
1 Rt 129 Hamilton
Fairfield City Schools
Cincinnati
Middletown City Schools BCESC Monroe Local Schools
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Ross Local Schools
Oxford
Talawanda City Schools
Dayton
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Madison Local Schools
Middletown
Beavercreek City Schools
Lane Libraries
Sycamore Community Schools Butler Tech New Miami Local Schools Hamilton City Schools
BUTLER ADVANTAGE LOCATIONS: Current Future
Great Oaks Career Campuses
Health Center Locations
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6,000 Employees 14,000 Covered Lives $70M Annual Premium Rev
Insurance Partners Enrollment Statistics
PPO HDHP MVP
Enrollment Statistics
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Search for in-network Anthem Blue Access providers at www.anthem.com PPO HDHP MVP Medical Preventive Care Preventive services covered 100% for all plans Annual Deductible*
This is the dollar amount you must pay first in a year before the plans begin paying specified benefits.
$650 /person $1,300 /family You do not have to meet the deductible before copays apply. $2,800 /person $5,600 /family You must meet the deductible before prescription copays apply $6,900 /person $13,800 /family Annual Maximum Out-of-Pocket
Includes deductibles and copays. This is the most you will pay toward your in-network medical and prescription expenses.
$2,650 /person $5,300 /family $5,000 /person $10,000 /family $6,900 /person $13,800 /family Doctor Office Visit
Primary care includes family practice, internist, pediatrician, OB/GYN, mental health and chiropractor.
$30 for primary care $50 for specialist Ded, then Plan pays 80% Ded, then Plan pays 100% Urgent Care $40 copay Ded, then Plan pays 80% Ded, then Plan pays 100% Emergency Room $200 copay
(waived if admitted)
Ded, then Plan pays 80% Ded, then Plan pays 100% Inpatient and Outpatient Services Ded, then Plan pays 80% Ded, then Plan pays 80% Ded, then Plan pays 100% Prescription Drugs Deductible does not apply After deductible is reached After deductible is reached Retail Up to a 30-Day Prescriptions $15 generic $35 preferred brand $15 generic $35 preferred brand Ded, then Plan pays 100%
Express Scripts Prime Pharmacy Network Nationwide network which includes CVS, Kroger, Meijer, Target, Walmart and more.
Mail Order or Smart90 Up to 90-Day Prescriptions $35 generic $85 preferred brand $35 generic $85 preferred brand Ded, then Plan pays 100%
Express Scripts Home Delivery or Smart90 Standard Pharmacy Network Long-term maintenance medication up to 90-day supply filled either through Express Scripts Home Delivery or a Smart90 Standard retail pharmacy which includes Kroger, Meijer, Walmart and more.
Specialty Up to 30-Day Prescriptions $75 $75 Ded, then Plan pays 100%
2020 In-Network Medical Plan Options
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Butler Health Plan Goals & Objectives
Primary Objective: Eliminate cost as a barrier to BHP members obtaining primary care, urgent care and prescription drugs, ultimately resulting in lower claim costs and trend. Health & Wellness Objectives 1. Improve access to care by offering a no cost alternative and convenient hours 2. Increase drug adherence 3. Increase engagement in health mgt & wellness programs 4. Increase number of members with a primary care provider 5. Coordinate wellness programs through health center Medical Cost Reduction Objectives 1. Redirect unnecessary emergency room visits to the Health Center 2. Redirect urgent care visits to the Health Center 3. Reduce unnecessary use of specialists 4. Redirect lab services to health center
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Butler Health Plan & Preliminary Outcomes
With Staffing of:
We Promoted the Health Center with:
We Achieved:
below Anthem benchmark
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Net Promoter Score
NPS, Net Promoter Score, is a patient loyalty and satisfaction index. 0-6 Detractors, 7-8 Passives, 9-10 Promoters. NPS = Promoters minus
Good, 50+ Excellent, 75+ World Class
Butler Patient Satisfaction Survey
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CareHere BoB Patient Satisfaction Survey
Net Promoter Score
How would you rate the CareHere health center & team in the following areas? Patient Satisfaction Survey
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Patient Feedback
"We find as a family that Butler Advantage is just what we've been needing: a doctor who will hear our concerns and want to address them and not just send us to another doctor. We have had excellent care since starting with Dr. Gantt. I highly recommend this place to all of my coworkers." "Oh my goodness. I loved it. It will definitely be my place to go. Liz was awesome." "Butler Advantage is now my primary healthcare provider. It may keep me working past retirement just so I can keep this benefit." "I am so thankful to be able to get help from such a wonderful staff. I finally feel like I'm being heard and that someone is there to help me navigate through all of my health issues." "I absolutely love the decision I made to switch my primary care to Butler Advantage.
another medical chart."
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Stephanie Hearn SHearn@planmanagementservice.com Randy Bertram RBertram@middletowncityschools.com Edward W. Schwartz, MD ESchwartz@CareHere.com
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