Collaborative Health Centers – The Solution for Smaller Employers
WeCare TLC’s first health center were for employers with fewer than 500 employees.
But over time, we found that smaller health center operations also have certain disadvantages. It can be difficult to recruit clinicians into part time positions, particularly in rural areas. Office hours may be limited, which reduces convenience, access and, ultimately, effectiveness. And a health center’s services for a smaller population may be scaled down to a core of essentials.
Then there’s the straightforward complexity vs. cost issue. To be effective, a smaller health center requires nearly the same infrastructure – tools and skills – as a larger one, but it spreads the cost over far fewer patients. It takes nearly the same effort to create and manage a health center for 500 patients as it does for 5,000, but the larger health center has the numbers to be more efficient.
The Solution for Smaller Employers
The sweet spot appears at about 1,200 employees. The arithmetic works like this: 1,200 employees, with adult dependents, typically equal about 2,400 eligible lives. About two-thirds of that group, or 1,600 people, will start actively using a WeCare health center in the first year. That’s the optimal patient panel size for a WeCare TLC physician. (Compare this, by the way, with the 2,500-3,000 patients most primary care physicians see, more hurriedly, every year.)
So a minimum of 1,200 employees facilitates an efficient full time health center. But to the extent that more patients participate (or the client is willing to pay for additional staffing hours), the health center can be open more hours and become a more available resource.
Larger health center have other advantages. For example, with larger patient volumes, we can mine a group’s claims experience to identify the most frequent, high cost services that can be brought inside the health center, like pain management, physical therapy or even dentistry. This approach can provide far more management oversight and quality control, driving out waste and assuring care appropriateness. At the same time, it can lower cost, since the service is delivered through an employed position rather than through “retail” fee-for-service rates.
For employers with fewer than 1,200 employees, the obvious answer is to collaborate with other nearby firms to create the critical mass that makes a “near-site” health center work well. The health center can be located conveniently for everyone involved, and patients from different employers can be easily tracked so costs are correctly assigned to the proper account.
A variety of arrangements can work in this situation. In some cases, the sponsoring firms can chip in, based on each company’s employee census, to cover the build-out and startup costs. In others, a single employer might pay to establish the health center, and then others might join later, paying a small monthly fee to the initial sponsor to compensate for taking the leap. Or in some cases, WeCare TLC may be willing to finance the build-out and startup, amortizing that cost with a small addition to the monthly per employee per month (PEPM) fee. The goal is to efficiently create an environment for better, more efficient health care that is available to mid-sized employers.
WeCare TLC has several “collaborative health center” up and running now. They perform just as well as our stand alone employer health center, and we expect to develop many more in the future. We believe this kind of model makes sense for mid-sized employers, and opens access to a level of medical management, care quality and savings that has only been available to larger employers in the past.