Emphasis on wellness program, high-cost claimants and pharmacy benefits results in large savings
MSD of Wayne Township is one of the 10 largest public school systems in Indiana and has more than 1,500 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 maximize their investment in the program. Specifically, the team saw low employee engagement with an onsite clinic and poor retention in its wellness coach position.
“We’ve always prided ourselves on health and wellness and had programs in the past, but often felt they weren’t maximizing the potential of our employees’ ability to hone their health and mental wellness,” said Barry Gardner, MSD of Wayne Township Chief Financial Officer.
Beyond wellness, the team wanted to explore avenues to lower healthcare costs for the district and its employees – without sacrificing the care the employees enjoyed.
“One of the major costs that continued to drive up healthcare for our schools was pharmacy and the cost of prescription drugs,” Gardner said. “Apex came alongside and took a look at our plan and found ways to save us dollars that we had not explored in the past.”
Apex’s Kinetiq Health team of clinical and financial strategists recommended taking a unique approach to addressing the client’s challenges.
A registered nurse was hired by Apex to serve as a program manager and clinical analyst dedicated to working on site with MSD of Wayne Township employees. The district also hired two employees to work hand-in-hand with the Kinetiq Health nurse in roles tailored toward lifestyle management and wellness.
The district’s healthcare data was analyzed by the new team, specifically data related to high-cost claimants and prescription drugs, to find avenues for savings.
Cost-savings opportunities were immediately identified by reviewing programs deemed underused or duplicative. The Kinetiq Health experts also discovered that mental health and financial well-being represented the school system’s highest claims. This led to helping the district refocus its wellness program offerings on those areas.
“Working with Apex allowed us to look at these programs in another light and find areas we were doing very well and maximize those opportunities,” Gardner said. “More importantly, we found areas where we were not maximizing the opportunities with our employees. Apex really came in side-by-side with us, looked at the program overall and helped us fine-tune it and take it from a single-focused program into a multi-faceted program that provides many opportunities for employees—and meets them at their individual levels.”
The analysis of prescription drug data revealed an opportunity for immediate savings through J Code prices. After negotiations, the district realized savings of $239,000 per year on those drugs prescribed to its employees.
“(Apex) found hundreds of thousands in savings in that area that we had not been able to tap into in the past,” Gardner said. “They helped us carve out specialty drugs to take the costs off the district and off the employee, while at the same time ensuring the employees were still covered and confident their prescription drug or healthcare would not be diminished or taken away from them.”
Apex’s benefits strategies also helped the district adjust its healthcare plan and find savings in their ancillary products and pharmacy costs. Since the district became a client at Apex, it has saved more than $466,000 across J-code, ancillary and pharmacy costs.
“The leadership at Apex worked with our health insurance carrier and negotiated behind the scenes to drive down costs and get a more market value for the district,” Gardner said. “That created tremendous savings. We’ve been able to really focus on high-cost claimants that often drive the cost for our district in terms of healthcare premiums, and that has been a valuable asset to us.”
By better understanding its workforce and plan members’ claims and how they utilized health benefits and the wellness program, the client has focused health and wellness programming more on physical, mental and financial well-being. In turn, the district now has healthier individuals who know what resources are available to them. The district additionally was able to repurpose funding earned through cost savings to round out tits wellness team and invest in three onsite health coaches.
More Case Studies
- August 31, 2023
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
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
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.