Human-Centered Care at Scale: How Aplos Health Plans Partners with ICM
Dr. Jon Van Der Veer, more commonly known as Dr. Jon, is working to make care more accessible while lowering costs. In 2019, he founded Hy-Vee Health Exemplar Care, a direct primary clinic that works on a membership basis.
Subsequently, Dr. Jon and a colleague, BJ Spyksma, co-founded a second organization, Aplos Health Plans to offer unbundled, direct partnership employee benefit plans.
Offering self-funded employee health plans involves more regulations and increased complexity. To support each plan’s success, Aplos Health Plans engages several WRAP partners including Innovative Care Management (ICM).
Choosing ICM for White-Labeled Utilization Management
BJ Spyksma, the CEO of Aplos Health, had worked with ICM in the past, as had several of the team’s other partners, so it was an easy decision to contract ICM to provide a human-centered approach to utilization management.
Dr. Jon remains highly involved and provides ongoing oversight and guidance while ICM performs thoughtful utilization management services, under the Aplos brand, as a trusted extension of the Aplos team.
Determining what is and what is not medically necessary can be tricky, but ICM takes a balanced approach. Decisions are made based on clinical evidence and in a way that supports both regulatory compliance and member well-being.
Aplos Health offers plans for employers in five states:
- Iowa
- South Dakota
- Nebraska
- Missouri
- Kansas
Coordinating Quality Care
ICM’s role is to provide medical management services in accordance with the plan design and to help ensure care is consistent with plan provisions and evidence based standards.
When appropriate, ICM conducts clinical reviews and escalates cases requiring physician involvement for medical necessity determinations. ICM also collaborates closely with Aplos and other plan partners to coordinate across the health plan and support alignment with the employer’s intent.
Aplos and ICM have been successfully collaborating for a few years now. “Our own internal employees who interact with ICM say they are very responsive, especially on urgent issues,” says Dr. Jon. “They’re collegial, they’re friendly and they do exactly what it is they’re supposed to be doing.”
The Aplos Health Plans model has rapidly expanded, and ICM has grown with them through a strong, collaborative partnership. By working closely with Aplos Health Plans, ICM helps ensure clinical oversight and care coordination are aligned with the plan design, supporting a more predictable and member centered experience.
When asked about his team’s satisfaction with ICM, Dr. Jon had this to say: “They’re good at what they do, and good at adapting to new systems and processes. When we launched Aplos, they helped us fine-tune our processes, and now things run very smoothly. Our key contact, Ember Gard is a great partner and a very level headed person. You could say that we’re pretty darn happy with them.”
“They’re good at what they do, and good at adapting to new systems and procedures… We’re pretty darn happy with them.”
Dr. Jon Van Der Veer
Aplos Health Plans