Client

A nationally recognized financial sector client in Indiana with 400 employees.

Challenge

The client hired an employee whose dependent needed weekly infusion therapy and the hospital system was charging $55,000 per week for the treatment. Without intervention, the employer would have faced a very difficult reinsurance in year-two of the plan and future financial liability of $3 million in subsequent years.

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 week — no markup involved.

Solution

Kinetiq Health’s teams contacted the insurance provider, showed them the data and shared the loss they would be taking for the remainder of the year after the stop-loss amount was exceeded. The team came up with a solution to purchase this treatment directly from the manufacturer at actual cost while the hospital continued administering the dependent’s infusion therapy each week — no markup involved.

Results

The client saved $2.4M for the first year, and several millions of dollars were saved in subsequent years. Early identification and quick intervention prevented the need for the client to move to a different insurance provider during renewal.

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