Centrus Health Kansas City lands clients like Nebraska Furniture Mart with its health insurance alternative

Centrus Health Kansas City is giving employers an alternative to traditional health insurance, and central to its mission is improving quality of care and health outcomes for patients while also reducing health care costs.

Founded in 2017, the Westwood-based clinically integrated provider network (CIN) is gaining traction. Its local direct-to-employer clients include big names such as QuikTrip and Nebraska Furniture Mart (NFM), which became a customer two years ago through its Kansas City, Kansas, store. An insurance broker introduced the two entities.

Winning NFM was validation that Centrus Health is headed in the right direction, said Jill Watson, Centrus Health executive director and a 2020 Women Who Mean Business honoree.

"To be selected by a prestigious company like that was gratifying," she added. "It's also been a ton of learning since we have been working with them."

CINs allow health care providers to work together without a merger agreement and collectively enter direct to employer contracts and value-based contracts with major payers.

Centrus Health's network now surpasses 2,000 providers, including primary care physicians and specialists, across 440 locations in the Kansas City metro. It includes the Kansas City Metropolitan Physician Association and major health care systems such as The University of Kansas Health System, AdventHealth, Meritas Health and Children's Mercy Health Network.

Centrus Health's network embraces a value-based model, which means it's focused on helping patients be as healthy as possible, including through preventative care, while keeping costs in check.

"You are aligned with providers that are doing what's clinically relevant," she said. "If you have a chronic disease, they’re helping to coordinate care when necessary and helping you manage your chronic disease so you don't continue to get worse, which typically costs you more time and money and impacts your health."

On average, Centrus Health helps its payer and employer clients save 12% in health care costs. The CIN serves a patient base of about 185,000 people, but by 2024, Watson expects to reach 200,000. Its future goals include maintaining a strong network that meets the community's needs and can help Kansas City be a destination for businesses, she said.

In addition to its value-based model, Centrus Health's hands-on approach sets it apart.

"It's a much closer relationship than what you’d experience with a traditional model," Watson said. "We’re able to do unique things that don't come about in a typical relationship that has a carrier in the middle."

Centrus Health, for example, has a biweekly call with NFM to stay abreast of employees’ health needs and solve their challenges, such as finding a specialist or getting an appointment scheduled sooner. Watson likened it to a help desk or ombudsman.

"It also helps the employer know what's on the minds of their employees, what matters and what do they need?" she said. "They don't have to wonder if the insurer is providing everything. They have a lot better feedback on what they need and are they getting it?"

Centrus Health also can schedule health fairs for employers, but instead of using a vendor, it uses providers within its network who can see employees for follow-up care and build an ongoing relationship.

Centrus Health earns revenue through quality performance bonuses, care coordination fees and shared savings programs by meeting both cost and quality of care benchmarks. Last year, Centrus Health achieved roughly $10 million in shared savings, which it distributed among its provider network; part of that was driven by working to prevent hospital readmissions and unnecessary emergency room visits.

Although the Kansas City metro is still a traditional insurance market, more employers are voicing interest in Centrus Health, she said. Having employer clients like NFM also helps.

"Having local experience you can point to in a market is going to be helpful," Watson said. "It's hard to just sell a theory to people. People like to see something that's really working and see what's gone well and what's gone wrong. A lot of people don't want to be first."

As employers face rising costs, such as inflation and interest rates, CINs also become more attractive because they can help employers save money on health care costs.

"Given the economy, I think people are having to think about every cost," she said. "It is forcing people to think about what options do they have, and so for that reason alone, I think people start looking at innovations they might not have had on the table before."