HealthEngine Overview March 26, 2014 Kane County Profile Western - - PowerPoint PPT Presentation

HealthEngine Overview

March 26, 2014

Kane County Profile

• Western Edge of Northeast IL Region
• Growing and Diverse population, 692,346 expected by

2030

• 1250+ Employees covered on Self-Funded Plan
• BC/BS of IL

Vision

• Being an innovative and strategic leader in a

fiscally prudent manner

• Being good stewards of the natural and

economic resources

• Promoting and environment that advocates

health, welfare and safety;

• Encouraging and valuing citizen communication,

input, and involvement in governing so that residents are proud to call Kane County "home”

Health Plan Challenges

• High Costs of Healthcare, Kane County current

Burden on Tax Payer is 83% of a spend that is approximately $12M

• Lack of transparency tools and concierge service

to help employees shop

• Price Variation Everywhere – Thomas Reuter

Study

• Service Sites impact cost – In study Chicago Average for Colonoscopy

was $2330-6330, while New York Colonoscopy averaged $450

• Provider contracts vary within employer plan
• Knee Arthroscopy patient out-of-pocket difference out of pocket $200-

500 Savings

Health Plan Challenges

Why Healthengine?

• Leadership
• Forward Thinking Approach
• Large % of plans are becoming high deductible/shared cost with

employees

• Consumer Driven Health can’t work without Transparency in cost along

with quality metrics

• Transparency only the beginning
• Stage 2 Negotiations within BCBS of IL provider network
• Stage 3 Reverse Auction to enable providers to engage and compete
• Employee Engagement Consulting
• 3rd Party needed to fill void
• Singular Focus on driving down costs for employers and patients
• Contractual Obligations - Health Plans contract with providers every 1-2 years
• Difficult for Health Plans to expose pricing due to variations
• Continual Interaction with Provider Network
• More quality data from outside sources

Healthengine Approach

• Claims Data Analyzed
• Key Procedures Identified > than 50% of Cost
• Employee Dashboard and 800# Concierge Service Implemented

providing Cost/Quality information

• Select High Quality, renowned providers in relevant geographies
• Negotiate Drastically improved pricing for members’ employees
• Benefit Advocacy – Specialized Negotiation unit pre/post charges
• Monitor Patient Satisfaction
• Monitor Provider Competitiveness
• Competitive provider real-time bidding platform
• Comprehensive Change Management Approach – Employee

Engagement

Healthengine ROI

• No Risk Partnership for Pilots
• Kane county Health Benefit approximate cost $12M
• HealthEngine Solution annual cost reduction long-term (2-5

year) goal (30% minimujm) - $

• Company Benefits
• Employee Benefits

What Employees See – Personalized Dashboard

9

Employees see their

• wn deductible

spending summary Search for procedure or select it from pre-defined lists

What Employees See – Provider Choices

10

Employees can now select their provider based on price, quality and location Additional cost savings for flexible days/times

What HR & Managers See – Rollup Reports & Utilization

11

Employees can now select their provider based on price, quality and location Additional cost savings for flexible days/times