Transparent RBP Model Streamlines Healthcare Costs

Case Study Snapshot
  • Southern California
  • Privately Held Commercial Bank
  • Low Balance Bill Activity
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THEIR STORY OFFERS

Real World Success

data-driven insights

proven solutions

THE CHALLENGE

A New TPA & RBP Partner Search

Sunwest Bank faces the challenge of aligning its innovative and entrepreneurial approach with an efficient healthcare plan. Previous experiences with reference-based pricing (RBP) vendors were heavily influenced by the relationship with their third-party administrator (TPA). Looking to change their TPA and the need for a cohesive and streamlined strategy, Sunwest Bank began exploring alternative RBP partners.

OUR SOLUTION

A Simplified, Transparent RBP Model

AMPS became an ideal partner for Sunwest Bank because of our transparency, user-friendly reporting, and strong collaborative relationship with the bank’s TPA. Through our RBP model, common errors in medical bills were rectified. Claims were repriced fairly at a percentage of Medicare rates, resulting in low balance bills.

Results

The Power of AMPS

Since partnering with AMPS in 2021, Sunwest Bank has seen significant changes in their healthcare expenses. The initial billed charges in 2022 amounted to $1,557,564. AMPS reduced these charges through strategic negotiations, resulting in an adjusted amount of $350,337—an impressive 77.5% discount through RBP. This reduction equates to substantial savings totaling $1,207,227

Challenge
The effectiveness of various RBP vendors was contingent upon the bank’s partnership with their TPA. As they sought to change TPAs, the bank aimed to explore new, more transparent RBP partners.
Solution
The effectiveness of various RBP vendors was contingent upon the bank’s partnership with their TPA. As they sought to change TPAs, the bank aimed to explore new, more transparent RBP partners.
Results
$1.6
MILLION OVER 2 YEARS Saved
76.5%
Savings Over 2 Years

BECAUSE OF AmPS,

“AMPS has made RBP simple. When things are simple, my staff is happier and my employees feel better using their benefits.” - Kara, an AMPS customer

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