AultCare: A plan developed with the community in mind
Success is a Reflection of Dedicated, Hard-Working Staff
In 1983, Aultman Hospital President Richard Pryce called in his young personnel director Rick Haines. “Rick, I have a project for you,” said Pryce. “We need to start our own health plan, our own insurance company.” The goal, said Pryce, was to develop a quality plan with low premiums. The premium savings to companies, both agreed, would benefit the community.
Haines, who joined Aultman in 1981, had been part of a team working to reduce costs in the hospital. Pryce foresaw Medicare reducing its payments to hospitals, Haines said, and he wanted Aultman to be ahead of Medicare’s cost- reduction curve. This was the first component to starting AultCare.
After a year of development, AultCare launched in 1985 with its first member – Aultman Hospital employees. From there, it expanded as an administrator of self-insurance plans for several local businesses. In 1989, AultCare added a fully insured product, mainly to serve small businesses.
By 1994, it grew to cover more than 60,000 people. Today, AultCare has more than 2,200 employer members and covers more than 420,000 people, including more than 20,000 PrimeTime Health Plan members who benefit from AultCare’s Medicare Advantage Plan.
Its structure remains the same, said Haines, who is President and CEO of AultCare. “Offer high-quality insurance coverage at an affordable price by capitalizing on Aultman’s low-cost structure and utilizing a local network of high-quality Primary Care and Specialist physicians who are dedicated to the health care of this community.”
That structure allowed the goal to be reached, said Haines. “If employers are paying less for health care, they can invest in their companies, they can hire more people,” he said, and that is good for this community. If it is good for this community, it is good for AultCare and Aultman and the local physicians.”
The key to reaching the goal was to operate on slim margins when compared to traditional for-profit insurance companies. Since 1989, AultCare’s profit margin has been less than 0.2%, purposely kept low, said Haines, so the savings could remain in the hands of local companies and residents and be used to benefit the local economy.
By many measurements, AultCare has been successful. One number in particular – retention rate of members – reflects how the community has embraced the company’s health insurance products. Annually, 95 percent of customers continue with AultCare. The retention rate for national insurance companies hovers around 75 percent. “We have a great insurance company, working with a great hospital and a great group of physicians,” said Haines, “and that is how you keep customers and benefit the community.”
Haines says the staff is Ault- Care’s best asset. “AultCare began with a group of dedicated employees and it continues with them,” said Haines. “Our success reflects their hard work. They handle more than $728 million in claims annually, with 99.9 percent accuracy. More than 7,500 calls per week flow into our service centers and that staff treats each one as if a neighbor is calling; after all, we are Stark County’s only local health insurance company, so the caller very well may be their neighbor.”
As the health insurance world changes, AultCare finds itself as the local resource for companies and residents trying to understand health care reform. In 2013, for example, more than 4,000 area people have attended AultCare informational meetings about health care reform.
AultCare adapted to the ever-changing health care industry in the 20th century and into the 21st century. It began as a local business and stayed that way by being innovative. It is some- thing that makes all AultCare employees proud. “As the years go by, we will continue to make strategic changes to keep our local business viable,” said Haines, “because we know if we do that it will contribute to the viability of the community in which we all live.”
This article appeared in Stark 100 | The Canton Repository.