In the rust belt town of Ashtabula, Ohio, Ashtabula Area City Schools, an inner-city school district within Ohio’s 8th poorest County, faced a daunting challenge. Year after year, they continued experiencing rising healthcare costs, and no real solutions to improving patient care while finding a way to lower costs.
Undeterred by these obstacles, Ashtabula Area City Schools set out on a transformative journey to redefine their health plan. In the Fall of 2019, they made a bold decision to embrace an innovative benefit design that would not only curtail costs but also prioritize patient care for their employees and families by use of independent providers such as a Community Pharmacist, a Direct Primary Care physician, and other independent provider groups.
The cornerstone of their new plan was a relationship-based nurse navigator program, aimed at assisting employees in navigating the complex healthcare landscape. This program offered support with selecting providers, seeking second opinions, managing care, accessing specialty medications, and providing the concierge-style model of Advanced Primary Care. Employees and their family members who partnered with the nurse navigator program were rewarded with reduced or zero cost-sharing healthcare services, making healthcare free in many instances.
To ensure the highest quality of care, autonomy, and transparency, Ashtabula Area City Schools selected unconflicted vendors for third-party administration, pharmaceutical benefit management, direct primary care, in addition to patient navigation. These vendors were chosen based on their commitment to excellence, transparent practices, and alignment with the employer and employee goals, free from any conflicting interests.
The results of Ashtabula Area City Schools’ innovative plan design were nothing short of astounding. In just the first year, the school district saved a staggering $2.4M, representing a remarkable 21% reduction in healthcare costs. As we close out their 3rd policy year, AACS expects to realize a full $10M+ in savings. Simultaneously, employees were provided with a best-in-class health plan which eliminated or significantly reduced their out of pocket costs, breaking down access barriers and offering members the support they needed throughout their healthcare journeys.
Ashtabula Area City Schools’ playbook serves as a shining example of how a dedicated and forward-thinking public entity can revolutionize healthcare benefits while saving its community and employees’ much needed resources. As their story continues to inspire other organizations, Ashtabula Area City Schools stands as a beacon of hope to public school districts nationwide, proving that with determination and buy-in from teachers and unions, everybody wins.