Medical Group Case Study

The Challenge

A medical group based in the Philadelphia area with 180 employees on their healthcare plan was facing a one million dollar increase from their current insurance carrier.

Working with a large, national broke, the cost of the current fully insured plan would have almost doubled, going from $1.45 million to $2.6 million had they decided to accept the increase.

The medical group was extremely frustrated by the lack of transparent data behind the large increase.

The challenge was to avoid a significant raise to the employee deductibles and out-of-pocket expenses while at the same time maintain the profitability of the business.

The Solution

The medical group collaborated with Andus to implement its unique, partially self-funded purchasing model.

The strategies recommended by Andus allowed the group to not only keep their current plan offerings in place but also maintain current employee contribution levels.

Furthermore, the Andus model enabled the group to receive transparent claims and member behavior data, which is something they had long been seeking.

The Results

The company completed its first year utilizing the Andus purchasing model and the plan ran at $1.358 million with no major plan design changes. The total plan costs in the second year came in at $1.54 million.

The total savings for the medical group over two years was approximately $2 million, the original insurance carrier remained in place and no major negative plan design changes were made.

The Continuous Impact

The first year would serve as a benchmark against which the medical group's progress and future results could be measured.

Looking back on their previous experience, the group realized how misleading the data was that they received from their previous carrier and broker.

The premium increases that they had accepted were completely unnecessary. The group's new data-driven approach employed by Andus is now putting them in position to actually make plan enhancements, something that would be unattainable under their former purchasing methods.