Case study: SimplePay Health

Case study: SimplePay Health
October 17, 2024 Sue Riordan
Case study: SimplePay Health
Simplifying the Path to Savings and Top-Quality Health Care

We’re an administrator built around making health plans simple, transparent and versatile. So,
naturally we’re drawn to other solutions in the marketplace who are doing this, too.

SimplePay Health is transforming health care from the inside out. Plus, they share many of our
own values, including improving savings, member experience and access to high-quality care.

But what is SimplePay? And what can clients expect when they implement an alternative health
care plan such as this?

Our latest case study will dive into this. We’ll also be exploring real-life results Meritain Health®
customers have experienced after implementing SimplePay Health.

What’s driving customers to alternative health care plans?
    • Employers are looking for new strategies and new models of insurance as inflation climbs.
    • Employees need help with costs in the midst of an affordability crisis.
    • Health care as an industry consistently ranks low in terms of simplicity and being able to use and understand.
    • Customers want a simpler, all-around streamlined experience with fewer obstacles.
Is the adoption of alternative health care plans expected to grow?

Yes. Alternative health care plans are expected to grow to approximately 30 percent of market share in coming years. It’s being compared to the adoption of high-deductible health plans (HDHPs) in the early 2000s.

How does SimplePay work?

SimplePay offers a simpler model and experience with less confusing paperwork. In this model, deductibles and coinsurance are removed in favor of copays which are aligned around provider quality. Copays can be low, medium or high—but are lower for higher quality providers. This is what drives the bulk of the cost savings.

So, as an example, if a member patient needs knee surgery:
    • They can choose any in-network provider they prefer.
    • The patient is able to base their decision around price (also based on quality).
    • One bundled copay amount will cover everything, from admission to discharge.
    • They’ll receive one total monthly statement.
    • They can pay this over time, with zero percent interest.
    • The member patient has price certainty for services and no unexpected out-of-pocket costs.
Average results from SimplePay

SimplePay Health has worked with clients around the country. And those experiences have been producing consistent results. Here are some typical results they project for clients:

    • Average claim savings of 12 percent.
    • Greater utilization of top-tier providers, up to a 60 percent increase after implementation.
    • Average rise from 26 percent utilization before SimplePay to 86 percent after.
    • 92-percent satisfaction rate from members (based on how they felt about SimplePay versus their prior year medical plan).
Conclusion

While we recognize alternative health plans might not be right for everyone, they can be the right fit for certain clients. Results we’ve seen from our own book of business have shown solutions like SimplePay can in fact lower employee and employer costs, while making a significant dent in the total cost of care.

To learn more about what’s possible with solutions like SimplePay, contact your Meritain Health representative.

Download this case study.

The reference to previous outcomes made as a part of this communication does not guarantee success in any new or future case(s), as the result of each case depends upon many factors, including the facts of each case.

This material is for information only and is not an offer or invitation to contract. Health benefits and health insurance plans contain exclusions and limitations; see your plan documents for complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary and are subject to change.