We introduced the Roundstone Cost Saving Investigators (CSI Team) to help employers optimize the value of transparency and control. The CSI Team is always looking for ways to help employers maximize their self-funding benefits by providing cost saving solutions that can be implemented into their health plan. We want to share one of our most recent success stories that will help one employer save nearly $40,000.
Recently, as part of the renewal process, one of our underwriters began reviewing the previous year’s claims for one of the employer groups. The group seemed to be running fairly well, but the underwriter identified several individuals in the group who had much higher claims than their average employee. They realized this handful of individuals were negatively impacting the health spend of the group and shared their concerns with the CSI Team. The team got to work digging deeper into the claims data to investigate the cause.
The CSI Team found these individuals were being prescribed some very costly, yet necessary specialty drugs, which were impacting the group’s pharmacy spend. The team reached out to several other preferred Pharmacy Benefits Managers (PBMs) to see what they could do to help reduce the Rx spend for the specialty drugs. These PBMs use a model of being both pass-through and transparent, to provide the best possible cost savings to a group. The team provided Rx data to the PBMs; the PBMs then completed price analysis and comparison of not only the high cost specialty drugs, but of all the group’s drugs.
Once the comparisons were completed, the CSI Team reached out to the advisor who presented a recommendation to switch to a PBM that would save the group approximately $40,000 annually in comparison to what the group spent the prior year with the incumbent PBM.
With the combined effort of the advisor and the CSI Team, the group was able to implement a new PBM and renew their self-funded health insurance plan for the coming year. Roundstone’s proactive approach to helping this employer take better control of their Rx spend has positioned them to save almost $40,000 in the coming year.
Give us a call if you have questions on how Roundstone’s CSI Team can help you proactively implement cost saving strategies to control your health care spend.
Cost Containment Consultant
I am a graduate of John Carroll University with a degree in Political Science. I went on to obtain my Masters in Exercise Physiology from Cleveland State University. Prior to joining Roundstone, I was a Business Development Representative at the Visiting Nurse Association of Ohio. I also bring experience from the medical device and healthcare industries to provide innovative solutions to Roundstone’s employer groups. As part of Roundstone’s Cost Savings Investigators (CSI Team), my responsibilities allow me to work with many departments to examine employer’s health spend. I am constantly in touch with vendors to find potential solutions. I am very active, riding my bike to work, racing for a local bicycle team and climbing a rock wall that I built in my garage. To relax and recover, I hang out with my wife, friends and two rescue dogs.