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 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
Our Guest Speakers 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. 2
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. 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. 3
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 4
Health Center Locations BUTLER ADVANTAGE I - 7 0 LOCATIONS: Beavercreek Current City Schools Dayton Future I-675 Madison Local I-75 Schools Middletown New Miami Middletown Local Schools Oxford City Schools Talawanda Hamilton R Butler Tech City Schools 2 City Schools t 7 Monroe Hamilton BCESC 1 7 Local Schools - I Lane Libraries Rt 129 Ross Local Schools Fairfield City Schools I - 7 4 Great Oaks Career Campuses Sycamore Community Schools I-275 Cincinnati 5
Insurance Partners Enrollment Statistics Enrollment Statistics 6,000 Employees PPO 14,000 Covered Lives HDHP $70M Annual Premium Rev MVP 6
2020 In-Network Medical Plan Options Search for in-network Anthem Blue Access PPO HDHP MVP providers at www.anthem.com Medical Preventive Care Preventive services covered 100% for all plans Annual Deductible* $650 /person $2,800 /person $1,300 /family $5,600 /family $6,900 /person This is the dollar amount you must pay first in a year before the $13,800 /family plans begin paying specified benefits. You do not have to meet the You must meet the deductible deductible before copays apply. before prescription copays apply Annual Maximum Out-of-Pocket Includes deductibles and copays. $2,650 /person $5,000 /person $6,900 /person This is the most you will pay toward $5,300 /family $10,000 /family $13,800 /family your in-network medical and prescription expenses. Doctor Office Visit $30 for primary care Ded, then Plan Primary care includes family practice, internist, pediatrician, Ded, then Plan pays 80% $50 for specialist pays 100% OB/GYN, mental health and chiropractor. Ded, then Plan Urgent Care $40 copay Ded, then Plan pays 80% pays 100% $200 copay Ded, then Plan Emergency Room Ded, then Plan pays 80% (waived if admitted) pays 100% Ded, then Plan Inpatient and Outpatient Services Ded, then Plan pays 80% Ded, then Plan pays 80% pays 100% Prescription Drugs Deductible After deductible After deductible does not apply is reached is reached Retail $15 generic $15 generic Ded, then Plan $35 preferred brand $35 preferred brand pays 100% Up to a 30-Day Prescriptions Express Scripts Prime Nationwide network which includes CVS, Kroger, Meijer, Target, Walmart and more. Pharmacy Network Mail Order or Smart90 $35 generic $35 generic Ded, then Plan Up to 90-Day Prescriptions $85 preferred brand $85 preferred brand pays 100% Express Scripts Home Delivery or 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. Smart90 Standard Pharmacy Network Specialty Ded, then Plan 7 $75 $75 Up to 30-Day Prescriptions pays 100%
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 8
Butler Health Plan & Preliminary Outcomes With Staffing of: We Promoted the Health Center with: • 1 Physician • Open House • 1 Nurse Practitioner • Face-to-face Meetings • 1 Physician Assistant • Digital emails & communications • 2 Medical Assistants • Home Mailings | Word of Mouth • 1 Registered Nurse We Achieved: • 90% Utilization of Available Appointments within 3 months • Reduced “low intensity” ER visits by 11% which is 13% below Anthem benchmark • Reduced Specialists Visits by 12% (Still above benchmark) • Added additional provider hours • Plans to Open 2 Additional Centers in 2020 9
Butler Patient Satisfaction CareHere BoB Patient Survey Satisfaction Survey 96 85 Net Promoter Score 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 Detractors. The creators of NPS label scores of 0+ Good, 25+ Very Good, 50+ Excellent, 75+ World Class 10
Patient Satisfaction Survey How would you rate the CareHere health center & team in the following areas? 11
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." "I absolutely love the decision I made to switch my primary care to Butler Advantage. Dr. Moore takes her time to get to know me and what health issues I have. I feel like a person and not just another medical chart." "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." 12
Thank You. Questions? Stephanie Hearn SHearn@planmanagementservice.com Randy Bertram RBertram@middletowncityschools.com Edward W. Schwartz, MD ESchwartz@CareHere.com 13
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