Changing TPAs can always carry a risk. Especially when the relationship has been in place for over a decade.
Recently, we caught up with one of our clients who moved to Broadspire after spending the past 12 years with another TPA. Their previous risk management program was less than outstanding and metrics weren’t showing good signs. While there was concern over the stress and logistical challenges of transitioning many years of old claims and data to a new TPA, our dedicated team stepped in to improve processes and build a more efficient and robust program while ensuring a seamless transition. A little over a year later, here’s what he has to say:
When we made the decision to move to Broadspire, my reputation was at stake.
I was the new guy coming into the company. I wanted to make big changes to improve our program following 12 years with our previous TPA. We are a large company with 16,000+ employees, so I knew our transition process would take time and there was a chance it would be difficult.
The relationship we had with our former TPA was longstanding but troubled. Adjuster performance was poor. They weren’t motivated and the turnover was extremely high. The case management program was just "OK". Network penetration rates were low and causing us to lose money. While our previous TPA’s overall pricing was low, given the other factors, it wasn’t enough. A variety of factors impacted our TCOR and we needed to fix them all.
From the first meeting with Broadspire, I got a good feeling. They were able to do things the other TPA simply couldn’t. I knew I had to champion this change.
Across multiple teams, I shared future plans for our risk management program. I spoke with dozens of people across various teams in the organization. We discussed where this TPA was falling short, and how Broadspire would be able to help us get where we needed to be.
Internally, there was concern over the stress of transitioning 12 years of old claims and data. Broadspire’s team and processes removed the concern right out of the gate. We were impressed with how seamless the transition was for takeover claims. And for new claims, the adjusters were ready from day one. What we heard would happen in the RFP actually happened.
At our previous TPA, the one highlight was our account executive. She provided the kind of support I thought would be hard to replicate. Again, I was pleasantly surprised.
As we moved to Broadspire, our AE, Doris, was able to provide the one-on-one support we’d grown accustomed to. Her partnership has carried on to this day. She is our advocate across the entire partnership and feels like an extension of our team. She offers strategic suggestions on how we can improve and makes sure Broadspire delivers. She’s also tough when she needs to be and truly has our best interests and goals at heart.
Only six months into our partnership with Broadspire, we were able to see immediate changes. We were closing older, takeover claims faster than with the previous TPA. Our overall experience improved as well. Adjuster response was faster, our account executive is always there to help, and senior leadership was fully engaged.
Now, a year later, our program continues to show stellar results.
- Our network penetration rate has skyrocketed from the original 65% to 91.5%.
- Our pharmacy program penetration rate is now at 97.7%.
- 62% of takeover claims were closed within 9 months.
- We achieved 26% savings in total incurred on takeover claims for total claims incurred at 21 months maturity.
- We also see direct savings through improvements in our indemnity claim count, average incurred, and claim closures.
Our needs and goals are clearly understood by Broadspire. Every day, we constantly work together to find the right solutions to help us get there. And, when we do find the right solution, they deliver on their promises.
With a program of our size, the decision to move TPAs carried some risk considering all the years we’ve spent with our previous TPA. But, it was a risk that, to this day, continues to pay off.