Should you add APC to
your benefits or access it
through your health plan carrier?
Access to high-quality primary care is the foundation of an effective benefit strategy.
In response, many employers use self-funded health plans that allow them to adopt the financial risk for their employees rather than paying a premium to an insurance company. When employers adopt the financial risk, they have the power to change the dynamic: setting up a high-deductible health plan and reinvesting the savings in primary care. Whether you provide that care directly, through your insurance plan, or through a primary care partner, you can make sure your employees get the best primary care.
The following case study demonstrates how employers can improve benefits and control cost by self-funding a value-based approach to primary care.
How primary care helped a city improve benefits and reduce spending
Faced with skyrocketing healthcare costs, the City of Kirkland in Washington State was ready to try an unconventional approach to their benefit strategy. Their 10 million dollar budget was steadily increasing yearly by 11% and they couldn’t sustain that trajectory for much longer.
The City didn’t want to reduce benefits (and indeed could not, due to agreements with labor unions.) Instead, they set a seemingly impossible goal: reduce spending and improve benefits.
An unconventional strategy
The City consulted with Keith Robertson of Alliant Health Services and, together, they came up with a bold, new benefit strategy:
- Move employees to a high-deductible plan and directly re-invest resources into employee benefits
- Get into the business of primary care in order to provide employees with unlimited access to free or low-cost primary care
The City couldn’t achieve its goals by relying on the network of a traditional plan. Instead, they chose to turn primary care into a fixed cost by partnering with Vera Whole Health. Vera worked with them to provide primary care directly through their own care center.
They were dedicated to the best outcome and willing to go out and do that. They basically blew up their entire benefit strategy and built it from scratch.
Keith Robertson, V.P./Corporate Benefits Consultant at Alliant Insurance Services
Strong incentives and clear communication about the new benefit model led 90% of employees to engage with the new care center. At long last, employees were getting preventive treatment when they needed it. This meant that chronic conditions were effectively managed and fewer health concerns became elevated enough to require an ER visit. Employees could even have generic prescriptions filled onsite for free.
This simplified, targeted model created a better experience for employees, which increased utilization of primary care by 23%. Employees became more and more engaged with their health and this in turn led to improved health outcomes and a reduction in claims dollars. Costs fell by $137 per member per month.
The City saw a 25% reduction in healthcare costs and a 15% net savings in the first two years of care center operation.
The City of Kirkland proved that employers can improve benefits, increase utilization, and reduce costs by providing primary care directly to their employees.
A powerful alternative to a self-funded health plan
Getting into the business of primary care is an effective benefit strategy solution for employers — but it’s not the only one. There’s another way that you can provide your employees with high-quality primary care and achieve the same results. Look for an insurer that provides APC.
Many payers are getting into the business of providing APC themselves, for the same reasons that employers are — to improve employee/member experience, improve health outcomes, and lower the total cost of care. This is good news for employers for whom building and managing their own care center isn’t the right choice, so ask your carrier about this option. By finding an insurer network that embeds APC into its health plans, you can connect your employees with innovative, easy-to-access care — without the ownership.
Weighing the benefit: By working with an insurer that offers built-in primary care at the center of their plan, you can finally control costs while offering better benefits and a better care experience for employees.
If you want to step outside the cycle of rising costs while providing your employees with more comprehensive benefits and helping them improve their long-term health, you can. The key is to design your benefit strategy with high-quality advanced primary care at the center.
To learn more about how APC can transform your benefit strategy, contact us today.
Download as PDF Get in Touch