Case Study

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.

The team of Certified Pharmacy Benefits Specialists reviewed the employer’s pharmacy claims and pharmacy benefit manager (PBM) contract. Apex contract assessments include taking a deep look in to pharmacy benefit contractual terms.