How Imagose360 employers save 19% compared to traditional health plans
Jamie Benton, the company’s vice president of human resources, said that after consistently experiencing double-digit health care costs with traditional health insurance, Rollins knew it had to do different things for employees.
“We did plan the design. We went to Mercer Exchange. We did all of these things. Then, that only cuts the cost for a year and then they will recover immediately.”
So in January 2023, employers began working with Imagine360, an alternative health program for self-funded employers. According to an independent analysis released last week, the company is getting results for Rollins. Axene Health Partners' analysis found that Imagine 360 saves 19%, or $7.7 million per year, compared to Rollins' traditional health plans. It also obtains 90% satisfaction and 99% claim acceptance rate.
The report analyzes Rollins’ claims data starting in 2023 and compares it with Axene Health Partners’ benchmark data, which includes nearly $2 billion in health care claims.
How do you imagine 360 achieving these results? The company provides program design assistance and management. It contracts with top providers and health systems and provides one-to-one membership support for care and billing issues.
Additionally, it uses a reference-based pricing model to pay claims. In this model, Imagine360 uses a benchmark, such as the actual cost of a program reported by Medicare for the service or the healthcare facility, and then adds profits over that reference price. In contrast, the traditional preferred provider organization pricing model used by insurance companies often exaggerates costs. In fact, a recent Rand study found that employers paid 254% of the same services at the same hospital.
Rollins has approximately 20,000 employees in 47 states. Employees can choose between Imagine360 or a traditional preferred provider organization (PPO) program. In 2023, 46% of its employees enrolled 360, and in 2024, the enrollment rate rose to 51%. With the savings it gained from Imagine360, the company was able to reinvest its employees’ health, such as providing free primary care.
Benton expects Imagine360 enrollment to continue to increase in the future. Those who are most hesitant are the higher cost claimants. However, Benton announced that these members will benefit the 360 members of the largest 360 members from Imagine360.
“We're not doing well with cancer patients because they're worried about changing the doctors,” he said. “We have to do better to make their goal and let the conversation say, 'Look, your doctor will be there. This low disruption will happen. All it's going to do is charge you less money and then charge us less money and you can save a premium.''''''”
This analysis was conducted when employers faced a sharp rise in health care costs. PwC predicts an 8% increase in 2025, the highest rate in 13 years.
Ellen Kelsay, president and CEO of the Business Group Health Organization, said in an interview at the conference that more employers are pursuing alternative sexual health plans and pharmacy benefits managers due to these costs. She listed Imagine360, Centivo, Surest, Capital RX and Navitus as examples.
Imagine 360 is noting this shift. Chris Cigarran, chief commercial officer of Imagine360, said the company has nearly 1,000 customers and is looking to see double-digit growth in the coming years. He noted that some employers are interested in turning to alternative health programs but want to start with independent third-party administrators and still use a traditional network of carriers that imagines 360 to offer as a transition period.
“We're really working to make it easier for employers to switch,” Cigarran said in an interview. “Many consultants and brokers have persisted in the myth that there is no other choice. We have a real choice.”
Images: Feodora Chiosea, Getty Images
