I’m excited about 2022. Here’s why.
Phil Christianson, CEO, HealthSmart
Welcome to the new year! As 2021 vanishes in the rearview mirror, I want to take a moment to recognize the entire HealthSmart team for their dedication to our clients and to each other during what was unarguably a challenging time. Their unwavering commitment to serving our clients and members with dignity and respect by providing innovative solutions to improve member health while lowering healthcare costs is what makes HealthSmart so special.
Now, on to 2022. The future looks bright for HealthSmart, especially the opportunities that await us and our clients. Let me highlight just a few:
• SmartDecision Reference Based Pricing
: New for 2022, HealthSmart is working with a new reference-based pricing (RBP) partner – HST, and we’re looking forward to the savings we can bring clients in the coming year and beyond. SmartDecision reduces hospital charges while focusing on improving quality of care, but we’re taking RBP to a new level. SmartDecision leverages a multi-pronged approach for quality, cost-effective care: Medicare-based pricing for healthcare facilities, a PPO network for physicians/clinicians, and personal, concierge-level member support coupled with a powerful transparency tool that helps the concierge identify providers based on quality and price. SmartDecision also offers a bundled payment solution in select markets that provides quality care for non-emergent surgeries, procedures and imaging at ZERO member out-of-pocket! Additionally, we offer care management services to assist members with severe, rare or chronic conditions, and high-cost specialty drug management through HealthSmartRx Solutions. Clients using SmartDecision RBP can realize up to 70 percent cost savings compared to standard commercial insurance costs.
• Smart RxAssist:
Formerly known as Copay Maximizer, Smart RxAssist is an innovative solution that targets one of the biggest pain points for plan sponsors, high-cost specialty drugs. Smart RxAssist targets more than 400 drugs filled under the pharmacy benefit and 190 infusion drugs filled under the medical benefit. By addressing both side of the pharmacy cost equation – pharmacy spend and medical spend – Smart RxAssist saves plan sponsors on average 10 to 15 percent on specialty drugs. We also provide member access to a team of specially trained Smart RxAssist Patient Advocates. They work with plan members to help them understand and maximize their savings. Based on our experience in 2021, we expect interest to grow rapidly in the value Smart RxAssist can deliver to our clients as more specialty drugs receive FDA approval. As an example, a 200,000-member plan in the Southeast saved more than $1 million in their first month alone, thanks to Smart RxAssist!
In 2021, we partnered with Employers Health Network and Elan Insurance to introduce Orlando SmartCare, a new insurance plan in central Florida designed for small and mid-size self-funded plans. With the cost savings, improved provider access and enhanced quality of care this program delivers, HealthSmart is working to expand this innovative approach to other parts of the country in 2022.
• Employee Clinics:
In late 2021, HealthSmart joined forces with an independent school district (ISD) in south Texas to reopen an employee health clinic. While open only a few months, we’re already seeing the benefits of the clinic’s revitalization for school district employees and their families. Watch for more such ventures with school districts and employers as the year progresses.
• Price Transparency and No Surprises Act:
2022 marks the beginning of health plan compliance with two new consumer-focused regulations, the Transparency in Coverage rule and the No Surprises Act. HealthSmart has been proactive in educating and supporting health plan sponsors with updates on these regulations and providing data where appropriate. In 2021, we published a white paper covering key aspects of the Transparency in Coverage regulation and an e-book covering the key details of the No Surprises Act. Keep an eye on the transparency resource center on HealthSmart.com for updates as they unfold.
These are just some of the promising new opportunities HealthSmart will be pursuing in 2022. They are a perfect example of “success building on success.” It promises to be an exciting journey and I’m looking forward to working with our clients to provide innovative solutions that plan sponsors need to reduce healthcare costs and treat members with dignity and respect.
Phil Christianson joined HealthSmart in 2016, bringing more than 30 years’ executive leadership experience. Throughout his career, Phil has established an outstanding record of improving operations and growing revenue for mid-sized healthcare companies, including SaaS health information technology, revenue cycle management, disease management, and third party administration services to payers, providers and employers. He also led divisions of Fortune 100 companies, including The Walt Disney Company and United Health Group.
Prior to joining HealthSmart, Phil served as President & CEO for Payment America Systems, Focused Health Solutions, RealMed, and Corporate Benefit Services of America, leading each company to differentiated and improved services for employers, payers, physicians and hospitals. Most recently, he was an advisor to and investor in various health services and information technology companies.
Phil earned a Master of Business Administration from The University of Southern California, a Juris Doctorate from Loyola Law School, and a Bachelor of Arts, summa cum laude, from California Polytechnic State University, San Luis Obispo.