Health Plan Design is a Strategic Business Decision

According to a Korn Ferry Institute professional survey, the top reason candidates choose one job over another today is company culture. Twenty-three percent of respondents selected this reason as their top priority. Benefits were not far behind, with 19 percent choosing this as most important. However, the two are closely related. 

Companies are focused on being the best in their industry. They don’t have the time to devote to staying abreast of changes in the healthcare industry as new options become available. They look to their benefits brokers to help them add value to their employees while also protecting their profits. Here we’ll examine what employers are looking for and how brokers can help them stand out to potential candidates. 

Employers View Healthcare as Strategy
The nonprofit Business Group on Health (BGH) represents large employers and conducted the 2021 Large Employers’ Health Care Strategy and Plan Design Survey  in May and June 2020. The survey captured data from 122 large employers offering coverage to more than 9.2 million employees and dependents. Seventy-seven percent of the companies were building health plans for more than 10,000 employees. 

In addition to strategies for high-cost claims, employers are looking for fresh approaches to linking healthcare with workforce strategy. Forty-five percent of the employers said their healthcare strategy was an integral part of their workforce strategy, compared to 36 percent in 2019. 

Direct Primary Care (DPC) is a healthcare model that helps employers attract, motivate and retain employees in employer groups of all sizes. Here we’ll examine how DPC helps companies build full-bodied health plans that not only promote better employee health but make employees feel valued. 

Virtual/Telehealth Services 
Telehealth was rapidly gaining acceptance when a global pandemic catapulted it into the national spotlight. Many former in-person activities are being re-envisioned remotely, and that trend is here to stay. 

With 52 percent of large employers looking to offer more virtual care and telehealth options, it’s easy to see why direct primary care has become a go-to strategy. One of DPC’s key benefits is unlimited telehealth or virtual DPC visits for no out-of-pocket costs to members. The affordable monthly membership fee gives employees access to licensed medical providers online or by phone 24/7/365 for minor illnesses and injuries.  

This benefit means there are no deductibles to meet before insurance can cover a sick child or an injury from a minor accident. Families don’t have to forgo care because they don’t have the emergency funds saved to visit a primary care provider. 

Mitigating High-Cost Claims
Thirty-one percent of large employers surveyed want a strategy to contain the cost of high insurance claims. Direct primary care is not insurance but rather a healthcare membership that typically covers acute care, early chronic disease management, annual physicals, and urgent care. DPC shields employers’ health plans by diverting claims for care provided within the membership from insurance plans such as high deductible plans, Minimum Essential Coverage (MEC), health share plans, or others. 

Because DPC is a healthcare membership, it can be layered into any health plan at any time of the year to begin modifying employee behavior and impact costs by limiting claims exposure.  

Flexibility is the Future
The Korn Ferry survey asked professionals to predict what job seekers will value most from a prospective employer five years from now. Twenty-six percent of respondents chose flexible working situations. 

Even before the pandemic, flexible and remote work opportunities were waxing. Work from home productivity stats from 2018 shows that people who work remotely at least once a month are 24 percent more likely to be happy and productive. 

As brands expand their workforce nationally and remotely, they want to offer a healthcare solution for their employees that is consistent across all 50 states. Twelve percent of large employers are looking to adopt networks of high-performance healthcare providers in 2021. 

With a nationwide direct primary care provider like Healthcare2U, members can access primary care physicians in every state, face to face or virtually, for one low membership fee. This membership takes flexibility to a whole new level for today’s mobile workforce. 

When designing a health plan that works for today’s labor pool, the only limit is your imagination. If you’d like more information on how to bring a DPC solution to forward-thinking clients, contact Healthcare2U. 

Increased Demand for Virtual Healthcare Going Forward

As the largest living segment of the population, Millennials will comprise 75 percent of the workforce within the next six years. It’s no secret their appetite for convenience and technology has driven innovation in every sector, including healthcare. Even before 2020, telemedicine and virtual healthcare were considered the wave of the future.

