White paper

Vera Advanced Primary Care for Multiemployer Groups

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Multiemployer groups face unique challenges when designing benefit strategies. With so many stakeholders involved, the purchase process can be long and complicated. Achieving alignment among labor and management groups takes time and an experienced primary care partner. But it’s necessary. Without buy-in even the best solutions will fail.

The advanced primary care (APC) model provides multiemployer groups with a new way to strengthen their benefits packages and attract and retain talent while reducing their administrative overhead.

This white paper demonstrates the viability of the APC model as a solution for multiemployer
groups
by examining the following topics:

Challenges multiemployer groups face when crafting a benefit strategy

Public labor groups and trusts face a myriad of challenges when they embark on crafting a benefit strategy including:

Privacy and trust

Whether it’s for a wellness program, disease management, or a complete primary care solution, success depends on member engagement. Engagement is built on a foundation of privacy and trust. An experienced and trusted third-party care team gives members confidence that their health data is kept confidential.

Dispersed workforce

With members dispersed across a wide geography and job sites, convenient access to care is more challenging than for other workforce populations. The workforce’s multiple employers may find it difficult to coordinate communication about the benefits of primary care. This often leads to low engagement and poor outcomes for typical wellness programs.

Fragmented benefits, diverse populations

With good intent, multiemployer groups offer a collection of wellness, disease management, and other programs meant to serve diverse populations — from healthy millennials to aging boomers with chronic disease concerns. Unfortunately, the result is often a range of disparate programs that are a hassle for benefits administrators and difficult for members to understand and use.

Chronic disease management

Cost management of chronic diseases is a key fiduciary responsibility of funds in order to stay solvent and support members. Effective care coordination ensures that members with chronic diseases are well cared for, engaged, and proactive about managing their health.

Ability to attract new members

With union membership in long-term decline, public unions and labor groups need ways to attract and retain younger members that will sustain the union going forward. A rich benefit strategy could be one of the primary recruiting tools.

Uncertainty and risk

Multiemployer group providers must have the ability to be agile in a crisis and help members navigate challenging sociopolitical challenges, like the COVID-19 pandemic.

Skyrocketing costs

Between 2007 and 2016, the median cost of benefits for multiemployer health plans increased by 54%, reaching $10,853 per year. This type of runaway cost puts groups at risk of not being able to provide the same level of healthcare to their membership going forward.

Any successful multiemployer group benefit strategy must tackle these challenges to be effective.

But benefit strategy design isn’t just about overcoming challenges. Multiemployer groups have a number of goals in mind as they seek benefit strategies that deliver value to their members, not just increased care.

What multiemployer groups are trying to achieve with their benefit strategy design.

Despite the many challenges multiemployer groups face, they also have ambitious goals. They know that the path to better care and health outcomes for their membership is through value-based care.

As a result, they’re looking for plans that will not only improve these top-line outcomes but will also:

  • Increase Access

    so that their members who typically avoid seeking care until issues become acute will be able to seek out and get care more frequently, hopefully improving overall health.

  • SIMPLIFY HEALTHCARE

    for their workforce by reducing the number of vendors and increasing clarity about what is covered under their health plan so it will be easier for members to determine when to seek care.

  • Reduce total spend

    on healthcare so that their organizations can continue to remain financially solvent while serving current members and attracting new ones.

  • Optimize investments

    by stretching each dollar as far as it will go in service of the membership.

What is advanced primary care?

We're so glad you asked.

Expand to find out

APC is a value-based model that builds on the foundation of true primary care, at the core of which is the provider-patient relationship. In the APC model, just like in true primary care, this relationship is nurtured through longer appointments and empathetic listening.

APC moves beyond true primary care by:

Leveraging informatics and data to meet the needs of a specific population

Data sets from claims, electronic medical record (EMR) data, and user-generated surveys inform how the APC model should be tailored for a specific population. These data sets serve as the foundation of the population health management strategy and influence both care delivery and member outreach.

Providing 80-90% of care in the primary care setting, and coordinating care when specialty care is appropriate

In the APC model, care centers provide a medical home for members where they can receive the vast majority of care. The care team also coordinates specialty care, including follow-up and integration into the member’s care plan back at the care center. This type of coordination prevents gaps in communication and treatment. It’s especially beneficial to Medicare Advantage populations who are often managing multiple chronic conditions.

