Health & Wellness Centers
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Cooper Johnson: SVP Employee Benefits, S.S. Nesbitt & Co. Presenting: Shared Wellness Clinics Cooper is a student of employee benefits. Having spent his entire career consulting in this space, he has also worked at the forefront of moving S.S. Nesbitt & Co’s benefits practice from a brokerage-only focus in the early 2000s to a post-ACA, “beyond benefits” and holistic health plan design consulting practice.
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Health & Wellness Centers
- 1. HEALTH & WELLNESS CENTERS REINVENTING PRIMARY CARE
- 2. THE CURRENT EMPLOYEE EXPERIENCE Employee View: – Difficult to get appointments – Waiting room – Exam Room – Time with physician – Trip to drug store
- 3. THE CARE MODEL • Primary Care • Urgent Care • Telemedicine • Biometric Screens/HRAs • Workers Compensation • Annual Physical • Pre-Employment Physicals • Drug Screenings
- 4. STAFFING MODEL – 1 full-time M.D. – 1 part-time Nurse Practitioner – 1 full-time R.N. – 2 Medical Assistants – 1 full-time LPN – 1 full-time Clerical
- 5. HOURS – Monday to Friday Business Hours – Evening Hours – Morning Hours – Saturday Morning Hours – Additional Accessibility
- 6. WHAT WILL MY EMPLOYEES THINK? Employee View: – Easier access – More convenient – Better care – Perk of employment
- 7. EMPLOYEE’S TRIPLE AIM • Access • Time • Care
- 8. Will it reduce my primary care spend?
- 9. WILL IT LOWER PRIMARY CARE COSTS? Increase primary care spend to: – Reduce ER, urgent care spend – Drive referrals to high-value providers – Reduce gaps in care - identify and treat chronic conditions sooner – Reduce absenteeism – Increase adherence to treatment – Rx on site
- 10. BIRMINGHAM MODEL • Two locations – City Federal Building - Downtown – Chase Lake - Hoover • More as program grows • Could add mental health, physical therapy in the future • Long-term goal is higher value relationships with local providers
- 11. PRICING & COMMITMENT • One year commitment from each employer. • Cost is $75 PEPM – Marginal cost less as you are eliminating most of existing PCP, Urgent Care and some ER visits. • Labs, vaccines, and Rx pass through basis
- 12. SOURCE OF SAVINGS • Fewer ER visits • Fewer referrals • Lower Rx costs • Higher Rx compliance • Lower HRA/biometric cost • Manage chronic conditions • Reduced occupational costs • Reduced pre-employment physicals costs • Reduced post-accident testing costs
- 13. EMPLOYER’S TRIPLE AIM • Better Care • Better Health • Lower Cost
- 14. LONG TERM GOALS • Reduce Costs • Early, low hanging fruit: • ER visits • Physicals • Referrals • Longer term fruit: • Engaging more of the population • Managing chronic conditions • Avoiding catastrophic claims • Goal is 0-3% overall trend within 3-5 years • Provide better employee experience • Attract, recruit, and retain employees
Editor's Notes
- We in general don’t love our doctors the way we used to.
- It is open to employees, spouses, and dependents over 10 (over 2 for acute issues). Hours vary but will typically include at least one early morning, one evening, and some Saturday hours.
- This is the Huntsville model. Discuss how this could be adapted to serve a full-time clinic and a satellite clinic. Discuss scaling – as clinic utilization/size grows, staffing grows with it.
- This is the Huntsville model. Discuss how this could be adapted to serve a full-time clinic and a satellite clinic. Discuss scaling – as clinic utilization/size grows, staffing grows with it.
- Accessibility Completely voluntary No requirement that they give up their current PCP (although we hope to design an experience that will make them want to) Open to employees, spouses, dependents Children – age limitations Children 10 and over can establish with the Health Center for routine visits Children ages from birth to 9 years should have routine care provided by their pediatrician Children ages 2- 9 years will be seen for urgent/acute care Children under 2 will be referred to their pediatrician for all care Little to no cost Making an appointment (phone, web, walk-in) Appointments available same day, walk-ins as able No long wait Experience with doctor Length of visit Build relationship – encourage this to become PC home Other convenience factors Fill Rx on site Increases compliance Not a pharmacy – must see doc to get Rx Location convenient to work, home Flexible hours Services provided – PC, wellness/preventative, nutrition, flu shots, etc. Medical records – confidential EMR, can facilitate information exchange between PCP, specialists, etc. – just as any other health center Integration with Springbuk
- The goal is to double the amount of money you spend on primary care. Primary care is cheap and efficient and every extra dollar you spend you will take $2-3 out of hospitals, rx, and specialists. Today, an employee has to wait 1-3 weeks to get an appointment, 30 minutes in the waiting room, and then 10 minutes in the exam room – all for the privilege of spending 5-7 minutes with the doctor before getting a prescription or referral. And increasingly, the PCP is an employee of the hospital. In the PHWC model, the employee gets an appointment within 48 hours, waits less than five minutes, and then spends 20-25 minutes with the physician. This is a return to actual care and away from the reactive launch pad of Rx and hospitals.
- We want to push as much into primary care as possible Everything that happens in PCP instead of elsewhere saves money Accessible by employees, spouses, and dependents
- This is the Huntsville model. Discuss how this could be adapted to serve a full-time clinic and a satellite clinic. Discuss scaling – as clinic utilization/size grows, staffing grows with it.
- This is the Huntsville model. Discuss how this could be adapted to serve a full-time clinic and a satellite clinic. Discuss scaling – as clinic utilization/size grows, staffing grows with it.