©2012 - Confidential-Not for Distribution
©2012 ACAP Health Consulting Confidential-Not for Distribution
City of San Angelo
©2012 - Confidential-Not for Distribution
COSA’s - The 2012 Plan Year
The Charge:• Lower Overall Costs• Maintain Benefits• No Increase to the Employee/Employer
Funding
©2012 ACAP Health Consulting Confidential-Not for Distribution
©2012 - Confidential-Not for Distribution
COSA’s - The 2012 Plan Year
The Challenge:• Health Risks of Employees Declining• Procurement Process Showed Marginal
Savings– Insurance Carriers’ Network Discounts
Similar at 58%– Administrative Costs Not Enough to Offset
Projected Claim Cost Increase– No Administrator Able to Deliver Lower
Costs
©2012 ACAP Health Consulting Confidential-Not for Distribution
©2012 - Confidential-Not for Distribution
ACAP Health Engaged
• Former Insurance Executive with contracting knowledge
• Data warehouse to assess physician/hospital performance
• Based on the knowledge of the providers’ current costs:– First Step: Contacted hospitals’ CEOs on COSA’s
objectives– Second Step: Requested fixed cost financial
arrangement– Third Step: Analyzed the hospitals’ contracts– Finally: Resolved financial outliers to identify best
financials©2012 ACAP Health Consulting Confidential-Not for Distribution
©2012 - Confidential-Not for Distribution
ACAP Health Engaged
• Selection of Community resulted in a projected 35% facility cost savings from current
• ACAP’s paid on a results-based model - % of actual savings
©2012 ACAP Health Consulting Confidential-Not for Distribution
©2012 - Confidential-Not for Distribution
ACAP’s Next Steps
• Must address underlying health risks of COSA’s population
• Analyze claims and biometric data to identify the right interventions to avoid catastrophic claimants
• Work with Community to build a more connected Care Pathway for the individual
©2012 ACAP Health Consulting Confidential-Not for Distribution
©2012 - Confidential-Not for Distribution
ACAP’s Next Steps
• Create an Accountability Model for the physicians – Improve the Employees’ Health thru
Wellness– Close Clinical Gaps in Care for the
Employees– Better Connection with Specialists and the
Hospital• Additional savings available through an
accountable physician©2012 ACAP Health Consulting Confidential-Not for Distribution
©2012 - Confidential-Not for Distribution
Request
• Health Plan is realizing savings today• Year to date, we estimate the plan has saved
over $250,000• The health fund reserves are healthy• Seeking approval to contract with ACAP for
services rendered on a shared savings basis• Need assistance from ACAP to address
additional shared savings opportunities
©2012 ACAP Health Consulting Confidential-Not for Distribution
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