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Our Health Care System is Broken. It Can Be Fixed.

Ashok Subramanian

April 20, 2020


If insanity is the act of doing the same thing over and over again and expecting different results, our health care system is insane.


This madness is more apparent than ever in light of the COVID-19 pandemic. Small businesses that thrived just weeks ago are now facing an existential crisis, and those that somehow make it through this unprecedented economic turmoil will have to cut costs — including benefits— to move forward. At the same time, health care providers are losing hundreds of millions of dollars in revenue as they are forced to suspend any services deemed elective. Moreover, the fact that millions of people could lose long-term access to health coverage in just a matter of weeks reveals the fragility and ineffectiveness of our entire health care system.


Until now, many people treated the idea of lowering health care costs as a dream that would be nice to achieve one day. COVID-19 should end that way of thinking. This pandemic is a watershed moment in health care, and if we do not find a way to bring down the cost of coverage without eliminating the quality of that coverage, our entire society will suffer irreparable harm.


The high cost of care is a problem we’ve been trying to address for a long time. After 20 years working in the health care benefits space, we founded Centivo because we realized that even though workers have lots of health care options, none of them are very good. Our goal is to create the kind of health care plan that we would be proud to offer our own family members. We’re accomplishing that by harnessing local health systems and practices in order to deliver benefits that are high-quality and affordable for businesses and their employees, and we’re thrilled to be launching our new health plan in three markets: Metro New York, and Orlando and Jacksonville, Florida. And to serve the markets where Centivo’s plan isn’t yet available, we can also partner with employers and their advisors to implement customized local solutions.


Building the kind of health care coverage we want for our own families means putting primary care doctors at the center of the plan — with a dedicated care team that helps members get the right care, at the right time, from the right provider. Almost all health care is local, so we built local networks that include the best independent practices and health systems based on data and analytics. These are the doctors we know will focus on preventive care and condition management, steer patients away from low-value options, and are available outside the typical 9am to 5pm window. The result is an easy-to-use plan that includes free primary care provided by teams our members select for themselves, and simple, predictable co-pays for other in-network, coordinated care. Thanks to a partnership with Cigna, employees can either choose the Centivo plan or a more traditional plan option that accesses Cigna’s national network* while Centivo handles the administration.


The Centivo model means employers can save 15 percent or more across the board vs. traditional health plans. In fact, an employer can reduce costs approximately $425 per employee. For example, last year an employer with 8,000 eligible employees offered a Centivo plan for the first time, along with a high-deductible option and a PPO. Centivo’s plan came with no deductible, free primary care, and $30 specialist visits provided referrals came from a member’s primary-care team. The premium for the Centivo plan was just $10 more per pay period than the high-deductible plan, and $23 less per pay period than the PPO. Compared to 2018, employees who signed up for the Centivo plan visited a primary care physician 23 percent more, saw a 53 percent increase in preventive care visits, and visited the emergency room 31 percent less.


Centivo works hard to offer employers cost-effective coverage that doesn’t sacrifice quality, and to offer employees the peace of mind that comes with access to quality care at an affordable price right in their community. Any plan that doesn’t provide those things is simply insane.


*Centivo accesses three Cigna networks: the Cigna Open Access Plus (OAP) network for Shared Administration, the Cigna PPO network for Shared Administration, and the Cigna LocalPlus® network. The Cigna OAP, PPO and LocalPlus networks refer to the healthcare providers (doctors, hospitals, specialists) contracted as part of each network. Centivo is an independent company and not an affiliate of Cigna. Any Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company. The Cigna name and other Cigna marks are owned by Cigna Intellectual Property, Inc.

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