Like many employers, school districts struggle with consistent exposure to catastrophic claims related to conditions like diabetes, heart disease, and cancer. Active engagement with a primary care physician can help employers identify potential high cost drivers and improve the overall health of plan members – yet less than 30% of the U.S. population has an active primary care relationship. As part of a broader shared accountability strategy, incentivizing physician engagement can encourage your employees to utilize a primary care physician for routine and preventative care, and avoid unexpected costs.
Active engagement with a primary care physician not only increases less expensive routine and preventative care, it can also:
When it comes to chronic conditions, such as diabetes or heart disease, proper management, facilitated through a primary care physician, can significantly reduce costs per member, per year (PMPY). Take diabetes, for example:
A 200-employee (300 adult members) health plan group typically has 10% of members with diabetes, with over 50% undiagnosed or unmanaged. Getting half of these members to manage their care represents a cost avoidance of $26,250 (300 x 2.5% x $3,500) per 100 lives. This solution is just one piece of the health management puzzle that can reduce the overall cost of claims.
Using data to incentivize care
Incentivizing employees to engage with a primary care physician begins with an analysis of your population health plan usage. For instance, our health management team can review carrier data or run client data through a proprietary analytics program to determine the current level of engagement. Once you have analyzed health plan usage and identified potential cost drivers, you can then design financial incentives through plan and contribution structure, such as offering a premium discount for employees who participate in preventative screenings and wellness visits, to promote the use of a primary care physician. Continue to analyze health plan data periodically to evaluate the program’s effectiveness and make adjustments as needed. With proper incentives, employers often see a 70-95% increase in active primary care physician relationships within 12 months.
The doctor is in
Providing an onsite clinic can also encourage the use of a primary care physician and increase routine and preventative care visits:
As part of a broader strategy, an employer could not only increase participation in preventative care, but could also save quite a bit by encouraging onsite clinic usage. For example, the projected savings for an employer with 700 visits to an onsite clinic, saving $65 per visit, is $45,500.
USI evaluates opportunities to improve access and reduce cost of care through vendor and provider relationships. View our previous article, Partner with providers to save on health costs, as featured in the October 2020 Wisconsin School News (reprinted with permission from the Wisconsin Association of School Boards). Contact us to learn more about these and other cost containment strategies to help reduce expenses for your district and improve the health and well-being of your employees.
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