Employer Case Studies

A county government with over 450 employees partnered with Apex to implement reference-based reimbursement and saved millions over 7 years, decreasing their PEPM costs in the process.

Working closely with the insurance company’s reinsurance and pharmacy teams, the Kinetiq Health team came up with a solution to purchase the treatment directly from the manufacturer at actual cost while the hospital continued administering the dependent’s infusion therapy each …

After reviewing the language of the pharmacy benefit management (PBM) contract that determined the terms and cost variables, savings opportunities were identified without changing any benefits to employees.

MSD of Wayne Township was dedicated to employee health and wellness prior to engaging with Apex Benefits and its Kinetiq Health team in late 2019. While mostly satisfied with their wellness program, the school system was looking for opportunities to …

The savings found were substantial for the client. After discounts, rebates and fees the annual identified pharmacy savings were $110,156 for the client. Apex also discovered additional savings through clinical and specialty drugs of another $100,581. Those combined savings cut …

The client’s insurance provider would not release the detailed claims data and clinical case notes needed to help Apex negotiate the renewal. Therefore, competing stop loss carriers were comfortable with the risk profile only if able to “laser” one claimant …

It was determined that the client was due a refund. The Township not only saved money, but also saw an improved return on their investment for the clinic. The savings understandably left the client pleased knowing it was spending less …

A mid-sized company with diverse holdings in the food and entertainment sector with about 400 employees.

The client was experiencing rising and unsustainable healthcare costs while their revenue stream was capped. In 2015, two years prior to hiring Apex, its healthcare spend was $1.66 million. That spend increased to $1.81 million in 2016.

Apex was the first benefits advisory firm to introduce Reference-Based Reimbursement (RBR) pricing methodology to the public and private sectors in Indiana in 2012 and has the largest number of RBR clients among Indiana benefits advisory firms.

By identifying the employee’s medical and behavioral issues and specific needs, the Kinetiq Health team was able to establish individualized care paths to manage chronic conditions. The employee was steered to an appropriate place of service for ongoing monitoring. While …

Open Door Health Services is a fully funded not-for-profit health center providing comprehensive primary, urgent and preventive healthcare services to individuals and families throughout East Central Indiana. There are 99 employees enrolled in the medical benefits program.