As imaging and infusion costs continued to rise, particularly within hospital systems, the district recognized that simply maintaining the status quo would not be sustainable. In 2024, they operated under a fully insured model. As they transitioned to self-funding in 2025, leadership saw an opportunity to rethink how care was accessed and paid for. The goal was not to restrict care, but to create a system that would guide employees toward high-quality, lower-cost options without adding friction or complexity.
Rather than relying on a single vendor or point solution, the district focused on plan design—creating a coordinated "system of help" that guides employees to better care decisions.
A Direct Primary Care (DPC) model was introduced as the front door to care, giving employees zero-cost access to a trusted physician and a clear starting point for non-emergent needs. The plan reinforced this pathway by making preferred providers financially advantageous, often at no cost, while higher-cost options carried greater out-of-pocket responsibility.
Physician-led utilization management and pre-authorization protocols ensured imaging was appropriate and directed to the most efficient setting—consistently steering non-emergent care away from hospital systems and into high-quality outpatient providers like Smart Scan and Smart Infusion.
Early and consistent communication helped employees understand how the plan worked and why it mattered, aligning individual decision-making with the overall goals of the plan. This structure is what drove nearly 80% imaging utilization in year one, redirecting care at scale and unlocking measurable savings.
One of the largest school districts in Wisconsin partnered with Smart Scan Medical Imaging and Smart Infusion Therapy Services to take a more proactive approach to managing healthcare costs while improving access and experience for employees. What makes this case notable is not just the outcome, but how it was achieved.
First-year programs of this kind often see partial adoption, with utilization rates closer to 40%. Achieving nearly 80% in year one represents a new level of performance, and reflects what is possible when plan design actively guides member behavior.
For the district, this translated into meaningful financial impact. More importantly, it demonstrated that cost control and quality care do not have to be at odds when the system is designed correctly.
Healthcare savings only matter if they translate into real-world value. For this school district, the program generated over $680,000 in annual value—equivalent to funding more than eight teaching positions or reinvesting directly into student programs and staff resources. The data also revealed nearly $700,000 in additional savings potential, highlighting the financial upside that remains when plan design and employee utilization are not yet fully optimized.
This shifts healthcare from a fixed cost to a controllable lever within the organization's broader financial strategy. This case illustrates a clear principle: meaningful savings are not achieved through discounts alone, but through intentional plan design that aligns incentives, simplifies access, and supports employees in making better care decisions.
Smart Scan Medical Imaging and Smart Infusion Therapy Services provide employers with a high-quality, lower-cost alternative to traditional hospital-based care. By combining the highest quality care, advanced diagnostics, a full specialty medication formulary, rapid access, and transparent pricing, Smart Scan and Smart Infusion help organizations reduce healthcare spend while improving the employee experience.