On August 1, 2021 Oradell Animal Hospital was faced with a tough decision…stay the course with their long-time insurance carrier or change course and go with an independent Third-Party Administrator (TPA) and Pharmacy Benefit Manager (PBM).
Considering they were experiencing out of control medical and pharmacy claims on their self-insured health plan, the decision shouldn’t have been that difficult. However, fear of the unknown, the comfort zone, and the path of least resistance stand in the way many times, even for plan sponsors that can’t get a handle on their claims and insurance costs.
To their credit, and they deserve all of it, the benefit team at Oradell Animal Hospital decided to depart from the status quo and selected ACS Benefit Services (TPA) and BeneCard (PBM) to manage their day-to-day services and pharmacy benefits. Also, embedded in the new health plan were a specialty drug vendor (OptiMed) and a population health/care coordinator (Engaged Health Services).
Two years later, Oradell Animal Hospital, was voted among the top 50 health plans in the nation by Health Rosetta. BritePath Founder, Louis C. Bernardi, will accept the award in Oradell Animal Hospitals honor and present a case study to hundreds of Advisors, TPA’s, PBM’s, clinicians, plan sponsors and other solution providers at the RosettaFest 2023 Conference in Chicago, IL.
The results of the first two years have been remarkable. Despite, no change to benefits or prescription copays, Oradell was able to lower their total cost to insure the healthcare of their members by $900k. One member which had a laser of $600k and prior year claims in excess of $667k saw a 66% drop in claims and enjoyed 72 interactions with the nurse coordinator from Engaged Health.
Prescription claims dropped by over 50% in year one alone as a whole and the plan was $1.2 million under budget.
Here’s what the CFO of Oradell, Rita Sands, had to say about the incredible results, “After just two years, we can honestly say that the results have exceeded our expectations. We immediately saw a significant reduction in our prescription costs and within a few months, we decided to enhance our benefit program with employer paid life and disability for the entire staff. This was something that we had wanted to do for a while, but we just couldn’t because our health costs were so high.”
BritePath is so pleased to have been a part of this tremendous success story.
If your company is struggling to keep up with the cost of health insurance, we encourage you to connect with a BritePath right away.