The client is a two-campus East Coast health system comprises 600 inpatient beds in two hospitals, an outpatient facility, and various primary and specialty care practices across the region. Accredited by The Joint Commission and a three-time recipient of Magnet status, the system possesses a solid reputation for quality patient care, innovations in professional nursing practice, and nursing excellence.
In the face of increasing financial pressure, the client sought assistance in reviewing expenses across the organization. They specifically identified historical and anticipated future employee medical plan expenses as areas of concern. The increased plan costs were exacerbated by a decision to discontinue employee participation in the 340B program, which had a significant financial impact on the health plan. Understanding the urgency, and with a critical need to reduce the plan costs, the system chose to partner with Novia Strategies.
With a multi-disciplinary team comprising experts in pharmacy and employee benefits, Novia conducted a rapid-fire assessment that unearthed significant insight to help pinpoint specific opportunities. In reviewing the health plan, Novia found medical plan expenses totaling $20 million per year, with hospital proposed cost-shifting strategies that would not cover the estimated plan increases of 8.9%. In discussions with pharmacy personnel, Novia discovered opportunities to improve pharmacy operation and expansion of the 340B program outside the employee health plan. They also identified a number of cost-savings strategies for the health plan as well as pharmacy operations.
The approach is discussed in detail in the full case study.
- $3.4 million to $8.1 million in annual savings across the health plan, employee pharmacy program, and hospital pharmacy operations
- Improved service levels to employees and patients
- Strategies to create a sustainable employee benefit program