We use cookies to provide services and improve browsing experience on this website. See our Cookie Policy for more information. By continuing to browse this website, you agree to the automatic use of cookies. We’re sorry we are currently unable to provide real delicious cookies to you and your friends.
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.
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.
Case Study
Download a printable version of this case study
Download Case StudyMore Case Studies
- August 31, 2023
Second Opinion Program Provides Support and Answers for Plan Members
A family employed by an Apex client was seeking answers and resources as they navigated their child’s complex health challenges. Apex’s Second Opinion Program connected them with world-renowned experts and vital local support.
- July 27, 2023
County Creates Sustained Savings Through Switch from Fully Funded to RBR
A county government with 100 employees partnered with Apex to implement reference-based reimbursement. Over the next 6 years, they experienced sustained savings on both health care spend and PEPM costs.
- June 15, 2023
County Saves Millions with RBR and Changes to Pharmacy Benefit
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.