The pandemic accelerated that push toward the future and the demand for telemedicine and virtual care will only continue to increase. Kristi Mitchell, practice director for Avalere’s Center for Healthcare Transformation, recently highlighted research indicating patients are more and more comfortable using telehealth and virtual care, viewing it as a way to strengthen relationships with their providers. She said, “Now that we’ve gotten a taste of it, there is tangible consumer demand pushing for it to stay.”

The boom in virtual care for mental health, the ability to manage chronic diseases, and equity and access for underserved populations are three reasons the trend for virtual care will continue to surge.

Mental Health Care Remains Important

The pandemic forced many services to go online, including psychiatry. Patients were forced to either get treatment virtually or by phone or delay care until in-person sessions were safe again. In an environment of accelerated unemployment, loss of life, and social unrest, waiting for mental health care wasn’t an option for some.

Many patients adopted virtual treatment readily, according to the digital health publication JMIR. A recent study of 244 Michigan psychiatric patients reported that 96 percent were fine with virtual or telephone sessions.

According to the survey, more than 90 percent of respondents chose to continue virtual treatment after nine months, saying virtual visits met or exceeded their expectations. It seems the patients appreciated online sessions’ convenience and the ability to schedule emergency sessions more easily.

Consistent Management of Chronic Disease

Chronic diseases like hypertension, arthritis, and diabetes drive the $1.1 trillion in healthcare costs for chronic disease management. Active monitoring and medication management are a large part of treating chronic conditions, and virtual care can deliver these services.

Data shows commercially insured patients turned to telemedicine for chronic care management at significantly higher rates than traditionally. The number of telemedicine claims related to diabetes, hypertension, and back pain increased 642 percent, 441 percent, and 258 percent, respectively. That’s a lot of claims impacting employers’ bottom lines.

If employers adopted a no-claims healthcare option that still provided unlimited virtual care and telehealth to manage chronic diseases, the savings could be exponential. Direct primary care (DPC) is one such option. This monthly healthcare membership not only allows patients to see a primary care physician in-office as often as needed, but it also provides unlimited access to telehealth and virtual visits.

Access for All

It’s interesting to note that telehealth was initially created to help hospitals reach patients who lived in remote or rural locations. Even in 2017, rural Americans were getting notably sicker as health systems struggled to deliver care in their areas. Only 10 percent of physicians serve rural populations, and the number of specialists is even fewer.

While rural patients lack providers, urban Americans have access problems because there is a shortage of in-person appointments. A survey of uninsured or individually insured respondents found 32 percent of urban and 21 percent of rural patients said they experienced delayed care when they thought they needed care sooner. Delayed healthcare leads to escalating conditions and escalating costs.

Both rural and urban Americans need a system that delivers quality healthcare that is not constrained to a particular geographic location, and they’re finding it in direct primary care.

Experts estimate 35 to 50 percent of in-person care will be delivered in a virtual primary care setting going forward. While the role of DPC and virtual care came to the forefront during the pandemic, many employers and employees are unaware of this benefit. If you’d like more information on how to bring the virtual care revolution to more clients, contact Healthcare2U.

Be Prepared for the New Normal Through the Power of Partnerships

If 2020 has taught us anything, it is to be prepared. Businesses of all shapes and sizes have been hit hard by this past year’s events and need flexible benefit brokers with a portfolio of products to adapt to their new normal. By combining insurance options, voluntary benefits, and non-insurance alternatives, brokers can step out of the major medical box to deliver a customized health plan to their diverse clients—distinguishing themselves from their competition. Partnerships with pioneering third-party administrators, insurance organizations, and health care memberships allow brokers to listen to their clients’ pain points, then deliver a tailored solution that meets their needs.

Partnering with a Third-Party Administrator

Most benefits providers have the same goal in mind: connecting people to exceptional healthcare. A third-party administrator (TPA) is a powerful ally when designing an effective and easy-to-use health plan.

A TPA can blend different carriers to build a variety of healthcare products. Each product in the plan can stand on its own, but like a biochemist, a third-party administrator understands the synergy of combining products to provide the best options for clients and make sales and marketing easier for brokers.

Employers enjoy the simplicity of having one payroll deduction per employee for all their healthcare products. The administration is what TPAs do, so they can quickly relieve an employer of the burdens of payment processing, compliance issues, and other nuances that can get complicated if you’re not well-versed.

