Health Plan Replacement Case Study for Schools

This case study details the implementation of a new health plan solution by the Show-Me Benefits Consortium, which comprises three schools with a total of 741 members and 353 employees. Prior to 2021, these schools faced unsustainable double-digit premium increases under their fully insured health plan, leading to minimal transparency into claims data. The Consortium adopted the Vālenz® Health Healthcare Ecosystem Optimization Platform to replace their existing plan. This new approach aimed to align members, providers, and employers, resulting in a reported $1.68 million in savings during the first year. The case study outlines the various strategies employed, including improved provider networks and effective care management, which contributed to significant cost reductions. Future opportunities for additional savings through enhanced solutions are also discussed, emphasizing the importance of data transparency and member experience in managing healthcare costs effectively.