This is where health insurance leadership comes together.
Becker's fourth annual spring payer issues roundtable brings
together over 400
payer and health plan executives and more than
100 speakers to Chicago April.
This year's event includes keynote conversations with the
industry's top leaders and former president George w
Bush. For the full agenda and event details,
visit beckershospitalreview.com
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upper right. We're looking forward to hosting you
here in Chicago.
Hello, everyone. Welcome to Becker's Healthcare Podcast. I'm
Scott King. Thrilled today to be joined by
a very special guest, Jeff Beck, president and
chief executive officer with Imagine three sixty. Jeff,
how are you doing? Thanks so much for
joining us. Appreciate it. Yeah, Scott. Thanks for
having me. Looking forward to today.
Yeah. You know, we have a lot of
big topics to get to in in health
care and with health plans,
specifically here with you. But just wondering before
we get to all that, if you can
please tell us a little bit about your
background and your, career.
Yeah. You know, I'm a bit of a
lifer in health care. I've been doing it
for thirty years,
you know, twenty years or so in in
the private equity framework working for,
and with PE firms to help companies grow
and and,
improve
the services they're providing the industry.
And the past, seven years, I've been working
with what is Imagine three sixty,
where the mission is we're trying to help
American families afford, you know, group health care.
And, you know, we we exist because we're
super innovative on trying to figure out ways
to do that more affordably
without sacrificing
the member's experience. And so,
a lot of evolution,
a a lot of things that we've put
together to try to make all that come
to fruition. And and, we're we're having some
nice growth, and so we're pretty optimistic about
the future.
I appreciate you sharing your background information there,
Jeff, and great news about the growth.
Just first thing I wanted to ask you,
how are your relationships
with providers changing as both sides face cost
pressure and workforce shortages?
Yep. You know, for us, we're we're,
we're pretty predictable on what we reimburse
the the providers.
We we use a formulaic approach so they
know what they're gonna get paid.
We pay timely,
and we also have a high percentage of
all the members and employees that we work
with who who pay their deductibles and out
of pockets. And so in our book of
business, there's not a big chase factor.
And I think those three things kinda combined
make for
a a a good relationship starting point. Not
to say that we don't have, on occasion,
providers that wanna get paid a little more.
We do. But,
on par, you know, 97
plus percent of the time,
we we feel like we're delivering real good
value, and we're doing it quickly,
and everybody seems to be in a good
spot.
Where do you see the biggest gap today
between payer strategy and operational execution?
Yeah. You know, I I think in in
in the employer
sponsored health care arena,
there's just a lot of
limitations,
on what's available. And and, you know, I,
we've done a lot of thinking on this,
and I I kind of equate it to
you know, we'd all like to
drive a Range Rover. Right? It's a beautiful
car. It works great. Looks good in the
driveway,
but it's an expensive proposition. It's not for
everybody. And I think the
the way most employer benefit plans have been
created
is every everybody gets a a a Range
Rover,
you know, a broad panel PPO,
tons of choice,
but it's expensive.
And so our
idea is can we
can we narrow, right,
the the number of,
points of care and access? Still still citing,
you know, high quality,
sites of care,
and and and try to reduce the cost
so that an employee who may be not
be making
a lot of money can afford
to first, you
know, afford the coverage, right, with their contributions.
And can we put in a reasonable amount
of out of pocket,
before they can
use their plan,
you know, like a co pay or a
much smaller deductible level? Because what we're seeing
is it's very expensive.
Not everybody can afford it. And then when
it come times to use it,
people aren't using their plan because there's a
barrier to entry, which is a high deductible
and a lot of out of pocket costs.
And it's just not good long term for
the industry.
And so we try really hard to make
those two things work well,
for members.
Do do you think it might be kind
of a long battle in addressing those limitations
that you mentioned with the employee health plans?
I I don't think so. I you know,
I we're having success today. We're seeing good
adoption.
We're getting more done with carrots than we
are with sticks. So employees and their families
really appreciate
lower dollar access,
to care.
And,
you know, we'll take we'll take guidance, and
and and we'll take some steerage
and ask the question, you know, if I've
got four or five hospitals to choose from
in town
and, you're telling me hospital a and b
are somewhat of equal quality,
and hospital a has nearly no out of
pocket, and hospital b's got a 5,000, I'm
going to hospital a. You know? And I
think people are asking for that type of
data
and that type of design point
in order to kinda reduce the overall cost.
And, you know, with our solution,
we off it's you know, for smaller employers,
maybe we'll replace what's historically been,
you know, the broad panel PPO from BUCA.
With larger employers,
they're not gonna replace everything
overnight. What they will do, though, is they'll
bring our solution in as as a,
you know, as an alternative
option,
so call it a dual option,
where
employees can choose with their wallets and with
their comfort level and and decide which plan
they wanna have at open enrollment typically with,
quite a bit of savings and maybe a
little less choice. But, you know, that that
trade off has to happen if you're gonna
save some money in health care.
