City Council May 15, 2012 ACAP

©2012 - Confidential-Not for Distribution

©2012 ACAP Health Consulting Confidential-Not for Distribution

City of San Angelo


COSA’s - The 2012 Plan Year

The Charge:• Lower Overall Costs• Maintain Benefits• No Increase to the Employee/Employer

Funding



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



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


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



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



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


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


Economy & Finance

City Council May 15, 2012 ACAP