Challenges of the Current Landscape

Every person, regardless of age, gender, or socioeconomic background, needs healthcare. Research shows people who utilize a primary care physician have 33 percent lower annual adjusted health care expenditures and lower adjusted mortality rates than those who don’t.1

The challenge is providing primary care and other health benefits that are affordable and easily accessible to everyone. Small businesses too often feel they can’t offer benefits.

Unfortunately, the cost of health insurance is continually increasing. Some employers are forced to pass healthcare costs onto employees in the form of high deductible health plans (HDHPs) to combat rising premiums. While an HDHP may offer premium services, some employees can’t afford to meet the deductible before health coverage begins, making the benefits unusable.

Whether offering a MEC or HDHP, employers also struggle to manage health plans’ costs due to insurance claims. These unpredictable claims are the wildcard of any benefits package, and many employers are uncomfortable with that level of exposure. They’re looking for brokers who can offer solutions to mitigate these costs.

Synergy Contains Costs

One way to contain an employer’s healthcare expenses is to combine MEC and HDHP insurance options with a no-claims option like direct primary care (DPC). DPC is a healthcare membership that differs from insurance because there are no premiums or deductibles to meet. There are no claims to process or impact the employer’s bottom line later.

Facility operators encourage physicians who work in their network to push patients toward specialist care and facility tests and evaluations, because that’s where they generate the most revenue. This practice is terrible news for employers when those large claims come in.

In contrast, direct primary care seeks to keep employees healthy so that they won’t need specialized care in the long run. DPC members pay a low monthly membership fee for unlimited access to a primary care provider. Most providers offer telehealth services and virtual visits as well—a game-changer over the last year. Utilizing primary care as recommended keeps health from deteriorating into more costly disease states or conditions that may require specialized care, such as surgery.

Should a catastrophic event or accident occur, a DPC member could still engage their HDHP or other insurance at that time. But for routine family care, direct primary care softens the blow for employees and employers.

Negotiating Better Rates with Other Carriers

Putting direct primary care into a health plan also directly affects the aggregate rate for stop-loss insurance. Stop-loss carriers know that adding DPC to a health plan offsets claims, so they offer reduced fees for companies who incorporate it. This practice is another cost reduction just for adding a direct primary care product with other insurance alternatives.

Also, health shares offer substantially discounted rates to employers who provide DPC as well. Those savings alone could cover the direct primary care cost in the health plan while also shielding the plan from shareable expenses.

Partnering to Provide Solutions for Associations

Health plans for associations ended with the ACA. This issue left a severe void in healthcare for professionals. There aren’t many low-cost solutions in all 50 states, but direct primary care is one.

Sometimes forgotten by brokers, there are still many associations that want to provide benefits to members in every state, but they don’t know how to do it. A savvy broker partnered with the right TPA can help fill the void for these organizations who may not understand the benefits of a product like DPC or other offerings that can work alongside it.

A Shift is Happening

There was a time when everyone wanted a Blue Cross Blue Shield plan, but brokers noticed a significant shift happening. Consumers say these products are expensive, and they also don’t always provide the best coverage. Feeling there must be a better way, many clients are looking for more cost-effective alternatives like DPC to blend into health plans. The 2020 Large Employers Health Care Strategy and Plan Design Survey confirmed that implementing advanced primary care strategies is an emerging trend among employers for 2021.

Employees want healthcare they can afford to use, and employers want to provide benefits that won’t wreak havoc on their profits. By leveraging the power of partnerships, a new breed of benefit brokers offers health plans that are both affordable and robust.

 

1 Franks P, Fiscella K. Primary care physicians and specialists as personal physicians. Health care expenditures and mortality experience. J Fam Pract. 1998 Aug;47(2):105-9. PMID: 9722797.

Looking into Healthcare’s Crystal Ball – The Present and Future of Direct Primary Care

The sun was already setting on the traditional in-office business world as we knew it, but 2020 became an accelerant that forced a reckoning on all fronts. The conventional ways of doing business, having a workforce in one location, and one-size-fits-all benefit plans quickly fell out of favor. Companies on the cutting edge of technology and innovation fared better than those who were slower to adopt new methodologies.

