Industry: Auto Dealer
Number of Employees: 500
Headquarters: Parkserburg, WV
Matheny Motors is a family owned company of automotive and truck dealerships, headquartered in Parkersburg, WV with more than 300 employees in 12+ locations across 5 states. They were facing year over year double-digit rate hikes as high as 50% and 30% on their fully-insured carrier plan. Equally bad, the plan imposed thousands of dollars in cost-sharing on patients before the plan coverage kicked in.
Starting in January 2020, the company switched to an innovative benefit design that rewards patients who use a relationship-based nurse navigator program to help with provider selection, second opinions, scheduling, care management, specialty medications, clinical and psychosocial support. Patients who access care by partnering with the nurse navigator program have their cost-sharing reduced to zero in most cases. These vendors are managed by a transparent, unconflicted benefits advisor, who designed the plan around employer/employee goals and no other interests.
The plan uses independent, unconflicted, transparent and high-quality vendors for third-party administration, pharmaceutical benefit management, specialty drug sourcing, and a center of excellence program (for patients with more complex conditions).
By prioritizing highest-quality centers of excellence for free (to the patient) diagnosis and second opinions, the Mayo Clinic intercepted a misdiagnosed cancer and spared a patient years of anguish and inappropriate and dangerous treatments.
In the first two years of the plan, Matheny Motors saved $375,000 (37%) while simultaneously offering patients a re-humanized health plan that leapfrogs access barriers, handholds patients through complex care needs and high-cost drug sourcing, while eliminating or dramatically reducing their cost-sharing.