Meet a Health Plan Hero

Woodard Cleaning and Restoration

Industry: Cleaning & Restoration
Number of Employees: 238
Headquarters: St. Louis, MO

Woodard Cleaning and Restoration is a family-owned business in St. Louis, Missouri that began in 1946 when Earl and Nancy Woodard began to offer their customers in-home rug cleaning door-to-door, an innovation at the time. Today the Woodard family adheres to that same devotion to quality, customer service and innovation, not only with their core mission, but also their employee health plan. 

In 2020, Woodard was suffering through a 20% rate hike on its conventional carrier health plan and was now facing another increase of 37%. The company couldn’t bear to shift more costs to its employees, having previously already raised the plan’s deductible to a whopping $5,000, using a narrow network Instead, they engaged a transparent, unconflicted benefits advisory firm, Simpara, and set out to achieve three key goals: 1) reduce overall spending, 2) reduce employee spending, and 3) improve member benefits experience.

Starting in April, 2020, the company switched to an innovative benefit design that rewards patients who use a custom-built network of direct contracts with the local hospital systems. The plan uses independent, unconflicted, transparent and high-quality vendors for third-party administration, stoploss coverage, pharmaceutical benefit management, brand and specialty drug sourcing, surgery bundled contracts, and imaging procedures. Patients who access care, including more than 500 brand drugs, through these contracts pay zero in most cases. 

Woodard  has 238 employees, and prior to transforming their health plan, the company was projected to pay just over a million dollars. Instead, they ended up paying $761,000, saving almost a quarter million dollars. In the second year of the plan, Woodard was able to reduce their costs even more through a discounted stoploss premium due to the quality management of the plan. These savings did not originate from cost-shifting to employees. The plan’s savings would have been even more dramatic, but for Woodard’s commitment to reduce employee costs as well as the company’s. Employees now have zero deductible for most services and high-touch concierge care navigation, and lower monthly premiums.

Patients who seek care using the direct contracts have no cost-sharing, but even those who choose to go elsewhere have out-of-network can enjoy zero cost-sharing when they work with the plan to negotiate special contracts with their out-of-network doctors. For example, Woodard had an expectant mother who was going to an out-of-network facility and the plan was able to negotiate a maternity package that was the price of well-below-market-rates (100% of Medicare), and $0 to the mom-to-be. Woodard employees have also been able to obtain their medications at significantly reduced rates. One parent was taking a full day off work each month to handle medical bills and logistics for their special needs child. Through smart sourcing and streamlining the supply chain, the plan has reduced drug costs for this member’s child by 80%, and she no longer has to take a personal day every month.