Advisers seeking ways to help their clients contain their healthcare expenses are partnering with Amino, a data company that assists employees in making cost-based medical decisions.
San Francisco-based Amino, which sells its services exclusively through benefit advisers, tracks pricing and care quality metrics for some 35,000 healthcare facilities, 125 health insurers and 6,500 procedures across the U.S. Around two million consumers — most of whom are employees — use the service each month to determine where they can get the most affordable deal on the medical treatment best suited to their needs.
Such visibility is key to controlling medical expenses, says Amino CEO David Vivero, who notes that, according to a recent Gallup poll, the cost of healthcare has become the country’s No.1 financial concern.
“We’re reaching the point where our out-of-pocket healthcare costs surpass what we are paying for rent and mortgages, groceries or student debt,” Vivero exclaims. “There’s an urgent need for accessible, easy to understand information on cost and quality that can help us save more without sacrificing our health.”
If anything, Vivero adds, this matters even more to employers, who on average foot 69% of their employees’ medical bills. “Given that 80% of companies with more than 500 employees are now self-insured,” he notes, “they’re on the hook for bills big and small.”
Also see: “Transparency tool seeks to end ‘secret pricing.’”
Amino helps contain the size of those bills by making it simple for employees to determine what different providers charge for the same procedure. It does this by analyzing claims data from Medicare and up to 80% of private insurers, continuously adding new claims to its database of more than 10 billion health claims within 48 hours.
In a local or regional healthcare market, where the cost of an identical procedure can vary by many thousands of dollars, providing employees with a simple-to-use tool to locate the low-cost provider can make an enormous difference in their out-of-pocket costs, says Mark Gaunya, a principal and the chief innovation officer at Borislow Insurance.
“Costs for certain tests can vary dramatically,” says Gaunya. “It’s not uncommon where the cost of an MRI, for example, is $4,000 at one facility, but if you drive 10 miles down the street, the cost for the exact same procedure is $475.”
An exhaustive RFP
Borislow is an employee benefits agency based in Methuen, Mass. In 2014, it launched a program to help middle-market employers, with between 50 and 500 employees, self-insure by pooling their reinsurance costs. Then last fall, Borislow introduced the Amino service as part of that program, following what Gaunya terms “an exhaustive RFP process” that compared offerings from five or six health cost transparency providers from around the country. Borislow’s clients participated in the selection process and preferred the Amino service, “because it gives you the actual, contracted cost, as opposed to simply the cost range provided by some other services,” according to Gaunya.
As part of its offering, Borislow provides a 24/7 concierge service to help the employees of clients locate and schedule appointments with the low-cost providers in their area. Through an app that Borislow provides, both the concierge attendants and the employees have access to the Amino database. Employees can either call the concierge desk or, using the app, search for a provider themselves. In addition to avoiding higher out-of-pocket costs, employees receive a contribution to their health savings accounts from their employer, each time they make use of the low-cost provider.
Amino charges a per employee per month fee, which varies based on the number of employees. In some instances, Borislow pays the fee on behalf of the client, while in others the client pays it directly. But, in either case, Borislow treats it as a pass-through expense and does not markup the cost of the service. Amino’s value to the agency, Gaunya says, is how it helps clients get control of their healthcare costs, which are rising four-to-five times faster than any of their other business expenses.
“Amino is a transparency solution, and that’s a core component of what we offer our clients,” explains Gaunya. “If their employees can’t see how much things cost, or what the quality of those services are, how are they going to make an informed purchasing decision? The answer,” he says, “is that they’re not.
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