Actuarial report compares three years of medical claims in five large metropolitan areas, indicating that Imagine360 achieves significantly lower healthcare claims costs than traditional health plans

The study also determined that Imagine360’s reimbursement methodology greatly improves stop loss insurance performance, leading to additional savings opportunities

Imagine360, a leading alternative health plan for self-funded employers, today announced results from an independent actuarial analysis by Axene Health Partners analyzing three years of medical claims in five U.S. metropolitan areas to understand the impact of Imagine360’s innovative payment model. The report found that Imagine360 reduces healthcare costs by 19.8% compared to commercial health plans in the evaluated markets, and significantly improves stop loss insurance performance, leading to additional cost saving opportunities.

This press release features multimedia. View the full release here: https://www.businesswire.com/news/home/20240529758399/en/

Imagine360 reduces healthcare costs by 19.8% compared to other commercial health plans (Graphic: Business Wire)

The report compared healthcare claims incurred by Imagine360 members residing in the Atlanta (GA), Dallas (TX), Indianapolis (IN), New York City (NY), and Tampa (FL) metropolitan areas to a commercial population benchmark from January 1, 2021, through August 31, 2023. The benchmark data was formulated by Axene Health Partners and included nearly $3.5 billion of healthcare claims across millions of members enrolled in prominent commercial health plans in each market, including large national carriers.

“After a lengthy analysis, including a comprehensive healthcare claim matching process, we can definitively say that Imagine360 reduces healthcare costs,” said David V. Axene, FSA, FCA, CERA, MAAA, Managing Partner of Axene Health Partners. “Imagine360 directly addresses the highest costs typically incurred by self-funded organizations and enables employers to achieve measurable cost savings within the first year of the plan. Very few healthcare solutions can say the same.”

Rising healthcare costs have become a significant challenge for self-funded employers, and a 2024 RAND Corporation study found that businesses pay 2.54x Medicare rates for the same healthcare services.

Imagine360 achieves measurable cost savings and industry-leading member satisfaction by delivering a fundamentally different health plan experience. Imagine360’s integrated offering includes preferred provider and health system contracting, price protection through reference-based pricing, and personalized care coordination and medical management services. Imagine360 members report 98% satisfaction scores as a result.

“The Axene Health Partners report affirms Imagine360's unique ability to address one of the most urgent challenges in the United States today: healthcare affordability for American families and the self-funded employers that cover their healthcare costs,” said Imagine360 Chief Commercial Officer Chris Cigarran. “The unfortunate reality is that American businesses are subsidizing a large portion of today’s healthcare system, and costs are increasingly being passed to employees, as evidenced by the fact that nearly half of adult Americans experience medical debt. Through a fair and transparent healthcare payment methodology, Imagine360 gives businesses greater control over their healthcare costs, helping them reinvest those savings in their valuable employees and their families.”

Beyond healthcare claims cost savings, Imagine360’s transparent reimbursement model affords employers additional benefits including improved stop loss insurance performance. Stop loss insurance protects self-funded organizations from catastrophic healthcare expenses and caps exorbitant healthcare claims.

Axene Health Partners reported that 25%-67% fewer Imagine360 clients exceed stop loss insurance deductibles, which ranged from $25,000 to $250,000. The analysis indicates that Imagine360 reduces stop loss insurance payouts, which should translate to lower monthly premiums for Imagine360 self-funded employer clients.

You can access the Axene report, including detailed charts and methodologies, here.

About Imagine360

Imagine360 is an integrated health plan addressing one of the greatest challenges on behalf of self-funded employers: healthcare costs are harming the bottom line, increasingly unaffordable for employees, and the experience remains poor. Imagine360’s innovative payment model includes preferential contracting with providers and health systems, and additional price protection through reference-based pricing, saving employers 15-30% on average compared to the national carriers. With more than 17 years' experience, and 25-million-months of member data, Imagine360 offers care coordination and medical management to proactively guide members through the complexities of healthcare. Learn more at www.imagine360.com and connect with us on LinkedIn.

View source version on businesswire.com: https://www.businesswire.com/news/home/20240529758399/en/