City of Albany Human Resources Director Henry Cohen has his blood pressure checked by city wellness center manager and RN Dawn Laster. The wellness center, which operates 40 hours a week, is an element of the city’s group insurance plan. (Staff photo: Carlton Fletcher)
ALBANY — As health care, and subsequently, insurance costs continue to skyrocket, businesses have gotten creative in their attempts to provide insurance benefits that don’t threaten their bottom line to the point of extinction.
The city of Albany has joined a growing number of businesses whose group insurance plan includes an on-site wellness center, a mini doctor’s office that allows employees who are part of the plan to get primary medical treatment without costly emergency room or clinic trips, to receive pharmaceuticals at considerably discounted costs and to take part in assessments and follow-up treatment designed to lessen the incidences of catastrophic illnesses.
Need for such an initiative hit home for city officials when the recent release of health care statistics showed 21 such catastrophic claims (those in excess of $75,000) during the most recent fiscal year, numbers that elevated the city’s group plan more than $3 million beyond projected costs.
“There’s only so much you can do to control health care costs,” Albany Human Resources Director Henry Cohen said. “That’s a problem all employers are struggling with. Twenty to 30 years ago, employers picked up 100 percent of the cost of their employees’ insurance, but that model is no longer feasible.
“Wellness centers give employers an opportunity to impact health care costs by cutting the number of costly emergency room and primary care visits their employees make, by realizing savings in pharmacy costs and by helping maintain a healthier work force. Our insurance broker (ShawHankins) showed us the numbers, and they’re indisputable. Long-term, wellness centers pay dividends.”
The city started a wellness program in November of 2011, but results were spotty at best. It recently contracted with CareHere! of Brentwood, Tenn., to take over management of its program, and early results have been overwhelmingly favorable.
“We never really got the wellness program off the ground like we were hoping,” City Manager James Taylor said. “That’s one of the challenges you get sometimes when you go with the lowest responsible bidder. But we learned a lot the first time around, and we knew more what to expect from a wellness provider.
“CareHere! got great responses from other communities, so we believe we made the right choice to fit our health care requirements.”
In its 10 years of providing on-site wellness services, CareHere! has grown to include 150 locations in 26 states. The company provides wellness care for the entire state government of Montana and has a large presence with the city government of Montgomery, Ala.
“I think the primary difference in the services we provide is our personal, one-on-one relationships with each employee we see,” CareHere! Senior Director of Client Operations and Occupational Services Tim Hoback said. “After we do employee assessments and find potential health concerns, we provide individual wellness coaches to help employees modify their behavior.
“If an employee is overweight, our wellness coaches will help them plan a diet and exercise regimen. We help with smoking cessation programs and even some behavioral issues. Our program is designed where we know we’ll help our clients have healthier employees. We’ve never not been successful; we have a 100 percent success rate.”
The city bought the facility that houses its wellness center, located at 2000 N. Monroe St., from Phoebe Putney Memorial Hospital. That, Hoback said, was a plus.
“We have an equipment list for our clinics from nothing to turn-key,” he said. “Since this building had been used as a medical clinic, there were things already in place that saved the city a considerable amount of money.”
City employees are accepted at the wellness center by appointment only, but blocks of time are set aside each day for emergency calls. A physician, Dr. Kevin T. Brown; a certified physician’s assistant, Kimberly Powell; and a registered nurse, Dawn Laster, who also serves as the clinic manager, staff the center. They see employees from 7 a.m. to 6 p.m. Mondays and Thursdays, from 8 a.m. to 5 p.m. Tuesdays and Wednesdays and from 8 a.m. to noon on Fridays.
Currently, Brown is on duty 20 hours a week, Powell 20 hours a week and Laster 40 hours a week. Both Brown and Powell are certified to prescribe and dispense medications, many of which are stocked at the clinic.
“If someone is removed from one of the time slots during any given day, (Laster) will triage any emergency calls and get them into those slots,” Hoback said. “The important thing, though, is for employees to make and keep those appointments. We try to schedule them a 20-minute time slot with little wait time. Our goal is a wait time of five minutes or less, but our average is around two minutes.
“That cuts on employee downtime significantly.”
Brown, who has been involved in private medical practice since 1988, largely in the Macon area, said the clinic concept is the future of health care.
“It’s one of the most cost-effective means of health care,” the physician said. “Pretty soon you’ll see from 40 to 50 percent of all physicians working for a private company or government entity. That’s the current trend. The way the schedule is set up for employees, it gives you more time with each patient. That’s a plus. And the health coaches allow for not only corrective, but preventative health care practices.”
Powell, a native of Thomasville, said the “one-stop” concept of health care is a plus.
“They’re diagnosed here, treated here, and many medicines are dispensed here,” she said. “Having wellness coaches on standby further enhances the care employees receive. And, of course, if we diagnose more severe health concerns, we recommend that the employee see a specialist.”
Hoback said CareHere! hires the medical staff at each of its clinics, but the company does not tell the caregivers how to practice medicine.
“We hire them and check their credentials,” the CareHere! official said. “But we work with our clients to make sure our hires are a good fit. In Albany, we use our model based on (the city’s) health care vision. They know their population.
“We have medical directors for consults and training. Any medical questions will be addressed MD to MD.”
That, according to Laster, allows the wellness clinic staff to practice “right now medicine.”
“The big difference in what we do and the care that our patients would get at an emergency room or walk-in clinic is the ‘right now’ factor,” the Turner County native and Albany State University graduate said. “Our patients are getting right now treatment, they’re not sitting around hoping to get in. Their appointments are scheduled for a particular time, and we see them, dispense medication if required, and get them back to work.
“It’s an effective system.”
Cohen said the city would “break even at best” in the first year or so under the CareHere! wellness plan, then start seeing significant results in the third, fourth and fifth years. After that, he said, the impact will be dramatic in a different way.
“After the fifth year or so, you’ll see a tapering off of usage of the clinic because by then we should have healthier employees,” he said. “We’ll provide health risk assessments every year to determine lifestyle, medical history, blood and biometric factors that impact individual employees’ health. Since there will be a $60-per-month surcharge for any employee who does not have the assessment, we think that will be incentive enough to have most of our employees participate. Our first assessments in November 2011, we had 97 percent participation.
“From the assessment, our health care providers can develop a detailed medical profile that can help prevent some of the catastrophic illnesses that are common. Early detection is the name of the game.”
When it comes to the business of running the city, Taylor notes, having healthy employees is vital.
“It’s not just the employee health costs,” the city manager said. “It’s the lost time, too. If your people are out, the work still has to get done, whether you hire part-time employees or shift the burden. Certainly those costs are important because they’re taxpayer funded. But we care about our employees, too. The healthier they are, the better the quality of life they’ll enjoy.”