Innovative Option to Reduce Healthcare Benefits Costs for Your Business

by Lauren Hedde

Last year, CNBC aired a special on five ways small businesses can save on healthcare costs. “Robin Wiener [‘owner of health-care IT firm, Get Real Health in Rockville, MD’] has achieved something many small-business owners have struggled to do: She has lowered her firm’s health-care premiums.”

One of the five recommendations highlighted by CNBC and implemented by Wiener is to “Explore Direct Primary Care.” They highlight that “a growing number of primary-care physicians are partnering with employers to deliver affordable preventative and primary care on a fixed-monthly membership model, in what is known as direct primary care. Instead of billing patients’ insurance, direct primary care providers charge users a monthly fee for unrestricted access to their doctor….Unlike in concierge practices, which also charge monthly fees, providers in direct primary care do not bill insurers or Medicare for medical visits.”

According to last year’s article in Time Magazine, Qliance – which is the largest Direct Primary Care practice in the nation – has “signed up previously undreamed-of populations: big private employers like Expedia and Comcast, public and industry employee unions like the one for Seattle firefighters and–most radical of all–at least 15,000 Medicaid patients….Treating a wide variety of patients – young and old, healthy and chronically sick, well-off and poor – Qliance claims to be saving approximately 20% on the average cost of care compared with traditional fee-forservice providers.”

One of Qliance’s largest clients is Expedia. According to Time, “Expedia was motivated to try direct care for reasons that are familiar to business executives everywhere: health care bills were skyrocketing, but employees were not getting healthier. ‘We had a number of catastrophic illnesses in 2011 and a disturbing number of deaths–12,’ vice president for human resources Connie Symes tells me. ‘We found Qliance and their model of spending quality time with patients addressed our need to get employees involved in their own care….’ At the end of last year, Expedia surveyed the staff, Symes says, and the response was emphatic. More than half the employees had tried Qliance, and of those, more than 95% said they were satisfied. ‘They love the doctors,’ Symes says. ‘They love the personal relationships they’re forming.’ And although Expedia still classifies Qliance as an experiment, Symes says direct primary care, with its emphasis on prevention, ‘is taking us in the right direction on lowering costs.’ ”

Local small business owners and larger company CFOs in Rhode Island now have access to a similar option for covering their employees’ healthcare benefits – Direct Doctors. As a Direct Primary Care practice already established and seeing 100s of patients on an individual level, Direct Doctors physicians are now starting to branch into the world of employers/small businesses by discussing wrap-around types of health insurance plans (at lower premium costs to business owners and their employees) alongside employee memberships in this DPC practice. This is an extremely unique, new, and exciting alternative to the traditional health insurance benefit offerings most companies can provide to their employees. And, unfortunately, in this world of ever-rising premium costs & deductibles, employers are struggling to provide affordable benefits to their employees without sacrificing access to their physicians/health care (in the form of higher copays, narrower provider networks, etc). In other words, health insurance is being offered instead of health care.

Direct Primary Care practices, on the other hand, are able to provide patients (including employees of member businesses) 24/7 cell, text & email access, same day visits, convenient scheduling with longer appointments and no waiting. They can even see employees at their job site if feasible. All together, this can reduce employee absenteeism (no inconvenient visits during the middle of the day with long wait times, less preventable chronic illness, and less time out of work for acute illnesses that can be treated quickly and conveniently at the office).

Qliance has shown great cost reductions with this concept for both employer and employee. By reducing the amount of claims sent in to an insurance company (no copays for visits, no bills to the insurance companies, and no charging patients coinsurance), premiums stay lower, coverage costs picked up by employers and employees are more manageable, and everyone is happier and healthier.

Dr. Lauren Hedde & Dr. Mark Turshen practice Direct Primary Care at their Direct Doctors office in Wickford. They are hosting an Open House geared toward introducing and explaining this concept to employers June 9th 4-8pm at the Quonset Annex. RSVP to directdoctors@gmail.com.

Last year, CNBC aired a special on five ways small businesses can save on healthcare costs. “Robin Wiener [‘owner of health-care IT firm, Get Real Health in Rockville, MD’] has achieved something many small-business owners have struggled to do: She has lowered her firm’s health-care premiums.”

One of the five recommendations highlighted by CNBC and implemented by Wiener is to “Explore Direct Primary Care.” They highlight that “a growing number of primary-care physicians are partnering with employers to deliver affordable preventative and primary care on a fixedmonthly membership model, in what is known as direct primary care. Instead of billing patients’ insurance, direct primary care providers charge users a monthly fee for unrestricted access to their doctor….Unlike in concierge practices, which also charge monthly fees, providers in direct primary care do not bill insurers or Medicare for medical visits.”

According to last year’s article in Time Magazine, Qliance – which is the largest Direct Primary Care practice in the nation – has “signed up previously undreamed-of populations: big private employers like Expedia and Comcast, public and industry employee unions like the one for Seattle firefighters and–most radical of all–at least 15,000 Medicaid patients….Treating a wide variety of patients – young and old, healthy and chronically sick, well-off and poor – Qliance claims to be saving approximately 20% on the average cost of care compared with traditional fee-for-service providers.”

One of Qliance’s largest clients is Expedia. According to Time, “Expedia was motivated to try direct care for reasons that are familiar to business executives everywhere: health care bills were skyrocketing, but employees were not getting healthier. ‘We had a number of catastrophic illnesses in 2011 and a disturbing number of deaths–12,’ vice president for human resources Connie Symes tells me. ‘We found Qliance and their model of spending quality time with patients addressed our need to get employees involved in their own care….’ At the end of last year, Expedia surveyed the staff, Symes says, and the response was emphatic. More than half the employees had tried Qliance, and of those, more than 95% said they were satisfied. ‘They love the doctors,’ Symes says. ‘They love the personal relationships they’re forming.’ And although Expedia still classifies Qliance as an experiment, Symes says direct primary care, with its emphasis on prevention, ‘is taking us in the right direction on lowering costs.’ ”

Local small business owners and larger company CFOs in Rhode Island now have access to a similar option for covering their employees’ healthcare benefits – Direct Doctors. As a Direct Primary Care practice already established and seeing 100s of patients on an individual level, Direct Doctors physicians are now starting to branch into the world of employers/small businesses by discussing wraparound types of health insurance plans (at lower premium costs to business owners and their employees) alongside employee memberships in this DPC practice.

This is an extremely unique, new, and exciting alternative to the traditional health insurance benefit offerings most companies can provide to their employees. And, unfortunately, in this world of ever-rising premium costs & deductibles, employers are struggling to provide affordable benefits to their employees without sacrificing access to their physicians/health care (in the form of higher copays, narrower provider networks, etc). In other words, health insurance is being offered instead of health care.

Direct Primary Care practices, on the other hand, are able to provide patients (including employees of member businesses) 24/7 cell, text & email access, same day visits, convenient scheduling with longer appointments and no waiting. They can even see employees at their job site if feasible. All together, this can reduce employee absenteeism (no inconvenient visits during the middle of the day with long wait times, less preventable chronic illness, and less time out of work for acute illnesses that can be treated quickly and conveniently at the office).

Qliance has shown great cost reductions with this concept for both employer and employee. By reducing the amount of claims sent in to an insurance company (no copays for visits, no bills to the insurance companies, and no charging patients coinsurance), premiums stay lower, coverage costs picked up by employers and employees are more manageable, and everyone is happier and healthier.

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