What is an Onsite Healthcare Facility?

Imagine yourself at work, you are beside yourself coughing, sneezing and blowing your nose relentlessly into hysterics. You feel a chill, some goose bumps, and a slight dizziness.  Your phone rings, it’s your primary care physician saying “Dennis, please come see me as soon as possible.”  You gather yourself, dreading the move out of your seat and you make your way down the hall into an adjoining office.  You are greeted by your primary care physician.  Does that sound too good to be true? Onsite healthcare facilities are starting to populate within the core work environment and surprisingly they are becoming an employer’s best friend.

With the new Affordable Care Act, companies with fifty or more employees must provide adequate healthcare for all full-time workers.  This leads to the question, “will companies pay more money to supply healthcare to all?”  What if your company could combine saving money and delivering healthcare access without your employees leaving work?  Think of the benefits this would provide. 

First, employees with access to a provider at their office would develop a personal relationship with that provider, and would be able to identify concerns, create healthy strategies and encourage a change in patient behavior.  Providers will be fully aware of each case and highly sensitive to each patient’s needs.  Detecting symptoms early is paramount to minimizing (or possibly eliminating) any illness.  With daily visits and ongoing diagnosis, you could attack symptoms at the most treatable stages.

Secondly, with access to onsite providers your employees will live a healthier lifestyle.  With preventative measures and wellness programs, your employees will have less sick days away from their job and more time being productive at work, therefore reducing healthcare costs.    

How does it work managing onsite healthcare?  Take for example Walgreens and its Take Care Health Systems subsidiary, which manages approximately 400 worksite health centers using the Complete Care and Well-Being Health Service Network.  They deliver personal primary care coverage based on the needs of their client using special short term providers, better known as “locum tenens” providers. 

These locum tenens providers are unique.  They are physicians and/or mid-levels who are board certified in different specialties and who have different healthcare experiences.  Locum tenens providers can work for a day, a week, a month or as long as you like. They deliver onsite health and wellness screenings, primary care, occupational medicine, medical exams, flu shots, x-rays, pain medication and physical therapy to address acute and chronic health conditions.  The benefit for the Walgreens Network is that they can add or subtract locum tenens providers based on what service is needed and how many providers are warranted. From the Walgreens perspective, “Together, we work to customize your health and wellness initiatives so they complement the specific needs of your company.”

In summary, companies should embrace the onsite healthcare model as a possible solution to reducing healthcare costs.  It will reduce the employee’s time away from their desk and create healthier employees while reducing healthcare costs due to fewer claims. On the flip side, employees will enjoy a better lifestyle benefiting from less time spent in waiting rooms, more opportunities to be productive at work while still having immediate access to their doctor next door.

Is it time to prescribe an Onsite Healthcare Facility for your company?  

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Written by: 

Dennis Webb, Director of Business Development at Medestar

Phone: 214-932-1414

Email: dennis.webb@medestar.com

Website: www.medestar.com 

Follow us on Twitter: @medestarlocums

Follow us on LinkedIn: http://www.linkedin.com/company/medestar

Check us out on Facebook: http://facebook.com/fidelismedestar 

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What is your stance on the Patient Protection and Affordable Care Act?

After the release of the Supreme Court’s decision last Thursday to uphold the Patient Protection and Affordable Care Act, Americans clearly had mixed feelings about the new law. This decision was met with both excitement and disappointment nationwide.

One week after the Supreme Court’s 5-4 ruling, one public opinion poll reported that 54% of American voters wanted the law repealed. MDLinx surveyed U.S. primary care physicians after the court ruling and found 64% of the physicians do not believe the Affordable Care Act will be able to achieve 100% effectiveness of health care coverage for Americans. The MDLinx survey revealed that 45.7% of primary care physicians are skeptical of the decision, whereas only 22% think the act will result in an extremely positive impact for their practices. However, KevinMD’s physician blogger Kevin Pho, M.D., stated that the court decision is one everyone should be happy with. Physicians can expect lower Medicare and Medicaid reimbursements. KevinMD also states the benefits of for patients, not only uninsured but also those most vulnerable in the U.S. He suggests that the benefits will be tangible for more than just progressive Americans.

