This morning, Sherpaa launched an entirely new offering for small and medium-sized businesses.

#1: Companies can now pay for Sherpaa based on actual usage. This means each time an employee creates a medical case within Sherpaa’s app, companies are charged a flat fee. No matter how complex and long a case goes or how simple it is, it’s a flat fee. Prior to this, we were charging companies a per employee per month fee and this led to all kinds of headaches. Companies had to trust us that their employees would use Sherpaa. Then we had to spend all kinds of time and effort justifying our value. A flat rate per case eliminates this dilemma. Paying for Sherpaa based on actual usage de-risks the company. Companies can simply sign up and see what happens!

#2: It now takes less than a minute for a company to sign up for Sherpaa. You can do so here. Prior to this, selling Sherpaa was a complicated sales process. We found that companies, especially small companies, were interested in Sherpaa, yet we were not working with companies smaller than 100. Now, any company can sign up and get started implementing Sherpaa within their company in 5 minutes.

A Sherpaa case costs a company $150. Compare this to the average cost of care in traditional settings:

  • PCP visit: $175
  • Urgent Care: $350
  • ER visit: $2,000

When employees don’t have an access point before they get in-person care, they’re on their own trying to get their problems solved. This often results in piecemeal, expensive, paid for out of their own pocket care from urgent care centers, ERs, and random doctors. When employees have accessible doctors who can nip an issue in the bud before they spend on in-person care or direct their in-person care to exactly who and what they need, they spend their money wisely. Seventy percent of all cases created by your employees are diagnosed and treated without in-person care. Out of 100 cases diagnosed and treated by our doctors without an in-person referral, each $150 Sherpaa case prevents:

  • 35 PCP visits at $175 each
  • 50 urgent care visits at $350 each
  • 15 ER visits at $2,000 each

Just considering those 15 Sherpaa visits that prevent 15 ER visits, for a $2,250 investment, you’re saving those employees $30,000. That is an unprecedented gift questionably more valuable than unlimited coffee in the office.

Here’s what this means for your company:

Based on Sherpaa’s 5 years of data, 50% of employees will use Sherpaa as their PCPs and they will create, on average, 2.5 cases per year. So, here is what you can expect per month:

10 employees = ~$150 per month
50 employees = $750 per month
100 employees = ~$1,500 per month

What does “Can I use my health insurance for x?” actually mean?

To “use” your insurance to most people means “will my insurance cover this in-full?” Here are the conditions that must be met for your health insurance to cover things in full:

  • You must have spent your entire deductible
  • You have a plan without co-pays (very, very rare)
  • You have a plan without co-insurance (increasingly rare)
  • The expense happened during a routine annual physical and was a recommended screening test for your age/gender/risk factors (thanks Obama!)
  • Certain forms of contraceptives (thanks Obama!)

The real questions are:

  • What will it cost me to see a doctor or visit an urgent care center or ER?
  • What will it cost me to get tests?
  • What will it cost me to get procedures?

The answer to these 3 questions is, before you’ve spent your entire deductible, you are responsible for paying for the entire cost of these things.

So, now the question becomes “will my health insurance cover this in-full after I’ve spent my deductible?”

The increasingly likely answer is no. In decades past, when we as adults were introduced to the concept of health insurance, insurance used to cover all visits. Then they started introducing co-pays (to visit the doctor, you have to pay $25 at the time of the visit). Then they introduced co-insurance (your health insurance pays, say 80%, of the bill and then you pay the rest after you’ve met your deductible). The real reason people are confused about this is because deductibles, co-pays, and co-insurance are relatively new concepts that were introduced gradually over time. As you can see, these are measures to offload costs from health insurance companies and employers onto you. The days of insurance fronting the costs of all things are over.

To clear things up, until you’ve spent your entire deductible, co-pays and co-insurance do not yet apply. After you’ve spent your entire deductible, you start sharing the cost through co-pays and co-insurance.

So, before you’ve spent your deductible, the smartest thing to do is to be a super savvy healthcare consumer. If you have to spend $4,000 out of your own pocket before insurance even kicks in, it’s important to spend that money wisely in partnership with a doctor who’s looking out for your spend. And that’s what we do at Sherpaa.