This is Laura Dierda with the Becker's Healthcare
podcast. I'm thrilled today to be joined by
Jeff Beck, president and chief executive officer at
Imagine three sixty. Jeff, it's a pleasure to
have you on the podcast today. Yeah. Thanks
for inviting me.
Absolutely. My pleasure. You know, I'm excited for
our conversation because I know we'll be digging
into issues around health care affordability, quality, access
to care, health equity, and more, which are
all so important within the health care space
today.
But before we dive into that discussion, I'm
wondering, can you tell us a little bit
more about yourself and Imagine three sixty?
Yeah. Sure.
I have been in health care for, you
know, three decades,
have helped grow and manage health care services
businesses, and,
you know, have always been proud that I
can help employers become,
you know, more cost cost effective when they're
purchasing health care and look for alternative and
creative ways to, to save money and get
the most bang for the buck for their,
for their employees.
And Imagine three sixty is a a growing,
business that is,
an alternative health plan,
with a mission to make health care more
affordable with with a great member experience and
and help the
lives of American workers and their families,
be able to afford health care.
That's an amazing mission and so important, especially
today as I know a lot of families
are struggling in in the health care, you
know,
expenses
are continuing to pile up. And so I
I really appreciate,
that kind of ability to innovate and jump
into an alternative plan that could really make
a big difference for,
patients and families across the board.
From your perspective, I know balancing affordability and
quality is a constant challenge for health plans.
How is your organization
innovating to manage the cost of care while
also maintaining or improving member outcomes?
So from a,
in our perspective,
we're interested
in doing
direct contracts,
with certain high quality health systems.
We're
mainly focused on,
ensuring that what we reimburse
those systems is fair and equitable.
If they don't go to those contracted relationships,
we have a price protection approach, which is
reference based pricing,
which again,
holds the line on reimbursement
and makes health care a lot more affordable.
And from
a member experience perspective, it's really up to
us to ensure that those employees and their
families,
know
about their health care,
program,
know how to navigate to the appropriate sites
of care.
And then when they are, you know, experiencing,
you know, a a medical situation,
be be there for them and engage with
them to ensure that they're having a good
experience under some very tough conditions. And so,
you know, that's that's kind of our MO
in terms of how we're driving to this
lower price point.
Got it. That makes a lot of sense.
And, you know, I I really appreciate how
you can have, as you mentioned, that network
of preferred and quality providers, but at the
same time,
allow for the members to also make decisions
and and navigate through their own care as
well. So I think that makes a lot
of sense and is really helpful.
And addressing health equity
has become a really critical focus for many
health plans. Can you share an overview of
a key initiative here that you're involved in
or are particularly excited about. What are you
hoping to achieve?
You know, health equity,
it is something that's top of mind for
Imagine three sixty. We,
recognize that
there are a lot of Americans who
can no longer afford their out of pocket,
their deductible,
and there's been a ton of cost shifting
that's happened over the,
past, you know, several years.
Medical debt, as everybody knows, 40% of Americans
have it,
and it's because the the their care from
an out of pocket perspective,
is something they don't have the the discretionary
income,
to meet. And so
what we
primarily try to do
is
ensure that they get the lowest cost of
care,
which saves money for the first dollar claim
that they would use and the provider they
would access.
We have programs that check for things like
financial assistance,
to ensure that if they qualify for anything
that's subsidized or free, they they they would
get it. And so, you know, our our
main theme is to reduce the cost of
care, to reduce
out of pocket costs,
and when there is a chance that somebody
may qualify for something that's free from a
health equity perspective like financial assistance that that
they get it.
Got it. That makes sense and is really
helpful and certainly
helpful for those who are struggling with the
that medical debt or who need care,
but without the funds to really, purchase it
effectively. And so I think that it is
great, and and especially for those, as you
mentioned, who qualify for subsidized or,
free assistance, it seems like, it really makes
a big difference for them to access the
type of care that they need.
And then I wanted to ask about member
satisfaction as well. I know member satisfaction is
essential to thrive in today's competitive health care
market.
What experience or engagement strategies have proven effective
for your organization, and how are you measuring
success?
Yeah. We we measure success in many ways.
We have NPS scores and member satisfaction scores,
and they're consistently,
from a member satisfaction,
you know, in in the nineties high nineties.
And I think it's partly because we
we help employees take that extra step in
their health care.
When they call into,
member support,
we can do things like schedule an appointment
for them.
We can
idea, you know, a facility in advance.
Typically,
that
is gonna assist them in terms of spending
the least amount of money possible out of
pocket for that initial
consult.
You know, we we may ask an employee
and and give them an option if they
wanna drive an extra three or four or
five miles.
They may be able to save 200 to
$2,000,
for a facility that could be slightly higher
quality. And, you know, people just don't have
that data. They're not that as conscious of
it as we are. And so
we we do a lot to try to,
you know, hug and wrap those members as
best we can and guide them the best
we can. And when they when they listen
and do and follow, they typically wind up
in a much better place.
That makes a lot of sense. And it's
really comforting to know that,
an organization like Imagine three sixty has that
data and information and then process it and
communicate that, in an effective way for for
members.
Now looking ahead, what do you see as
being the biggest opportunity for payers to lead
the charge in transforming
care delivery and driving better outcomes for all
stakeholders.
How can leaders really take that step into
this direction now?
Yeah.
So,
at the,
upcoming Becker's payer issue roundtable,
we
we announced some findings from a study,
about the perception of health care costs. And
given health care costs have become a topic
of, such a national conversation
debate,
you know, we wanted to understand
how the average American feels,
about their health care. The results kinda confirm
that we
what we've been hearing in our conversations
with,
benefit leaders and employers,
that there's there's a serious affordability issue in
health care,
and American families are are impacted pretty dramatically.
We find that nearly half of our responders
either skipped
or postponed, you know, necessary health care or
medications due to the cost.
Many of them saw their conditions worsen.
This has kind of increased over the past
couple of years.
And as an industry, you know, we're heading
in the wrong direction
when that's kind of the state of play.
And, you know, inaction
and not taking a proactive,
you know, step from a solution perspective or
a strategy perspective
ultimately affects the health, of, of American families.
And so
we we also kind of found that health
plan premiums were the number one factor that
are causing the affordability
challenge,
followed by high out of pockets.
And this is where employers,
I think, and benefit leaders,
brokers, company likes like Imagine three sixty
need to step up,
and step in to see how these things
can
resolve themselves, become more affordable.
And, you know, it's it's most employers' most
valuable asset. Right? It's their employees.
And if they're feeling,
you know, unprotected, if they're feeling exposed financially,
they're they're not gonna be at their best.
They're not gonna be fully engaged.
And the last thing you want as an
employer is, you know, people with, you know,
half their attention on your job and, you
know, half their attention on things, you know,
like
access to care or,
medical debt or, you know, just how are
they gonna afford something as simple as an
annual,
checkup or procedure or colonoscopy. And so
I I I I think that's the key
theme for us.
Absolutely. No. That makes a lot of sense,
and, you know, it's certainly inspiring to hear.
Jeff, thank you so much for joining us
on the podcast. This has been a really
fun conversation. I look forward to connecting with
you soon and especially at our, payer issues
roundtable as you mentioned. It's gonna be such
an amazing event bringing together so many leaders
from across the industry,
to really engage in these types of discussions
on, you know, innovation in the field and
what we need next in order to, really,
really evolve the health care system. So, Jeff,
I appreciate it and look forward to seeing
you soon. Yeah. Thank you. Thanks for the
time.