AULTCARE HEALTH PLANS
VALUE IMPACT
AultCare’s core beliefs are as deeply rooted today as they were at our inception. • Local access to quality care • Primary Care Physician engagement • Strong commitment to cost control • Exceptional customer service These core beliefs matter to us, and they matter to our customers. Within these beliefs, we offer a ‘Value Impact,’ which leads to a lasting influence to lead our community to improved health. Through strategic endeavors and innovative ideas, our products, partnerships, coordination, network, and service seamlessly combine to provide the foundation of our core beliefs and our efforts to deliver value. As healthcare continues to evolve, AultCare will also make the necessary advancements to remain competitive in the industry. Throughout this progress, we will stay committed to our core principles and will be proud to serve our members, clients, providers, and brokers. You Matter.
A DIVERSE SPECTRUM OF VALUE
Cost Control
Products and Services
Partnerships
Care Coordination
Network Access
Customer Service
Cost Control Integrated strategies to control pharmacy and medical spend • Network – Offering a controlled network while emphasizing quality, cost-effective care • Population Health Management (PHM) – A service provided to keep members engaged with their health and better control healthcare spend • Pharmacy Management – Variable Copay Solutions (VCS) – Leverages pharmacy coupon card for the employee/ employer benefit – AultSaveRx – State-of-the-art pharmacy transparency product • Reference Based Pricing – Alternative payment methodology promoting in-network care • Consumerism – IBM® Medical Cost Estimator – Empowers members to take control of their healthcare decisions through transparency of costs • Artificial Intelligence – Promotes process improvement to enhance integrity and financial savings • Wellness Services – Provides a 5.54% reduction in risk-adjusted per employee per month (PEPM) spending equating to a total savings of $69.97 PEPM between 2016-2020.*
Products & Services
Experience a complete spectrum of healthcare • Health – Self-funded – Insured
• Workers’ Compensation – Managed Care Organization (MCO) – Third Party Administrator (TPA)
• Dental
• Multiple Employer Welfare Arrangement Administration (MEWA)
• Vision
• Medicare Plans • Health Reimbursement Arrangement (HRA) – Medicare Advantage (PrimeTime Health Plan) – Medicare Supplement (PrimeTime Choices) • Health Savings Account (HSA) • Other Ancillary Products • Reference Based Pricing – Life Insurance – Accidental Death and Dismemberment (AD&D) – Short Term Disability (STD) – Long Term Disability (LTD) – Pet Insurance • Flexible Spending Account (FSA)
• Wellness – Health & Wellness Centers • Data Reporting and Analytics – Predictive Modeling – Self Service Employer Reporting • Stop Loss Coverage Products
Partnerships
A greater value on local and national levels AultCare understands the importance and value of collaborating with organizations on a local and national level to meet the healthcare needs of our customers. • Northwest Group Services (NWGS)
• AllHealth Choice
• Canton Regional™ Chamber Health Fund (MEWA)
• Milliman MedInsight®
• HealthEquity
• OptumRx®
• DenteMax®
• CCS Medical®
• IBM®
• VSP® Global
®
Care Coordination
Behind the scenes integration of healthcare Located under one roof, all of AultCare’s health and wellness services are streamlined into one collective program giving members the education and resources they need. • Population Health Management – Serves as the link between the member, the Primary Care Physician, and the health plan to help the member navigate the healthcare system and receive integrated care • Pharmacy Management – Works alongside prescribing physicians to ensure members receive the most appropriate, cost-effective medications • Disease Management – Provides members with education on prevention; ensures members with chronic health issues have the tools and services necessary to improve their health, including remote patient monitoring • Case Management – Promotes quality, cost-effective outcomes through assessment, planning, coordination, education, and referral • Utilization Management – Helps control costs through efficient management of healthcare resources • Wellness – Identifies and helps members understand their risks and assists members in decreasing those risks through coaching, goal setting, education, encouragement, and support
Network Access A wide spectrum of choices Our network grows to accommodate the needs of our membership. With more physicians, hospitals, and telemedicine choices in network, the options are plenty. • Over 40 network hospitals including University Hospital Health System locations • Over 16,000 network providers • 24/7/365 nationwide access through Teladoc® • All CVS MinuteClinics® nationwide • Cigna® National Network Access (Available to members outside of the AultCare network)** Centers of Excellence (COE) A COE is composed of highly skilled experts dedicated to a specific therapeutic field. University Hospitals is a COE for AultCare and it is strictly based on an approved referral from the AultCare Utilization Management Department.
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Customer Service A personalized approach
Superior customer service was embedded in the AultCare philosophy from the beginning. A simple request to answer the phone launched an organization-wide campaign to deliver personalized customer service. With each day, our colleagues and members alike, take pride in the human aspect of the AultCare culture. We implemented new features to provide convenient customer service. Online chat (available to all Self-Funded members) connects members to a customer service representative within minutes. Our website and mobile app were upgraded to give members access to their healthcare information wherever they may be.
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Community
A company-wide initiative to give back
Our community is the reason AultCare began over 37 years ago and together, as an organization, we are inspired to give back. Each year, an average of 130 employees donate more than 1,400 hours of time at local, nonprofit organizations. Additionally, AultCare supports a wide variety of local events, projects, and initiatives through sponsorship funds. Annually, AultCare provides over 40 scholarships to graduating seniors in high schools that are part of our five county service area. We take great pride in supporting the future leaders of our community. Through our AultCaring in the Community campaign and our scholarship program, we continually invest in collaboration, our youth, and our community, which we serve with gratitude.
2600 Sixth Street S.W. Canton, Ohio 44710 330-363-6360 1-800-344-8858 TTY: 711 www.aultcare.com *All statistics provided by AultCare Data Reporting. **Members who reside outside of the AultCare network may access the Cigna PPO Network for Shared Administration. AultCare is an independent company and not an affiliate of Cigna. All 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, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. Information and Statistics are reflected from 2021.
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