This past year drastically upended not only traditional business but also the way we consume healthcare. From virtual primary care to virtual urgent care visits, we learned that telemedicine isn’t only a helpful benefit in some healthcare plans, but it’s vital in this digital world. Here we’ll examine how outdated traditions are being replaced by a hybrid healthcare solution that transcends socioeconomic and geographic barriers for employers of every size.

The Past

In 2018, 40 percent of American households earned less than $50,000 per year per four-person household. Low wages with no benefits have left many Americans out in the cold when it comes to healthcare. According to the Bureau of Labor Statistics, 69 percent of low-wage workers, those in the 10th lowest percentile of median wage earners in the U.S. civilian workforce, do not receive paid sick leave benefits.

With earnings so low they can’t afford to take unpaid time off when sick, many keep working and expose others to illness in the process. COVID-19 taught us this practice could have serious, if not deadly, consequences. Direct primary care (DPC) is a healthcare model that evolved to be a cost-effective solution that makes healthcare more accessible to everyone via a multi-platform delivery of care through in-person, phone, or video visits. In situations like these, access to a primary care physician via telehealth became extremely meaningful.

Traditional DPC

To eliminate the stress of dealing with third-party payers, many doctors opt to see patients on a direct primary care model only. This practice is known as a traditional DPC practice. Instead of billing insurance, members pay a monthly fee for unlimited primary care. This model gives doctors the ability to offer the same level of high-quality care to all their patients without generating claims that will later impact an employer’s health plan.

Because traditional DPC eliminated insurance billing codes, physicians operating solely under the DPC model benefit from both the lower overhead associated with small practices and the absence of hassles created by insurance companies. With the model, employers and employees get an affordable healthcare alternative to insurance, but there are limitations. Traditional DPC practices are regional, meaning they can only see a limited number of patients because they exist in one location. Employers with multiple or nationwide locations and mobile or remote workforces need accessibility and convenience for their entire crew.

The Tipping Point

DPC Present and Future

The pandemic taught businesses to lean into flexibility. A recent survey found 74 percent of CFOs plan to keep workers remote after the pandemic. From a financial standpoint, having a remote workforce makes sense. The cost savings have allowed many companies to avoid further severe cuts and downsizing.

Even after the pandemic is over, many don’t expect to return to business as usual. Facebook announced its employees could work from home for the next 5 to 10 years. Twitter and other large companies have also announced a permanent switch to virtual-first work environments. We’ll likely see more central offices replaced with far-flung employees and contractors outside of metropolitan areas. The trend was already happening pre-pandemic, and now it’s accelerated.

In 2019, 65 percent of professionals said they would be more productive working remotely than in a traditional office, with 49 percent saying they go to their home office when they need to focus and get work done. With cost savings, increased productivity, and rising employee morale, it’s clear a remote workforce isn’t forthcoming—it has already ignited.

Situations like this will raise new healthcare issues for a team working from a variety of locations. And, for those employers who were forced to lay off workers, shrinking headcounts could also have an unforeseen impact on insurance premiums.

What that means for employers is the traditional options for health plans are incongruent with how employees live today. Traditional Direct primary care practices adapted to a hybrid approach to fill this ever-widening void for employers who have remote employees in various states and mobile workers who live on the go.

Nationwide, Hybrid DPC

A hybrid Direct Primary Care (DPC) model is especially beneficial when it’s part of a nationwide network of providers accessible in any state. This approach has been a game-changer for companies expanding their remote workforce across state lines. It’s also extremely beneficial for restaurants, hotels, and other hospitality industry businesses with locations in multiple states.

The Benefits of Hybrid DPC

For transportation, sales, and other mobile professions, a nationwide DPC membership is extremely valuable for several reasons. Each provider has its list of particular services, but some DPC membership benefits include:

  • Patient advocates to support members in navigating their healthcare options
  • 24/7/365 access to a primary care provider via telehealth or in-office visits
  • Unlimited in-office visits for a minimal-to-no fee
  • Annual physical provided to establish a baseline for member health
  • Early-stage chronic disease management

It’s helpful to have health insurance for catastrophic life events, but being able to see the doctor when you’re ill without paying expensive deductibles or copays is a reason people love DPC.

