Apta Cash - 3x3x3 Challenge With Tom Busler
Apta Cash delivers RBP-level savings without the pain, using cash-pay strategies and high-touch guidance to eliminate member out-of-pocket costs and outperform PPO networks.
Transcript:
What is Apta Health?
Apta Health is the evolution of our Apta Health program. Our Apta Health program was developed to provide guided healthcare to members so that we could help them at the onset of their healthcare journeys. The problem with that is that it is still only as efficient as the PPO networks on which it rests. Many of our clients are demanding more, which is why we developed the Apta Cash Program. Apta Cash leverages the ability to present directly with cash payments to providers, and then get RBP like outcomes. We combine that with guardianship so that we can ensure that the member experience stays to our very high standards.
How is Apta Cash different?
You can think of Apta Cash as a proactive protective version of RBP. As I mentioned, it's a proactive approach whereby we are actively having members go out and purchase their healthcare, but actually offering cash to the provider at that point of point of sale, at the point of consumption of the healthcare. So there are two primary types of cash pay claims. There are those that we facilitate with a debit card and merely by presenting a self-pay, we're actually purchasing just as efficiently as the federal government at a 100% of Medicare. There are those more significant claims though, where we're maybe inpatient outpatient procedures, and for those we're actively negotiating the claims. When you combine those two claims types, we're averaging about 130% of Medicare, which for those of you familiar with reference-based pricing is typically in excess of even what you're going to see. But by combining it with that guardianship approach, we're ensuring that the member still has that extremely high touch guided healthcare experience that Apta has become known for. We keep members in that cash lane by making sure that they don't have any out-of-pocket costs when they leverage cash. That means no deductibles, no out-of-pocket maximums, no copays, and we've been very effective with this approach.
Who is a good fit for Apta Cash?
I think it's for those consultants and clients who are sick of the status quo, who know that they can outperform PPOs. PPOs average, about 300% of Medicare in over half the states in the country right now, and those who are looking for a higher level of performance, but without sacrificing the member experience and want to put the benefit back in benefits. I think this is a perfect fit.
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Transcript:
What is Apta Health?
Apta Health is the evolution of our Apta Health program. Our Apta Health program was developed to provide guided healthcare to members so that we could help them at the onset of their healthcare journeys. The problem with that is that it is still only as efficient as the PPO networks on which it rests. Many of our clients are demanding more, which is why we developed the Apta Cash Program. Apta Cash leverages the ability to present directly with cash payments to providers, and then get RBP like outcomes. We combine that with guardianship so that we can ensure that the member experience stays to our very high standards.
How is Apta Cash different?
You can think of Apta Cash as a proactive protective version of RBP. As I mentioned, it's a proactive approach whereby we are actively having members go out and purchase their healthcare, but actually offering cash to the provider at that point of point of sale, at the point of consumption of the healthcare. So there are two primary types of cash pay claims. There are those that we facilitate with a debit card and merely by presenting a self-pay, we're actually purchasing just as efficiently as the federal government at a 100% of Medicare. There are those more significant claims though, where we're maybe inpatient outpatient procedures, and for those we're actively negotiating the claims. When you combine those two claims types, we're averaging about 130% of Medicare, which for those of you familiar with reference-based pricing is typically in excess of even what you're going to see. But by combining it with that guardianship approach, we're ensuring that the member still has that extremely high touch guided healthcare experience that Apta has become known for. We keep members in that cash lane by making sure that they don't have any out-of-pocket costs when they leverage cash. That means no deductibles, no out-of-pocket maximums, no copays, and we've been very effective with this approach.
Who is a good fit for Apta Cash?
I think it's for those consultants and clients who are sick of the status quo, who know that they can outperform PPOs. PPOs average, about 300% of Medicare in over half the states in the country right now, and those who are looking for a higher level of performance, but without sacrificing the member experience and want to put the benefit back in benefits. I think this is a perfect fit.
Book a 15-Minute Meeting with Chris Fisher
Learn how the 3x3x3 Challenge works and walk away with clear next steps.
Check Out the 3x3x3 Playback Report
Every 3x3x3 Challenge ranked by total seconds watched over the last 12 months.
Subscribe to The Floor Report
Get fresh insights from the Virtual Exhibit Hall every week, featuring the 20 latest 3x3x3 Challenges.