Embedding health coaches within each care team:

In the APC model, professional health coaches use the transtheoretical change model to help patients take ownership of their health, make positive behavior changes, and achieve life goals.

Learn more on APC

How advanced primary
care delivers

Delivering better care and health outcomes while simplifying healthcare

APC increases the quality of care and improves health outcomes by combining together a commitment to delivering 80-90% of care in the primary care setting and embracing a value-based approach to care.

Because the compensation model for APC is value-based, providers and their supporting care teams can shift away from an emphasis on procedures and specialists that were previously required in order to cover costs.

This shift in approach increases the quality of care because providers no longer work in a production-oriented environment. Instead, they can take the time to get to know the unique challenges each member faces and design a proactive health plan to address those challenges.

Increased focus on developing a proactive approach to managing each member’s health improves health outcomes because members no longer wait until they have an acute issue. They are instead motivated to improve their health with the support of their provider, a health coach, and the rest of their care team.

Increased access is essential to improved outcomes

In the APC model, increased access is beneficial. It leads to better population health through improved member engagement. Patient engagement outreach initiatives create a sense of belonging so members better understand and are more likely to fully utilize all available services.

APC increases access through neutral, geographically centralized care center locations, which makes it easy for families to receive care and provides privacy not easily obtained when care centers are located in union halls. Neutral locations also create the potential for shared or networked services with other care centers, whether they serve other multiemployer groups or the general public.

Targeted outreach for members with chronic conditions motivates them to use the care center for routine and recurrent care needs. Member reliance on urgent care diminishes dramatically. So does the cost of care, which leads to how APC solves the multiemployer group’s next goal, reducing total healthcare spend.

Reduced healthcare costs

How does a model that provides significantly more access to care drive down costs? It’s all about increasing the right kind of utilization.

The APC model increases utilization of primary care using a value-based economic model. As discussed earlier, patients get the majority — about 80% — of all healthcare needs from one convenient location from a dedicated care team. Care is delivered by a team rather than a single provider, so professionals with different skill sets are available to meet the patient’s bio, psycho, and social needs. It provides a hub and network of care when referrals to specialists are required.

At the same time, utilization of costly specialty, emergency, and inpatient care decreases. As a result, total costs drop. The Northern Arizona Public Employees Benefit Trust (NAPEBT) is a great illustration of this concept.

When NAPEBT implemented the APC model with Vera, they opened a care center that became a medical home for members and their families. The care center offered time-rich appointments, specialty care coordination, and embedded health coaching that enabled strong provider relationships and developed self-accountability for health.

By the end of three years, they had achieved a net savings of $1.28 million while increasing membership engagement (the number of people using the care center) by 67%.

These types of proven outcomes allow Vera Whole Health to offer performance guarantees to reduce risk and ensure that multiemployer groups will save money when they decide to implement APC.

Optimized healthcare investment

APC helps multiemployer groups not only reduce healthcare spend but also optimize that spend so that it’s most effective. This effort is guided by informatics and data.

Data sets from claims, EMR data, and user-generated surveys inform how the APC model should be tailored for a specific population. These data sets serve as the foundation of the population health management strategy and influence both care delivery and member outreach by:

  • Serving high-impact segments first: An informatics platform segments the population by risk so that you can provide care to the highest risk segments of the population first.
  • Conducting customized outreach: The next step is to contact members using relevant messaging that speaks to their specific health situations and encourages them to visit care centers.
  • Closing care gaps: When data indicates that members are missing out on vital care, the model should be adjusted to fill that gap.

The right solution for a unique challenge

An investment in APC creates long term value for multiemployer groups and their workforces.

Providing a more accessible and member-focused healthcare model has far-reaching health benefits for members. For multiemployer groups, this means increased employee productivity, reduced absenteeism, and often lower turnover.

Investing in a proven model of advanced primary care for members is the smart solution to simplifying benefits administration while ensuring improved health outcomes, high member satisfaction, and significant savings.

Get started with advanced primary care

Get in touch with Vera today to learn how Vera advanced primary care for multiemployer groups can achieve results that benefit everyone.