Thoughts from the CEO- Innovation is in our DNA
By Phil Christianson, HealthSmart CEO
Innovation is a key part of our DNA here at HealthSmart, and it is central to our brand promise. A lot of companies claim to be innovative, but in the past year or so, as the demand for flexibility and cost control has become more critical in the health benefits market, we’ve launched a couple of initiatives that are really raising the bar.
Earlier this summer, we announced a unique partnership that enabled us to introduce an innovative new product to the Orlando, FL, market – Orlando SmartCare
. Since the announcement, many people have asked me why HealthSmart pursued this out-of-the-box thinking to bring this new health plan to the central Florida marketplace. My immediate response is, “We’ve always been committed to innovation, and this represents a truly innovative approach that will deliver convenient access to cost efficient, high-quality care for Orlando-area employers with self-funded plans.”
Orlando SmartCare is a new PPO product that offers Orlando area self-insured health plans access to central Florida’s premier network of hospitals, clinics, and providers affiliated with Orlando Health, at price up to 20-25 percent lower than current market rates and discounts up to 75 percent off billed charges. In a nutshell, we’ve taken an innovative partnership approach to help self-funded plan sponsors in central Florida control their health benefit costs and offer coverage to their members tailored to their needs.
By collaborating with Orlando Health, central Florida’s premier health care system, its 15 facilities and 4,200 affiliated physicians, Orlando SmartCare offers access points from Tampa Bay to the Space Coast. Key to this initiative, Orlando SmartCare provides affordable comprehensive stop-loss coverage that protects participating health plans from catastrophic claims through Florida-based Elan Re.
Since introducing Orlando SmartCare in early summer, we have been gratified to see a great deal of interest from area employers welcoming this new addition to central Florida’s marketplace. Based on Orlando SmartCare’s initial success, HealthSmart is evaluating similar ventures with market-leading health care organizations in other locales across the country.
Orlando SmartCare clearly underscores HealthSmart’s mission: to improve the health of our members while treating them with dignity and respect and to reduce healthcare costs for our clients and members with innovative solutions and a flexible approach.
Thank you to Orlando-area self-funded health plan sponsors and our Central Florida broker-partners. We look forward to a long and mutually beneficial relationship.
Another shining example of HealthSmart’s dedication to delivering innovative solutions to our clients is Copay Maximizer
by HealthSmartRx Solutions. Copay Maximizer was born from a desire to help our clients and members overcome the financial burdens of copays for specialty drugs.
One of the fastest growing segments of pharmaceuticals, infusible drugs often come with member copays that reach into the thousands of dollars. While many pharmaceutical companies offer some type of financial assistance or discount program to patients who qualify, not every member benefits. The programs can be difficult to access and even when successfully navigated, they can reduce the member’s out of pocket, but leave the plan sponsor with significant losses.
The HSRx Copay Maximizer team springs into action when a prescriber orders an expensive specialty drug for a member. Based on the individual member’s circumstances, HSRx works with the plan’s sponsor to modify accumulators to maximize savings associated with assistance program requirements and benefits. And most importantly, we’re able to apply this program to help clients and members whether the drug cost hits on the pharmacy benefit or the medical benefit, where almost half of specialty drug claims occur.
The result is a unique win-win with members enjoying significant savings on out-of-pocket copays and plan sponsors realizing major cost savings on specialty pharmacy spend. One of our clients gained a 13 percent reduction in per member per month specialty drug cost spend year over year by transitioning to HSRx Copay Maximizer while using the same formulary, specialty pharmacy, and comparable pricing and rebates.
That’s HealthSmart innovation delivering value to our clients and their members, and it represents HealthSmart’s hallmark multi-dimensional, integrated approach to helping plans preserve their bottom line while improving care and member satisfaction with the plan’s pharmacy benefits. For more information about these and other innovative solutions, please contact us at firstname.lastname@example.org
Phil Christianson, Chief Executive Officer
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.