Traditional DPC practices and hybrid DPC providers are all working together to ensure people of all socioeconomic backgrounds can get the healthcare they need to live happier and healthier lives. If you’d like more information about access to affordable and convenient healthcare, contact Healthcare2U, the nation’s fastest-growing, hybrid DPC provider.

Affordable Healthcare Alternatives Can Minimize the Fallout from COVID

While lockdowns have helped save lives by mitigating the spread of COVID-19, their implications for the economy and the long-term health of the population are far-reaching. As companies struggled to adjust their business models to survive during the pandemic, many were forced to shut their doors or downsize to stay afloat. Economists predict the record unemployment seen over the past year will affect the health of Americans and increase the mortality rate.

Past studies show that decreasing the use of preventive care, an increased suicide rate, and an increase in cardiovascular disease deaths can cause death rates to surge when unemployment rises. Economists Francesco Bianchi, Giada Bianchi, and Dongho Song recently analyzed how changes in U.S. unemployment rates correlated with changes in U.S. mortality figures in recent decades.

Sobering Predictions

The economists predict pandemic-related unemployment could cause about 460,000 excess U.S. deaths over the next ten years. That doesn’t include the number of people killed by the COVID-19 virus itself. It’s a very sobering thought when you let it sink in. Financial experts expect nearly half a million people to die from health problems brought on by financial stress and a lack of preventive care.

According to economists, there are a few things policymakers and companies can do to get ahead of this dire prediction. They recommend mask-wearing and social distancing in the workplace and advocate ensuring people have access to health care. Here we’ll examine how affordable healthcare alternatives, such as direct primary care (DPC), can soften the financial blow for employers and current or laid-off employees who want to maintain their access to quality healthcare.

The Problem with COBRA

Millions of workers have been laid off or furloughed over the past year, and while many could opt into health coverage under COBRA, that can be very expensive for employees and employers. If an employee has chronic conditions, like diabetes or heart disease, getting regular care can also lead to excessively high claims costs for employers in this scenario.

A DPC membership with a low monthly membership fee can be an affordable healthcare alternative in cases like these. Suppose employees (current, laid off, or furloughed) are looking for day-to-day primary care and preventive care. In that case, a nationwide direct primary care membership can be a cost-effective healthcare option.

No-Claims Healthcare Alternative

The purpose of the relationship between a patient and a primary care physician (PCP) is to create a continuous health-management conversation rooted in trust and respect. Preventive screenings, knowledge of family health history, and managing chronic conditions are a few of the benefits of this relationship.

Even before the financial stressors and unemployment caused by the pandemic, 60 percent of Americans were living with one or more chronic diseases. Some of these conditions were preventable but went undetected due to a lack of primary care. Sometimes disease states escalate due to lack of consistent care, which is often tied to financial strain. This doesn’t have to be the case when you have a no-claims solution like direct primary care.

Because DPC isn’t health insurance, there are no claims to impact the employer’s bottom line and no deductibles for the employee to meet before getting necessary care. For example, Healthcare2U offers direct primary care memberships that provide unlimited in-office primary care visits for a low fee and telehealth or virtual visits for no out-of-pocket costs. These benefits allow workers to not only get preventive care, but the membership also includes unlimited treatment and management of 13 chronic disease states for the same $10 visit fee. Healthcare2U accepts pre-existing conditions within manageable ranges, including:

  • Anxiety
  • Arthritis
  • Asthma
  • Blood Pressure
  • CHF
  • COPD
  • Depression
  • Diabetes
  • Fibromyalgia
  • GERD
  • Gout
  • Hypertension
  • Thyroid

Hope for the Future

Economists predict the number of excess deaths caused by pandemic-related unemployment could amount to about 1 in 400 people in the U.S. population in 2035 or about 1 in 270 people in 2040. That’s .25 to .37 percent of the population, and it’s preventable with quality healthcare.

