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.