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This is where health insurance leadership comes together.

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Becker's fourth annual spring payer issues roundtable brings

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together over 400

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payer and health plan executives and more than

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100 speakers to Chicago April.

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This year's event includes keynote conversations with the

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industry's top leaders and former president George w

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Bush. For the full agenda and event details,

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visit beckershospitalreview.com

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and click on the events tab in the

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upper right. We're looking forward to hosting you

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here in Chicago.

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Hello, everyone. Welcome to Becker's Healthcare Podcast. I'm

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Scott King. Thrilled today to be joined by

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a very special guest, Jeff Beck, president and

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chief executive officer with Imagine three sixty. Jeff,

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how are you doing? Thanks so much for

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joining us. Appreciate it. Yeah, Scott. Thanks for

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having me. Looking forward to today.

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Yeah. You know, we have a lot of

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big topics to get to in in health

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care and with health plans,

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specifically here with you. But just wondering before

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we get to all that, if you can

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please tell us a little bit about your

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background and your, career.

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Yeah. You know, I'm a bit of a

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lifer in health care. I've been doing it

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for thirty years,

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you know, twenty years or so in in

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the private equity framework working for,

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and with PE firms to help companies grow

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and and,

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improve

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the services they're providing the industry.

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And the past, seven years, I've been working

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with what is Imagine three sixty,

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where the mission is we're trying to help

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American families afford, you know, group health care.

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And, you know, we we exist because we're

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super innovative on trying to figure out ways

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to do that more affordably

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without sacrificing

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the member's experience. And so,

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a lot of evolution,

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a a lot of things that we've put

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together to try to make all that come

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to fruition. And and, we're we're having some

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nice growth, and so we're pretty optimistic about

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the future.

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I appreciate you sharing your background information there,

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Jeff, and great news about the growth.

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Just first thing I wanted to ask you,

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how are your relationships

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with providers changing as both sides face cost

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pressure and workforce shortages?

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Yep. You know, for us, we're we're,

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we're pretty predictable on what we reimburse

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the the providers.

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We we use a formulaic approach so they

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know what they're gonna get paid.

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We pay timely,

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and we also have a high percentage of

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all the members and employees that we work

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with who who pay their deductibles and out

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of pockets. And so in our book of

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business, there's not a big chase factor.

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And I think those three things kinda combined

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make for

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a a a good relationship starting point. Not

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to say that we don't have, on occasion,

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providers that wanna get paid a little more.

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We do. But,

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on par, you know, 97

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plus percent of the time,

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we we feel like we're delivering real good

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value, and we're doing it quickly,

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and everybody seems to be in a good

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spot.

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Where do you see the biggest gap today

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between payer strategy and operational execution?

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Yeah. You know, I I think in in

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in the employer

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sponsored health care arena,

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there's just a lot of

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limitations,

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on what's available. And and, you know, I,

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we've done a lot of thinking on this,

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and I I kind of equate it to

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you know, we'd all like to

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drive a Range Rover. Right? It's a beautiful

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car. It works great. Looks good in the

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driveway,

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but it's an expensive proposition. It's not for

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everybody. And I think the

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the way most employer benefit plans have been

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created

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is every everybody gets a a a Range

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Rover,

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you know, a broad panel PPO,

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tons of choice,

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but it's expensive.

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And so our

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idea is can we

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can we narrow, right,

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the the number of,

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points of care and access? Still still citing,

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you know, high quality,

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sites of care,

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and and and try to reduce the cost

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so that an employee who may be not

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be making

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a lot of money can afford

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to first, you

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know, afford the coverage, right, with their contributions.

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And can we put in a reasonable amount

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of out of pocket,

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before they can

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use their plan,

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you know, like a co pay or a

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much smaller deductible level? Because what we're seeing

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is it's very expensive.

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Not everybody can afford it. And then when

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it come times to use it,

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people aren't using their plan because there's a

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barrier to entry, which is a high deductible

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and a lot of out of pocket costs.

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And it's just not good long term for

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the industry.

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And so we try really hard to make

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those two things work well,

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for members.

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Do do you think it might be kind

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of a long battle in addressing those limitations

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that you mentioned with the employee health plans?

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I I don't think so. I you know,

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I we're having success today. We're seeing good

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adoption.

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We're getting more done with carrots than we

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are with sticks. So employees and their families

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really appreciate

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lower dollar access,

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to care.

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And,

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you know, we'll take we'll take guidance, and

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and and we'll take some steerage

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and ask the question, you know, if I've

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got four or five hospitals to choose from

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in town

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and, you're telling me hospital a and b

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are somewhat of equal quality,

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and hospital a has nearly no out of

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pocket, and hospital b's got a 5,000, I'm

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going to hospital a. You know? And I

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think people are asking for that type of

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data

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and that type of design point

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in order to kinda reduce the overall cost.

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And, you know, with our solution,

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we off it's you know, for smaller employers,

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maybe we'll replace what's historically been,

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you know, the broad panel PPO from BUCA.

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With larger employers,

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they're not gonna replace everything

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overnight. What they will do, though, is they'll

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bring our solution in as as a,

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you know, as an alternative

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option,

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so call it a dual option,

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where

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employees can choose with their wallets and with

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their comfort level and and decide which plan

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they wanna have at open enrollment typically with,

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quite a bit of savings and maybe a

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little less choice. But, you know, that that

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trade off has to happen if you're gonna

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save some money in health care.

