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The Regenexx goal is to reduce the burden of orthopedic surgery on self-funded health plans and subsequently reduce the cost of company…
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The Regenexx goal is to reduce the burden of orthopedic surgery on self-funded health plans and subsequently reduce the cost of company orthopedic care by 50% or more. Orthopedic care makes up roughly 20% of health plan spending, and we can save partners up to 70% on elective orthopedic procedures while offering a valued alternative to orthopedic surgery.* When plan members are offered Regenexx procedures with insurance coverage they are choosing Regenexx in lieu of surgery a majority of the time.

The key to valuable use of a direct contracting partnership such as Regenexx is to have proper strategies aligned with consumer behavior. Strategies that help direct the best care decisions include covered travel to centers-of-excellence, step therapy practices, high deductible plan design and ongoing education about benefits options – all of which Regenexx has built as part of a turn-key on-boarding and implementation process for our partners.

Part of the Regenexx value is the architecting of and execution of a well designed direct contracting experience that encourages employee utilization in perpetuity. Proper positioning of Regenexx within an existing health plan is part of our execution strategy and comes at no cost to the plan owner. Regenexx has designed a proven education platform that informs your employees of the options in care and properly manages the pathway to orthopedic surgery so that surgery is only used when medically necessary.

One of the most effective education tools is the Regenexx benefits card that enables employees to understand the covered benefits available to them and make well-informed decisions at the time of an orthopedic event. Because orthopedic injuries are episodical, the best education elements are those that are present at the time of injury when the patient is considering treatment options.

*This applies only to elective orthopedic surgery without fracture related care and acute care trauma.

The Advantages of the Regenexx Benefits Card:

A Regenexx partner with a national footprint of 17,000+ health plan members added Regenexx effective 1/1/2019. After initially seeing limited utilization in the first quarter due to inadequate utilization enactment, this client implemented the Regenexx Benefits Card and experienced 20 times the engagement with roughly half of all inquiries generating a consultation to avoid a surgical encounter.

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We created a new pathway in medical care that no longer directs patients straight to surgical options. It is imperative to intervene on innovative care like Regenexx treatments to make members aware of an alternative option so they can make a fully informed decision. The Regenexx Corporate Program includes several ongoing utilization strategies like the benefits card that directs patients to the correct pathway of medical services and creates a high value health care option with significant corporate savings.

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I INTERVIEW WITH WALLY GOMAA

Title: CEO and Co-Founder
Company: ACAP Health
Industry: Health Consulting
Client Base: Several million members from greater than 2,000 employers

1. What are you seeing in the industry as far as the MSK diagnostic category?

We started ACAP Health back in 2006 to offer employers measurable strategies to slow the amount of disease we produce as a country. When we think about the highest cost category for most credible sized employers, musculoskeletal issues rank at the top, that’s higher than heart disease, higher than cancer, even higher than diabetes. A great deal of that is from orthopedic surgeries. Today employers spend more for unnecessary surgeries than ever before and we are looking for ways to curb that unnecessary spending. From statistics, we’ve seen more than half of knee surgeries either do not produce the desired outcome or were not necessary to begin with.

2. How do you encourage your employers to strategically attack orthopedic care as a top expense category?

We really think employers should look at dealing with orthopedic costs as a step therapy approach. In the past, employers have lacked the benefit of innovative solutions in this area. Rather than going straight to orthopedic surgery, we like the opportunity to bring other options, like Regenexx, to the treatment process that can help an employee avoid surgery all together. Regenexx is one of the first innovations we’ve seen that has had an impact on the orthopedic space. One of our clients that implemented Regenexx as a step therapy before surgery saw that the majority of patients who had a Regenexx treatment were able to avoid surgery altogether.

3. Can you talk about how simple it is to add to an existing plan?

Any program that is going to add more work for the HR and benefits team is going to be a non-starter. Regenexx is really simple to add to an existing benefits plan as virtually all the activities are performed by the Regenexx team for the installation. It means very little work for an employer and lives inside the benefits plan, which makes it very easy.

4. ACAP was at the forefront of bringing Metabolic Syndrome to the market when it was considered investigational, yet you still pursued this. How is the Regenexx experience similar?

ACAP Health prides itself on bringing innovations to the industry, sometimes before the industry was ready for them. We saw that when we introduced Metabolic Syndrome to employers and did not get universal support from the clinical community or the insurance industry yet employers continued to demand a solution. The exact same thing is happening now in the orthopedic space which is the reason why we have partnered with Regenexx. We can now help patients avoid surgeries and feel better more quickly and will continue to work with the industry to adopt Regenexx as a universal standard. There is too much anecdotal support and research that shows Regenexx is helping patients to not pursue this for our employers.

5. Please explain the considerable time and analysis you went through before introducing the Regenexx Corporate Program to your employers.

ACAP Health is intentional about reviewing intervention partners to verify they can make a clinical impact and are medically safe. We were pleased with how much Regenexx has conducted over the years and unlike other stem cell therapies Regenexx gave us the confidence that it was the most tested and researched in that category. We looked closely at the randomized control trials, the peer reviewed data and the national clinical registry with published outcomes which all got us excited and confident about introducing the Regenexx Corporate Program as a real strategy to our clients.

6. Why do you believe that adding the Regenexx Corporate Program will save employers up to 70%?

Regenexx is going to be at a lower price point than an invasive surgical procedure. In addition, employers are going to avoid non medically necessary surgeries from being performed by going through the Regenexx evaluation and procedure before jumping to surgery. We lower the price of treatment, plus we lower the number of surgeries performed, and subsequently see a lower cost. It’s ultimately about avoidable surgeries. The ability to avoid even a single surgery is an opportunity for an employer to see an immediate impact to their financials.

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HUB INTERNATIONAL ANNOUNCES PARTNERSHIP WITH REGENEXX TO REDUCE ORTHOPEDIC SURGERY COSTS FOR EMPLOYERS

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To read the Press Release, click here.

I CONTACT US

Find out how you can add Regenexx to your self-funded health plan. Call Regenexx at 877-341-5968.

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Regenexx 6151 Thornton Avenue Des Moines, Iowa 50321 United States (515) 523-7090

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