ECC's Approach
The Employers Challenge
In an effort to increase control and influence over unsustainable healthcare cost increases for their employees, adoption of employer sponsored worksite clinics – onsite, near-site or virtual – is accelerating.
The 20 Percent
About 20 percent of self-insured U.S. employers with 200-999 employees and 30 percent of employers with 1,000 or more employees have implemented primary care clinics on or near their campuses.
Clinic Vendors
Most have contracted with clinic vendors that pull together complex turnkey clinic operations, employing staff, building out the physical plant, acquiring the appropriate devices and drugs, and developing networks of downstream services – e.g., specialty physicians, laboratories, imaging centers, ambulatory surgery centers – that allow them to gain more control over the management of care quality and costs for their employees and their families.
Most clinic vendors claim dramatically better health outcomes and lower costs as a result of deploying their clinics. But there are few firms that provide rigorous, independent, third-party review of those claims. Many employer and union clinic sponsors receive performance information on their clinics from their clinic vendors, without validation. Which is actually not in compliance with ERISA regulations.
Three Clinic Performance Questions
There are really only three clinic performance questions to consider:
1. Did the clinic meet the sponsors’ original goals and expectations?
2. Did the investment in the clinic reduce the sponsor’s overall spend on healthcare, including the overall cost of the company health plan? Related, did the clinic’s activities result in measurably better health outcomes and satisfaction for the eligible population of employees and their families?
3. Are opportunities available for revisions and adjustments to the clinic’s design that have a high probability of further improving health outcomes and lowering overall cost? If so, what is the cost/benefit/disruption involved and what improvement can reasonably be expected and/or guaranteed?
Whether Planning a New Clinic or Improving an Existing One, Our Approach is Centered Around Three Core Areas
Efficacy
Efficacy is the capability of a product or system to impact the goal. The efficacy of a system is created in the modeling or design and tested on paper. An efficacious product is capable of achieving the goal or target. Does the model fit the need?
Effectiveness
Effectiveness is the measure of how adequately the product or system is at accomplishing an intended or expected result. How well does the product do whatever it’s supposed to do? What is the actual, real world performance of the product or system?
Efficiency
Efficiency is the measure of a product or systems ability to accomplish the goal with the least waste, energy, effort or financial load. Outside of the actual practice of medicine, ROI, satisfaction, and utilization are some examples of clinic efficiency measures. To improve, you must first accurately measure it.
Our Goals For You are Simple
Objectively Assist BOTH the Employer and Clinic Provider:
1. Quantify the Current Performance (an ERISA Requirement)
2. Identify Areas of Opportunity for Improved Outcomes and Lower Costs
3. Implement Proven Tools and Processes to Achieve Higher Performance
The Process
Work with the stakeholder team – employer, benefits advisor and clinic provider – to honestly answer the Return on Investment (“ROI”) and “Value” questions. Identify opportunities to unlock the potential.
A multi-faceted deep dive assessment and study of your clinic(s) that includes evaluation, extensive data collection and analysis, site visits and interviews.
We call it:
OpCare
Reporting & Recommendations designed to produce results in an executive level format for in-depth discussion and planning. This process will help us understand what is required to enable your clinic and partnerships to flourish.
A Verb. Achieving higher levels of success or performance at a faster rate than normal or expected.
A Note of Encouragement About Our Process
Once we engage, you might think “this process is intrusive.”
Yes, it is designed to be.
Success with a worksite clinic is a complex and costly endeavor. A simple survey process or data collection and analysis would be incomplete and leave important opportunities uncovered.
There is important work to be done! You and your team are worth it.
The Results
Our services are intended to promote and support the impact and success of clinics for the employer AND the long-term viability of the clinic provider.
Here is what you can expect:
1.
A relationship with professionals who enjoy innovating with like-minded people to impact the move to healthcare value.
2.
An arms-length, honest portrayal, including regulatory considerations, of your clinic’s performance.
3.
Understanding the levers we can pull to improve performance: financial, operational and clinical – to help achieve your goals.
Frequently Asked Questions
Per ERISA, an employer should establish and follow a formal review process at reasonable intervals to decide if it wants to continue using the current service providers or look for replacements. When monitoring service providers, actions to ensure they are performing the agreed-upon services include:
- Evaluating any notices received from the service (clinic) provider about possible changes to their compensation and the other information they provided when hired (or when the contract or arrangement was renewed);
- Reviewing the (clinic) service providers’ performance;
- Reading any reports they provide;
- Checking actual fees charged;
- Asking about policies and practices;
- and Following up on participant complaints.
A Return on Investment (RIO) assessment, much simpler than a comprehensive assessment requires less than 30 days from our receipt of your data. A complete assessment with site visits and more complex analysis, interviews and study will require longer and depend on the number of unique locations and data collected. Plan on less than 45 days for up to two locations.
All de-identified of course.