Cavalry Partners Health Plan Case Study

CASE STUDY

 

 

Health Plan Case Study

Cavalry Partners and this motivated self-funded client partnered together following one of the client’s best years in several years but with little hope of this being the sustainable path.

 

The Problem

This client has an average workforce age of XXX, 4 rural locations, range of salaries from $15hr to $100k+, and around 250+ employees actively enrolled. Their stated concerns were year over year increases that would become unsustainable, zero control over spend and quality care, and the need to recruit and retain. Previous broker and insurance relationships did not drive comprehensive change. Unsupported “programs” and renewals moving from one larger vendor to the next proved untenable.   

 

Lowering Costs Across the Board

Working with Cavalry Partners, the client found partners that had aligned goals and incentives. The general framework agreed upon was a no-network option, telemedicine, centers of excellence for the most major diagnoses, and a program for no/low-cost imaging, labs, therapy, equipment, and more.  Diligent efforts in the 4 months leading up to plan rollout and focused education and outreach every month following has mitigated disruption in the workforce.  

Employer health spend ended their fiscal year 2021 at $9,585 per employee per year (PEPY). The end of fiscal year 2022 showed a 41% decrease in spend to $5,618 PEPY and trending downward. $1,400 of the $5619 PEPY spend in FY 2022 was heavy 2021 lag from the previous plan. Stop loss, where our client has taken an aggressive position, was renewed without an increase. Employee out of pocket spend was reduced by more than 20%. The client chose to give employees premium holidays after year 1 and hopefully greater incentives with plan consistency in year 2 and beyond.

 

BACK TO RESULTS