What's one investment or initiative you believe will
most reshape how health plans operate over the
next two to three years?
Yeah. I you know, I'm a big proponent
that when you bring together
as many as the pieces of the car
or, you know, as many of the parts
of the car as possible
and can talk through,
you know, an entire end to end solution.
And that end to end solution
has its primary objective and goal of trying
to
save as much as you can for each
is each of the pieces and parts, whether
that's
how you administer it,
whether that's your narrow network strategy or your
out of area RVP strategy,
you know, whether that's a pharmacy benefit solution
that's transparent
and doesn't wanna take any, skin from the
rebates.
Like, the objective is if you can put
that together and get a compelling value proposition
that says it's turnkey,
you're gonna save 25 or 30% over what
you're spending right now. And and good news,
there's kind
of one quarterback
for all your needs, whether that's a clinical
need
or a make an appointment need
or just a general question about I need
my ID card.
The the ability to control the member experience
when you have all those pieces and parts
together
and your main objective has been what's the
lowest common price denominator we can pea we
could put together and put that in a
package
and then just service the heck out of
it and make members really feel like,
they they came to the right spot, and
you're gonna be really prescriptive on where to
use care
and and as importantly, be there when they
need you from a clinical perspective.
You know, it's gone a long way. I
think the other thing I would say quickly
is, you know,
being able to build enough trust with employees
and their families
over the course of a year
where you could reach back out to them
and say, you know, you're getting this particular
specialty drug at a site that is five
times more expensive than doing it at another
site, and they're both in your community.
You could save some money. The employer and
plan could save some money.
You know, will you trust us on this
one and make the change? And so getting
permission and building trust to be able to
have a conversation about changing site of care
is critically important. Not everybody can do it.
We we feel like it's one of our
specialties, and I think that's another big thing
that we're gonna
see as a reshape,
in the future.
Absolutely. And you mentioned a lot of great
ways to to serve members there as well.
And, Jeff, if you could change one
regulatory
or industry practice tomorrow to improve affordability and
access? What would it be and why?
You know, it this is a bit self
serving,
and maybe a more more narrow answer than
you might get from another health plan. But,
like, we don't enjoy the benefit of, brand
recognition, at least not yet.
And so when you're not, a Blues logo
on a card or, you know, a UnitedHealthcare,
on the front door,
you really need to fight for, mental shelf
space, and you need to really help the
brand what it is we're trying to do.
And a lot of brokers who do all
of our selling, right, we're a broker driven
business,
have a misconception
about Imagine three sixty or what I'll say
alternative health plan solutions.
We did a we did a a broad
survey,
reached out to hundreds of brokers with a
third party,
and and the the reveal was that
a lot of brokers
think they know what an alternative health plan
is that uses reference based pricing. But when
you ask them to cite a few basic
statistics,
they'll say things like, well, they probably only
save five or 10%,
and you're gonna get balance bills, you know,
50% of the time,
and you can't access
the facilities
and the doctors you wanna access.
And when we tell them today's facts, which
are, hey. 97%
of the time,
providers accept the reimbursement.
And 99%
of the time, you can see the provider
you want to see,
and you don't save five or 10. You
save 20 or 25, and we'll guarantee it.
The the the broker sentiment changes
almost immediately to, yeah, I do that tomorrow.
And it's our job to figure out how
we get that message out there
and to make sure that that's what people
are hearing because if they're if they're not
hearing it and believing it, they're not gonna
take it to their employers.
The last thing I wanted to ask you,
Jeff,
what issue is putting the most pressure on
health plan margins right now in your eyes,
and how are you responding differently in 2026?
Yeah. I mean, we're
we're trying to,
be really
mindful of the fact that we're not asking
people,
to do anything we wouldn't do ourselves. We're
we're on our own health plan.
All of our 1,600 employees use the Imagines
three sixty approach.
We've got hundreds of thousands of other employees
and,
you know, hundreds of referenceable clients that are
doing it as well,
and they all have a member experience that
they would tell you is better than average,
better than the average market.
We have thing like you know, we we
track a lot of stuff. NPS score is
at 78%.
Member satisfaction,
on any call that we take 98%
with a savings that's really material. And so
we think that
pairing those two things,
really pro really creates for us a a
differentiator in the market, and I think it
allows people to get the best of both
worlds, an experience you can be proud of
and savings you can bank. In fact, we
guarantee our savings so that if we don't
meet the numbers
that we've all committed to,
we make you whole on that dollar for
dollar. And so it it it's not something
you have to take a leap of faith
on. It's something you can take to the
bank.
Jeff, thanks for joining the podcast and for
a great conversation. I look forward to working
with you again soon. Yeah. Likewise. Thanks for
the time.