Real Middle Market
Employers. Real Results.

The Challenge

Mid-sized healthcare employer with opaque PBM contract experiencing 28% year-over-year pharmacy trend with no clear explanation or control mechanisms

Our Solution

Deployed Kincaid IQ's PBM Intelligence Engine to audit 850K annual claims, identify spread pricing patterns, and benchmark against NADAC pricing

Results

• $2.8M in annual pharmacy waste identified and documented
• 15% reduction in specialty drug spend through formulary optimization
• PBM contract renegotiation with transparent pass-through pricing
• CFO-ready evidence package with complete audit trail

The Challenge

GLP-1 utilization growing 180% annually with no clinical protocols or cost containment strategy in place

Our Solution

Implemented Kincaid IQ's GLP-1 Risk Engine to model population-specific cost trajectories and establish evidence-based clinical guidelines

Results

• GLP-1 trend reduced from 180% to 52% through clinical appropriateness protocols
• Member access maintained while controlling inappropriate utilization
• $1.4M in avoided costs over 18-month projection
• Board-ready GLP-1 strategy with actuarial backing

The Challenge

Suspected broker conflicts with override commissions and lack of strategic value despite paying $180K annually in advisory fees

Our Solution

Conducted Shady Broker Index analysis to expose hidden compensation and performance gaps, established governance framework

Results

• $425K in hidden override commissions documented over 3 years
• Transition to fee-transparent advisory relationship
• 12-month strategic roadmap replacing 'renewal theater'
• CFO and CHRO alignment on benefits strategy for first time

The Challenge

Rapid growth from 400 to 1,200 employees with poorly structured stop-loss coverage and 45% premium increase at renewal

Our Solution

Used Kincaid IQ to model attachment points, laser scenarios, and aggregate risk exposure with actuarial precision

Results

• Stop-loss premium increase limited to 18% (down from 45% proposed)
• Optimized attachment point saved $340K annually
• Documented underwriting strategy for future growth
• Risk-adjusted plan design reducing volatility exposure