One Minnesota company is bent on disrupting the health care industry. Minneapolis-based Bind aligns insurance with treatment paths, providing core coverage from the first dollar spent, but allowing members to add optional coverage at any time throughout the year, not just during open enrollment or a life-qualifying event. Premiums are 10%–15% lower than those of traditional plans.
Bind was founded in 2016 by Lemhi Ventures and health-industry veterans, including Dave Dickey, Glen Eiden, Tony Miller, Shawn Wagoner and Matthew Wiandt. The management team includes founders from Definity Health, Carol Corp. and Redbrick Health, as well as executives from Allina, Blue Cross Blue Shield, HealthPartners, Mercer, Optum and UnitedHealthcare.
The core plan
Bind’s core coverage includes preventive care, primary and specialty care, urgent, emergency and hospital care, chronic care for long-term and recurring illnesses, and pharmacy. Copays are straightforward: There is no deductible, no co-insurance and there are no restrictions on pre-existing conditions. “Add-ins” are options for nonemergency treatments consumers can plan ahead for, such as knee replacements or hernia repairs. Keeping those treatments out of the core plan, says CEO Tony Miller, allows monthly premiums to stay low.
“There is no deductible and no co-insurance anywhere in Bind. So, core is a very simple co-pay plan. What’s interesting is it’s not the co-pay plan of the HMO era; it’s what we call smart co-pays. So, everything that you could buy has a price tag on it. Some of those price tags are free or zero, and then depending on who you use and what treatment you choose, your prices could change,” says Miller.
Consumers are provided with a price menu for provider visits before receiving care. Prices vary by group and geography. For a certain group, for example, a virtual visit may be free, a retail clinic visit may be $15, a primary care visit may be $30, and a specialist visit may be $50. “And because there are no deductibles or co-insurance, there’s no fuzzy math for you to do as a consumer. You get to see exactly what you would have to pay,” says Miller.
Miller says that the response to Bind’s insurance product has been positive with consumers comparing it to another ordinary monthly expense: cell phones.
“We finally have a health insurance plan that consumers can understand. Consumers have come up to us and said, ‘This looks like mobile phone coverage. I buy a base plan. I need more data; I buy more data. I need to add a line; I add a line. And when I don’t need those things, it drops off my plan.’ So, health insurance finally looks like something else that consumers deal with, and it’s very intuitive for them to use,” says Miller. “What I like about Bind is the ability for us to precision target all the medical waste that keeps eating everyone’s paychecks. We now have an opportunity where you could potentially see health care spend recede.”
How it works
Using the Bind app’s “Is It Covered” feature, individuals search for a service, condition or procedure. They can specify a doctor or keep that box blank. The search will then either affirm that the service, condition or procedure is covered under the core plan and include your options with associated pricing, or it will reply, “No, this is not covered by your core plan. Don’t worry, add-in coverages and alternative treatment options are available to you,” along with that information. “We also let people know that if you’re not quite sure what to do, you have access to a free, expert medical opinion. That medical opinion is an outside service, so consumers get an impartial, independent review of the case,” says Miller.
The Bind app surfaces a range of provider options for the member, from the most cost-effective to more expensive options. Miller notes that a provider may cost more than another because he or she may have less experience with that particular procedure or higher readmission rates.
“We’ve looked at the practice patterns of physicians across the market over a period of time, and then we looked at how they perform, for example, knee arthroscopy. We look at the propensity for the treatment — how many episodes they’ve done — and at their overall episodic rate of performance, which would then embed their complication and readmission rates into a price,” says Miller.
For instance, in the Twin Cities, a knee arthroscopy can range from $6,700 to $23,000. “We’ve started by examining the clinical performance of providers, and we have a lot of pricing and performance waste in the system,” notes Miller.
Many companies across industries, says Miller, have embraced Bind, including retail, health care, education, technology and manufacturing. And it’s been popular with employees. Case in point: 68% of Minnesota-based Slumberland Furniture’s employees enrolled in the Bind plan, which was offered alongside its legacy high-deductible plan.
“People are hungry for health care price certainty. That’s exactly what Bind offers. We built Bind because we passionately believe that fear of unknown costs shouldn’t hold people back from getting the care they need,” says Miller.