Direct Primary Care Guide for Employers, part two

October 21, 2015

Direct Primary Care Guide for Employers, part two

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Part two: Key considerations leading employers to consider direct primary care options

What are considerations for employers considering direct primary care and its advantages, or the medical home concept, as a health and wellness strategy?

1. Do I have escalating healthcare costs and have I deployed traditional containment strategies?

There has been a long and variable history of cost containment strategies deployed by mid-sized and large employers and their benefits consultants. Many of these have produced successful outcomes since their deployment, while others either were deemed unsuccessful or difficult to measure at best. While a total health and wellness strategy must include a variety of tactics, addressing the root cause drivers of escalating healthcare costs is the most influential way to mitigate escalating costs in the near and long term.

For companies facing year-over-year healthcare cost increases, aggressive solutions are critical to sustain business health and remain competitive. CEOs, CFOs, and HR leadership working in partnership should evaluate the past, current state, and future trajectory of their company’s healthcare costs and push for deeper understanding as to the source and cause of these cost escalations.

Through research, innovative partnerships, and general trial and error of both economic and patient-centered strategies, the medical home provider community is learning that the imbalanced healthcare supply chain can be controlled and righted. Employers don’t have to be at the mercy of market forces, they are actually the most powerful force out there to make waves in this fast-changing industry.

For companies facing year-over-year healthcare cost increases—who have exhausted traditional cost containment strategies (e.g., increasing deductibles and out-of-pocket costs for employees, decreasing benefits)—incorporating direct primary care as a benefit offering allows for increased control over the healthcare supply chain, without decreasing perceived benefits for employees.

2. Are my employees geographically-concentrated?

The centralized provider and care team is the cornerstone for the positive health and financial results of the medical home—utilizing direct primary care with an onsite clinic offering. While virtual medicine can and should be heavily leveraged once initial care relationships are established, having some degree of geographic concentration is highly relevant for the success of a direct primary care program.

Corporate campuses, especially those with existing employee services onsite, are perfect testing grounds to pilot a direct primary care onsite clinic benefit strategy. Mid to large-scale industrial facilities, call centers, academic or government institutions, or other headquarters with employees concentrated in a single, or multiple major sites, allow for healthcare access to become optimized with the addition of a physician onsite, or near-site in a community doctor’s office.  

3. Is my organization prioritizing recruitment, retention and employee satisfaction?

As the modern workforce demographics have shifted, company loyalty has changed and employees are seeking not only differential benefits from their employer, but also employers who show commitment to quality of life. The total benefits picture from a recruitment perspective has changed dramatically in recent years. Employees are increasingly incentivized (by carrot or stick) through consumer-driven health plans, and employers need to find ways to provide more for less, to remain competitive and recruit and retain top talent across all industry types.

For organizations that recognize these shifts, and are intentional about their talent management, offering distinctly superior healthcare access and quality at little to no incremental cost can be a major factor in the decision to join or stay with a company. Out-of-pocket healthcare costs for employees are now such a significant portion of the total family budget – they are rising to the forefront of the dinner table discussion when evaluating the total compensation package.

One key advantage of a direct primary care program for employees is the lessening of out-of-pocket healthcare costs, including co-pays, prescription and lab costs, urgent care needs, and more.

The takeaway

The consumer appeal of direct primary care programs has moved beyond the localized, individual provider marketplace, and into the mainstream for employers looking to take the next step in cost containment, recruitment, retention, and overall employee health and well-being. While still early in evaluation, the medical home industry is starting to publish positive results from pilots and large-scale deployment of programs.

There are several considerations that employers need to evaluate to understand if piloting a medical home program will help them achieve their health and wellness strategy. Seeking advice from benefits consultants, doing due diligence, and evaluating past, current, and future healthcare cost containment initiatives are first steps towards making lasting change in gaining control and righting the economics of self-funding in the industry.

Don’t miss part one in the series: What is direct primary care and why employers should pay attention to it.

Contact us to learn more about the Paladina Health program’s approach to direct primary care, combined with the medical home concept. 

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