What is your stance on the Patient Protection and Affordable Care Act? Visit our Facebook page to weigh in. Are you in support of or against the ruling? Tell us why.

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How Will Bundled Payments for Care Improvement Affect Physician Compensation?

     On August 22, 2011, The Center for Medicare and Medicaid Services (CMS) innovation arm launched the “Bundled Payments for Care Improvement” program. This program outlines four different bundled payment models which provide an opportunity for providers to implement bundled payment systems which would also help control CMS’ costs.

     Trends like these will most certainly affect physician compensation models in the future. The CMS has launched a pilot program around paying hospitals, physicians and other providers a bundled payment for a diagnosis-related group (DRG) or DRGs and/or all associated post-acute care. This allows hospitals to gainshare cost savings generated through this initiative, providing a direct, meaningful incentive that hospitals have not traditionally been able to offer.

     Three of the initiatives would involve a retrospective bundled payment arrangement, with a target payment amount for a defined episode of care while the fourth initiative would be paid prospectively. The Bundled Payments Initiative would allow CMS to link payments for multiple services patients receive during a single episode of care, allowing more efficient delivery of health care and improvement in quality of care.

     Our clients with strong medical staffs and executive leadership are more likely to be successful with bundling efforts. Anyone interested in bundling would have filed a letter of intent to participate by March 2012 if inclined to do so.

     Please keep this in mind as you discuss compensation offers in the future. Below is a summary of the four initiatives offered:

     Model 1 defines an episode of care as the inpatient stay in the general acute care hospital.

     Model 2 defines an episode of care to include the inpatient stay and post-acute care and would end either a minimum of 30 or 90 days after discharge.

     Model 3 says the episode of care begins at initiation of post-acute care with a participating Skilled Nursing Facility, Inpatient Rehabilitation Facility, Long-Term Care Hospital or Home Health Agency within 30 days of discharge from the inpatient stay and would end no sooner than 30 days after the initiation of the episode.

     Model 4 entails CMS making a single prospectively determined bundled payment to the hospital that would encompass all services rendered during the inpatient stay by the physicians, hospital, and other practitioners.
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David Curtis is Executive Vice President of Business Development at Fidelis Partners.
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Emergency Medicine Physicians and Medical Liability Reform

According to an article from Kaiser Health News, the number of emergency room visits rose by about ten percent, or 13 million visits, to more than 136 million visits in 2009. The Centers for Disease Control and Prevention estimates this to be the largest increase ever. One factor contributing to this increase has to do with the Emergency Medical Treatment and Labor Act passed in 1986. This act requires hospitals to provide emergency services to all patients, regardless of their ability to pay for medical services rendered. The law, in and of itself, has driven up the number of patients seeking out emergency rooms and thus the number of overcrowded emergency departments in the nation. Another concern for emergency physicians comes from the Affordable Care Act which will require hospitals to reduce their readmittance rates by coordinating care or be financially penalized. This means physicians will be pressured by hospitals not to admit patients who cannot pay because the hospital will not receive payment from those patients. On the other hand, physicians will also feel pressure from their own conscience, from the family members of patients unable to pay, and from the continual specter of lawsuits.

All of these factors have led some emergency room physicians to focus on a possible means to reduce the nation’s health care costs—medical liability reform which they believe will discourage defensive medicine practice. One of the issues being discussed at the annual American College of Emergency Physicians conference this week is how many emergency physicians would like reform that would include indemnification based on recognized guidelines, caps on non-economic damages, and medical courts where providers would be judged by their medical peers. One important piece of evidence against medical liability reform is a study showing the number of congestive heart failure patients discharged from the emergency department dropped by sixty-three percent between 2006 and 2010 likely due to an increase in concerns about medical malpractice litigation.

What are your thoughts regarding medical liability reform?

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House Passes Health Care Reform Package

The House of Representatives passed a historic health care reform package late Sunday night. The vote on the last of the two bills in the package was 220-211. All 178 Republicans, along with 33 Democrats, voted against the measure.

What did you think of the vote?

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