Benefits brokers have a unique opportunity to educate employers who may or may not be forced to lay off employees about the cost savings associated with direct primary care. By utilizing an affordable monthly healthcare membership, people can continue getting preventive care and treating chronic conditions that could lead to mortality.

If you’d like more information about DPC for current or laid-off workers, contact Healthcare2U.

Affordable Healthcare and Financial Literacy for Millennials [How Direct Primary Care Delivers the On-Demand Healthcare Experience that Millennials Want]

Faced with a rapidly changing way of living and working, millennials (people born between 1981 and 1994/6) often struggle to find their financial footing. The pandemic has affected many Americans, but a recent poll says COVID-19 has had a significant negative impact on millennials’ finances and savings.

According to a Harris Poll, commissioned by DailyPay, Funding Our Future, and the Center for Financial Security, 52 percent of millennials say their savings have declined since the beginning of the pandemic. Only 35 percent feel they are on track to achieve their retirement goals.

A disturbing 44 percent of millennials had either no savings (17 percent) or lacked enough savings to cover a $400 emergency expense (27 percent). A mounting feeling of financial instability with no plan to reach short-term financial goals or long-term retirement goals is a significant stress source for millennial workers.

Unexpected medical bills can add unnecessary stress, and not knowing how to use the healthcare system properly can lead to racking up more medical expenses than necessary. Thus, affordable healthcare should be part of the financial literacy conversation. With a little help from benefits brokers and employers, these young staffers can learn about affordable healthcare options, like direct primary care (DPC), that can ease their financial burdens and keep them on track for the future.

Employee Expectations are Evolving

It’s abundantly clear that many of the changes we’ve adopted during the pandemic will become permanent in the years to come. For example, telehealth has become commonplace—and the preferred method of care for many. Much like going online for meetings, millennials were quick to take a digital approach to every area of their lives, including healthcare.

Whether they’ve been impacted directly by COVID-19 or not, the current crisis has led many employees to rethink which benefits they need most. Millennials who may have just started families or may want to shortly seek benefits that will provide a safety net for their family without further straining their financial health.

They may be more open to considering benefits they haven’t weighed in the past, such as direct primary care, to ensure they are adequately covered.

DPC is a perfect fit for Millennials

on-demand healthcareMillennials take responsibility for their care and are less likely to depend on a health system with which they are not satisfied. The Kaiser Family Foundation survey found that 45 percent of 18 to 29 year-olds and 28 percent of 30 to 49 year-olds have no primary care provider (PCP). They also learned that more than 33 percent of millennials prefer on-demand healthcare from retail walk-in clinics over visiting their doctor’s office.

These statistics point to a larger generational shift toward on-demand healthcare, where younger patients prioritize the delivery speed and availability of appointments. With a little education, this group can learn the benefits of developing a long-term relationship with a PCP in a direct primary care environment. They still get speed and availability, but they can also keep their health history in one central location.

DPC is an affordable monthly healthcare membership that gives employees unlimited access to a primary care provider through in-office visits, telehealth, or virtual visits. Instead of using an urgent care center or emergency room as the go-to primary care setting, DPC members save money in the long run by avoiding expensive copays, insurance premiums, and escalating health conditions that will cost more if not treated promptly.

Knowledge is Power

The post-pandemic economic recovery could include a massive expansion of job options made possible by the work from anywhere revolution. Some say it could ignite a battle for talent unlike any other. With turnover costing employers 20 percent of an employee’s annual salary, attracting and retaining employees becomes even more essential to business success. Part of retaining talent is helping employees understand the employment benefits available to protect them and their families regarding affordable healthcare.

According to a recent survey, many employees turn to their employer for financial advice and counseling. Millennials mostly want help creating a long-term financial strategy, and most can’t afford pricey financial advisors. However, employers can remedy this by partnering with knowledgeable benefits brokers to provide educational workshops for employees.

Nearly two-thirds of employees believe the COVID-19 pandemic will impact their path to retirement, and many are looking for ways to save more. This world-changing event has made millennials and other workers more aware of the coverage needed to protect their own health and wellbeing, as well as their family’s. Direct primary care can be an integral part of minimizing the cost of effective healthcare for young families.