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What's one investment or initiative you believe will

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most reshape how health plans operate over the

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next two to three years?

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Yeah. I you know, I'm a big proponent

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that when you bring together

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as many as the pieces of the car

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or, you know, as many of the parts

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of the car as possible

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and can talk through,

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you know, an entire end to end solution.

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And that end to end solution

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has its primary objective and goal of trying

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to

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save as much as you can for each

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is each of the pieces and parts, whether

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that's

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how you administer it,

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whether that's your narrow network strategy or your

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out of area RVP strategy,

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you know, whether that's a pharmacy benefit solution

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that's transparent

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and doesn't wanna take any, skin from the

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rebates.

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Like, the objective is if you can put

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that together and get a compelling value proposition

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that says it's turnkey,

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you're gonna save 25 or 30% over what

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you're spending right now. And and good news,

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there's kind

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of one quarterback

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for all your needs, whether that's a clinical

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need

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or a make an appointment need

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or just a general question about I need

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my ID card.

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The the ability to control the member experience

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when you have all those pieces and parts

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together

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and your main objective has been what's the

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lowest common price denominator we can pea we

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could put together and put that in a

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package

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and then just service the heck out of

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it and make members really feel like,

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they they came to the right spot, and

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you're gonna be really prescriptive on where to

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use care

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and and as importantly, be there when they

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need you from a clinical perspective.

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You know, it's gone a long way. I

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think the other thing I would say quickly

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is, you know,

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being able to build enough trust with employees

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and their families

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over the course of a year

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where you could reach back out to them

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and say, you know, you're getting this particular

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specialty drug at a site that is five

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times more expensive than doing it at another

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site, and they're both in your community.

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You could save some money. The employer and

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plan could save some money.

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You know, will you trust us on this

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one and make the change? And so getting

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permission and building trust to be able to

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have a conversation about changing site of care

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is critically important. Not everybody can do it.

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We we feel like it's one of our

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specialties, and I think that's another big thing

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that we're gonna

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see as a reshape,

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in the future.

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Absolutely. And you mentioned a lot of great

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ways to to serve members there as well.

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And, Jeff, if you could change one

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regulatory

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or industry practice tomorrow to improve affordability and

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access? What would it be and why?

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You know, it this is a bit self

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serving,

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and maybe a more more narrow answer than

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you might get from another health plan. But,

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like, we don't enjoy the benefit of, brand

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recognition, at least not yet.

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And so when you're not, a Blues logo

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on a card or, you know, a UnitedHealthcare,

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on the front door,

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you really need to fight for, mental shelf

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space, and you need to really help the

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brand what it is we're trying to do.

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And a lot of brokers who do all

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of our selling, right, we're a broker driven

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business,

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have a misconception

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about Imagine three sixty or what I'll say

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alternative health plan solutions.

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We did a we did a a broad

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survey,

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reached out to hundreds of brokers with a

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third party,

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and and the the reveal was that

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a lot of brokers

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think they know what an alternative health plan

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is that uses reference based pricing. But when

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you ask them to cite a few basic

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statistics,

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they'll say things like, well, they probably only

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save five or 10%,

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and you're gonna get balance bills, you know,

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50% of the time,

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and you can't access

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the facilities

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and the doctors you wanna access.

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And when we tell them today's facts, which

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are, hey. 97%

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of the time,

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providers accept the reimbursement.

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And 99%

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of the time, you can see the provider

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you want to see,

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and you don't save five or 10. You

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save 20 or 25, and we'll guarantee it.

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The the the broker sentiment changes

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almost immediately to, yeah, I do that tomorrow.

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And it's our job to figure out how

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we get that message out there

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and to make sure that that's what people

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are hearing because if they're if they're not

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hearing it and believing it, they're not gonna

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take it to their employers.

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The last thing I wanted to ask you,

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Jeff,

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what issue is putting the most pressure on

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health plan margins right now in your eyes,

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and how are you responding differently in 2026?

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Yeah. I mean, we're

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we're trying to,

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be really

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mindful of the fact that we're not asking

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people,

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to do anything we wouldn't do ourselves. We're

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we're on our own health plan.

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All of our 1,600 employees use the Imagines

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three sixty approach.

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We've got hundreds of thousands of other employees

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and,

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you know, hundreds of referenceable clients that are

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doing it as well,

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and they all have a member experience that

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they would tell you is better than average,

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better than the average market.

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We have thing like you know, we we

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track a lot of stuff. NPS score is

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at 78%.

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Member satisfaction,

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on any call that we take 98%

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with a savings that's really material. And so

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we think that

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pairing those two things,

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really pro really creates for us a a

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differentiator in the market, and I think it

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allows people to get the best of both

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worlds, an experience you can be proud of

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and savings you can bank. In fact, we

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guarantee our savings so that if we don't

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meet the numbers

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that we've all committed to,

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we make you whole on that dollar for

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dollar. And so it it it's not something

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you have to take a leap of faith

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on. It's something you can take to the

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bank.

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Jeff, thanks for joining the podcast and for

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a great conversation. I look forward to working

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with you again soon. Yeah. Likewise. Thanks for

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the time.