Imagine360, an alternate well being plan, launched a brand new product known as Full Care on Wednesday, which incorporates direct contracting with suppliers and a clear pharmacy answer.
Wayne, Pennsylvania-based Imagine360 serves self-funded employers, together with manufacturing corporations, nonprofits, eating places and extra. The brand new Full Care product builds on its present choices with Imagine360Rx, a pharmacy profit supervisor answer that’s powered by Liviniti, a PBM that shares an investor with Imagine360 (Water Avenue Healthcare Companions).
Imagine360Rx offers all drug reductions and rebates to employers and provides various sourcing for medication, akin to discovering lower-cost drugs from the U.Okay. and Canada. It provides reporting for employers on healthcare claims and pharmacy prices as nicely. Members may obtain solutions on each their medical and pharmacy wants by way of one portal and telephone quantity.
“Previous to this, we’d associate with some 70 several types of PBM options that have been on the market. … That is the primary yr that we’re launching and selling one which might be form of branded and aligned with Imagine360 and it’s good as a result of the identical people who find themselves serving to our staff and members of the family all day, each day with all their present well being plan wants can now be those self same individuals after they have a pharmacy want,” mentioned Jeff Bak, president and CEO of Imagine360, in an interview.
Along with Imagine360Rx, Full Care offers direct contracting with well being programs and suppliers and makes use of a reference-based pricing mannequin. On this mannequin, the corporate makes use of a benchmark like what Medicare pays for a service or the precise value of the process reported by the healthcare facility, and provides a revenue on high of that.
The launch of this new product comes at a time when healthcare prices are rising quickly, and prescription drug prices are a significant a part of that. Pharmacy prices signify a couple of quarter of whole healthcare prices for employers, based on the Enterprise Group on Well being. Conventional PBMs — together with Optum Rx, Categorical Scripts and CVS Caremark — have been going through plenty of scrutiny recently attributable to an absence of transparency. That is resulting in many employers adopting or contemplating adopting clear PBMs.
“We’re attempting to convey collectively what we predict are the 2 most cussed areas of value for employers and staff and their households, that are the price of medical companies when delivered by hospital programs and suppliers, after which pharmacy and the price of prescribed drugs for households and employers. … Our principal aim right here is to attempt to, one, lower your expenses in each of these areas of spend,” Bak mentioned. “Two, make the member expertise a heck of loads higher and simpler when they’re accessing care. And lastly, be capable of share the info, the declare info, with all people in order that there’s full transparency with who’s using and why.”
To measure the success of Full Care, Imagine360 will observe financial savings, the member expertise and development, Bak added. A current actuarial report found that Imagine360 decreases employers’ healthcare prices by about 20% in comparison with conventional well being plans. Now with the Full Care product, the corporate expects to realize an extra 5-10% in financial savings for employers.
Imagine360 isn’t the one various well being plan on the market. Others embrace Centivo and Surest.
Supply: weiyi zhu, Getty Photographs
