After constantly experiencing annual increases of two digits in medical care costs with traditional health insurance, the Rollins pest control company knew that it had to do things differently from its employees, according to Jamie Benton.
“We planned the design. We got used to Mercer’s exchange. We did all that. And then reduce the costs for a year, and then rise again,” he said in a recent interview at the Conference of Health Entrepreneurs.
Then, in January 2023, the employer begged to work with Imagine360, an alternative health plan for self -financed employers. And according to an independent analysis published last week, the company is obtaining results for Rollins. Axene Health Partners analysis found that Imagine360 achieved a 19%saving, or $ 7.7 million annually, compared to traditional health plans for Rollins. It also received a 90% satisfaction score and an acceptance rate of 99% claims.
The report analyzed the Rollins claims data of 2023 and compared them to the reference data of Axene Health Partners, includes almost $ 2 billion in medical care claims in millions of members registered in commercial health plans.
How do you imagine360 achieve these results? The company offers plan design and administration. IT hires the main providers and health systems and provides support from individual members for care and billing problems.
In addition, it uses a price -based pricing model to pay claims. In this model, Imagine360 uses a reference point such as what Medicare pays for the service or the real cost of the procedure informed by the health center, and then adds profits in addition to that reference price. This is compared to the traditional preferred suppliers organization prices model used by insurers, in which costs are generally inflated. In fact, a recent RAND study found that employers are paying 254% of what Medicare pays for the same services in the same hospitals.
Rollins has about 20,000 employees in 47 states. Employees have the option between IMAGINE360 or a Traditional Preferred Supplier Organization Plan. In 2023, 46% of their employees enrolled in Imagine360, and in 2024, that registration increased to 51%. With the savings he has received from Imagine360, the company has been able to reinvest in the health of its employees, such as offering free primary care.
Benton hopes that inscription in Imagine360 will continue to increase in the future. Those who have been the most doubtful to get away from traditional insurance have been the claimants more high cost. However, these are the members that would benefit most from Imagine360 due to the price -based price model, Benton said.
“We have not made real with our cancer patients because they fear changing the doctor,” he said. “We have to do a better job when attacking them, having the conversation to say: ‘Look, your doctors will be there. There will be this low interruption. All you are going to do is charge you less money and get the money”
The analysis occurs when employers face drastic increases in medical care costs. PWC predicted an 8% increase in 2025, the highest rate in 13 years.
Due to these costs of costs, more and more employers seek alternative health plans and pharmacy benefits managers, said Ellen Kelsay, president and executive director of Business Group On Health, in an interview at the conference. He listed Imagine360, Centivo, Surest, Capital RX and Navitus as examples.
Imagine360 is noticing this change. The company has almost 1,000 customers and hopes to see a two -digit growth in the coming years, Chris Cigarran, Commercial Director of Imagine360. He pointed out that some employers are interested in moving to an alternative health plan, but because to start an independent third party administrator and still use the traditional operators network, which I imagine360 is sacrificed as a period of transition.
“We are really trying to simplify that employers make change,” Cigarran said in an interview. “Many consultants and runners have perpetuated a myth that is no other option. We have a real option.”
Image: Feodora Chiosea, Getty Images