Amy Turner, Innovation Health Chief Operating Officer and Executive Director
 
Health plan prices for small businesses have been on the rise. Since the passage of the Affordable Care Act (ACA) in 2014 many are looking for new solutions to control costs and create more flexibility for employees.
 
What level funded plans do is create a new plan option for small businesses that enroll five or more employees. Because they sit outside of the community rating provisions of the ACA, these health plan options can price risk appropriately while offering several other benefits for small businesses. 
 
If you are a small business looking for a new health plan option, here is what you need to know.
 
Cost Savings
In today’s ACA environment we have what is called pooled risk. This means that many businesses may be paying more for their healthy group than needed based on that specific group’s risk composition. These new plans have the potential to save businesses as much as 25% a year which could result in savings as high as $72,000.[1] 
 
And employers also get the added benefit of multiple plan designs, greatly improving employee choice. With a diverse workforce reflecting different age groups and health plan needs the ability to pick from multiple plan designs not only benefits employers but empowers their employees to choose what is right for them.
 
Adjusting Utilization
Because level funded plans are created and operated differently employers may have the ability to get money back at the end of the year. With the potential to receive a surplus at the end of the year, there is a vested interest in changing utilization rates inside a company.
 
In the past, when paying fully insured plan coverage, there was little incentive for employees to get healthier or exercise. Under the level funded plan designs, because businesses can see a financial surplus at the end of the year (changes in utilization of services will affect the potential for a surplus), wellness and employee engagement to help employees stay healthy will have an even greater impact.
 
Today, 50 percent of the businesses that buy level funded plans get money back at the end of the year. What employers should know is that if they are interested in exploring these plans, they have a few options. The first is talking with their broker to see if these plans might benefit their employees. The second is that they don’t have to wait until their current fully-insured coverage renews to change their coverage.  Even if a company renewed their insurance a few months ago, new options might be able to save them more money, now.

[1] Actual results may vary. Illustrated savings are calculated by comparing total costs for a self-funded Innovation Health Funding Advantage plan case with narrow network coverage and the premiums for Affordable Care Act fully insured small group case with broad network coverage (calculated January 2017). Not all groups meet the eligibility criteria for Innovation Health Funding Advantage, including underwriting requirements related to the stop loss insurance. Innovation Health is not a provider of health care services and, therefore, cannot guarantee any results or outcomes. Health benefits and health insurance plans contain exclusions and limitations. Information is believed to be accurate as of the production date; however, it is subject to change.

Crystal Icenhour, PhD -- one of the rising stars in the field of biotechnology -- is a Chamber member who’s making waves across the country as CEO and co-founder of Aperiomics. She and her growing team in Ashburn are helping to save lives by completely changing the way medical professionals detect infectious diseases.  And the press, medical professionals, clinicians, patients and investors are taking notice.
During the first six months of 2017, Aperiomics grew its customer base ten-fold.  Each customer, such as a clinician or doctor, can represent multiple patients. The company is closing on its seed round of funding very soon – all of it from individual investors who believe in what Aperiomics is doing. Revenue during the same period alone was higher than the entirety of the company’s revenue since it started in 2014. 

Icenhour’s mission is to completely change the way the healthcare space tests for pathogens. And no wonder: Up to 75% of infections are never accurately diagnosed, leaving millions of people suffering from chronic infection. According to the Centers for Disease Control and Prevention, each year in the United States, at least two million people become infected with bacteria that are resistant to antibiotics, and at least 23,000 people die each year as a direct result of these infections. Aperiomics, under her leadership, has developed a technology that identifies all known pathogens - every bacteria, parasite, virus, and fungus - from clinical samples in one test – often when all other tests fail.

The results are amazing.  For example, Aperiomics helped a young patient who had a mysterious illness for six years! Test after test and treatment after treatment failed to detect the reason. Icenhour and her team helped the young man’s doctor determine the cause in just a few weeks and now he is recovered and well.  Among all of customers that Aperiomics has helped, about 300 are patients for whom their doctors could not find a solution to their illnesses until their DNA was analyzed by Aperiomics to detect which pathogens were present.  For some it was a life-death issue. 

Here’s how it works: Doctors collect a sample (blood, swab, urine, fecal, etc.). They send it to Aperiomics for a full DNA analysis of all microorganisms. Aperiomics receives that analysis in the form of a terabyte of data. The Aperiomics team then analyzes the data using their proprietary software technology and can quickly identify the specific pathogens in the sample. Their method saves people thousands of dollars and months of wasted time being sick. No other company has this capability and scope in the healthcare space. 

“As members of the Chamber, the contacts we’ve made and the knowledge we’ve collected about doing business in Northern Virginia have proven invaluable to our team,” says Icenhour.  And those contacts are springboards for reaching potential investors that are helping us grow and serve more doctors and their patients.”    

Aperiomics has received more than $1.6 million in grants from the National Science Foundation.  The latest is $100,000 to help improve its development of DNA analysis. Aperiomics just completed a pilot study with Lifenet Health -- the nation’s largest repository of human tissue -- in VA Beach to test pediatric cardiac tissue.  They lose 40% of pediatric cardiac tissue due to bacteria.  Aperiomics is helping them to solve this issue.  

Icenhour holds two patents, has authored and co-authored numerous research articles and theses, and has been a prolific speaker and presenter at scientific conferences.  She has served on review panels for National Science Foundation and Environmental Protection Agency and National Institutes of Health Small Business Innovation Research (SBIR) grants.  She is also an adjunct assistant professor at Duke University Medical Center’s Division of Infectious Diseases in their Department of Medicine.  Throughout her career, she has demonstrated strong leadership in business and science and has dedicated herself to “bridging the translational gap between these two worlds.

Before helping to start Aperiomics, Icenhour was president and chief science officer for Phthisis Diagnostics in Charlottesville, VA, a research and development company focused on development of easy-to-use molecular diagnostics for intestinal parasites. While a postdoctoral fellow at the Mayo Clinic College of Medicine, she was the first to identify and characterize Pneumocystis melanins.  
She serves as Chairman of VirginiaBIO and was chosen to participate in the SpringBoard Enterprises 2016 class of women-led companies.  She is a member of, Sigma Xi, Medical Mycology Society of the Americas, Association for Molecular Pathology, and the American Society for Microbiology. The Kauffman Foundation and Center recognized her as 2012 Entrepreneur of the Year.

Icenhour received her PhD in Pathobiology and Molecular Medicine from the University of Cincinnati Medical School of Graduate Studies in 2002.  She conducted postdoctoral research in the Thoracic Diseases Research Unit at the Mayo Clinic College of Medicine from 2002-2005 and in the Department of Infectious Diseases at Duke University Medical Center from 2005-2006.  She has been involved in local and national postdoctoral associations including the Mayo Research Fellows Association Executive Committee (president), the Duke University Postdoctoral Association (chair of membership committee), and the National Postdoctoral Association (2008 chair).