Nightingale Education Group drives 13% decrease in annual net paid claims with Garner
Key Results
13%
decrease in net paid claims
88%
lower employee out-of-pocket costs when utilizing Garner
61%
of all employees used Garner to find a doctor
Nightingale Education group, a Salt Lake City-based nursing workforce developer, previously offered a traditional PPO with a $2,500 deductible and a HSA plan. Employees faced high out-of-pocket (OOP) costs and lacked support in finding high-quality, affordable care.
Background
Nightingale Education Group is a Salt Lake City-based nursing workforce developer covering 530 lives in higher education across the western United States. To meet the needs of a diverse workforce, the organization previously offered two fully-insured plan options:
- A traditional PPO with a $25 co-pay, a $2,500 deductible, and a $6,500 out-of-pocket maximum.
- An HSA-eligible HDHP with a $3,500 deductible and a $6,350 out-of-pocket maximum.
Both plans were familiar, well-understood benefit structures, but neither did much to help employees actually find or afford the care they needed.
The challenge
Even with two plan choices on the table, employees faced high out-of-pocket (OOP) costs and lacked support in finding high-quality, affordable care. The PPO carried a $6,500 OOP maximum and the HDHP a $6,350 OOP maximum, meaning a single complex care episode could expose a member to thousands of dollars in spending. And on top of the financial exposure, employees were left to navigate provider selection on their own, with no guidance on which doctors in their network actually delivered better outcomes at a lower total cost.
Nightingale needed a way to steer employees towards better care and reduce medical costs without forcing a disruptive network change or shifting more cost onto its workforce.
The solution
To address these challenges, Nightingale partnered with Garner to introduce two new compelling plan design changes. They continued to offer both PPO and HDHP options, but now layered Garner on top in order to steer employees towards better care and reduce medical costs.
- For the PPO with a $4,500 deductible, Garner funded a $2,000 HRA
- For the HDHP with a $5,500 deductible, Garner also funded a $2,000 HRA
Employees were encouraged to use Garner's platform to find top-performing doctors across key specialties.
Plan design: Before Garner vs. After Garner
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The results
The results were immediate and impactful. A majority of employees — 61% —used Garner, locating high-quality providers in specialties such as OBGYN, dermatology, mental health therapy, and pediatrics. And these employees who used Garner saw an average 88% reduction in OOP costs by the end of their first year. By steering members to better care, the organization avoided more than $178,000 in unnecessary healthcare spending, resulting in 13% lower net paid claims.