For more information on bringing DPC to a workforce that includes multiple generations, contact Healthcare2U.

Direct Primary Care Helps Address Healthcare Inequality for Children [Accessible and Unlimited Primary Care]

Because of the important role health plays in all aspects of our lives, many feel more needs to be done to address the crisis of healthcare inequality for children. In addition to poor fitness and nutrition, a lack of proper healthcare also contributes to these children’s conditions. Unfortunately, the number of children with health coverage in the U.S. declined for the third consecutive year in 2019, according to census data—and that was during a period of economic growth. The pandemic also ushered in sweeping job losses that cost many families their health coverage, with certain parts of the country feeling the impact more than others.

According to a report by the Georgetown Center for Children and Families, Texas and Florida were among the states with a more pronounced loss of health insurance for children. The report also highlighted the fact that Latino children were disproportionately affected.

With nearly 4.4 million children uninsured as of 2019, the pandemic’s fallout is still ongoing and is yet known. It appears the future health of the American population is at risk unless families at the bottom of the socioeconomic ladder can find a solution to the healthcare crisis. Here we’ll examine the importance of addressing care inequality for children and how to eliminate the disparities.

What happens when we ignore the problem?

According to a report published by the Centers for Disease Control and Prevention (CDC), millions of infants, children, and adolescents in the United States do not receive essential clinical preventive services. The report revealed large disparities in the receipt of clinical preventive services between insured and uninsured children. Hispanic children were also less likely than non-Hispanic children to have reported vision screenings.

Preventive healthcare services delivered by primary care physicians support healthy development in children. Because primary care is the foundation for good health, these services prevent and detect conditions and diseases in their earlier, more treatable stages and significantly reduce the risk of illness, premature death, disability, and expensive medical care in the future.

Newborns and children usually see doctors more than adults because their needs change as they grow. According to the CDC, 32 percent of children’s visits to the doctor are for preventive care. Without access to essential healthcare services and screenings, sick children become even sicker adults with chronic conditions and other illnesses that could have been prevented.

Primary Care Providers Promote Wellness in Children

Primary care doctors care for adults and younger patients, including well-child visits and vaccinations, and provide care for illnesses, injuries, and other disorders. Having one doctor who tends to the whole family’s needs can be especially helpful when family members share the same health issues. Understanding your family’s health history and learning how to course-correct is invaluable, but when so many can’t afford health coverage, is this a luxury reserved only for affluent families? Not anymore.

Even when employees are fortunate enough to have health coverage through their employer, many can’t afford to cover their dependents. Premiums escalate for every family member added to a health plan. Because of the cost, many are forced to choose between keeping their lights on or providing healthcare for their children. For this reason, many have turned to direct primary care (DPC).

DPC is an affordable option for employees, but it can also be implemented as a dependent-only alternative. The employee can keep their employer-paid plan and choose primary care and chronic disease management for their spouse and children at an affordable monthly rate.

Significant Benefits for a Small Cost

Considering eighty percent1 of annual healthcare services can be addressed through a family physician, Direct Primary Care is comprehensive. Since DPC isn’t health insurance, there are no expensive monthly premiums, deductibles to meet, or costly copays. The member, or their employer, pays a low monthly fee for a healthcare membership that includes unlimited primary care office visits, telehealth, and virtual care for little-to-no out-of-pocket costs. Direct primary care providers like Healthcare2U even offer DPC memberships for employees that have been laid off or furloughed.

With a nationwide network of primary care providers, they’ve also eliminated geographic barriers to care. So regardless of where people live, they can get primary care and preventive screenings for their families at a very affordable cost.

It’s vitally important for employees to understand the scope of their health and their children’s health. Staff can’t function at their best when they are sick or worried about a sick child who can’t get needed care. By providing an affordable alternative like direct primary care, employers can provide peace of mind for employees and reap the rewards of productivity and increased employee morale.

If you’d like more information on implementing DPC to end care inequality for children and employer groups nationwide, contact Healthcare2U for more details.

 

 

Andrew Bazemore, MD, MPH, Stephen Petterson, PhD, Lars E. Peterson, MD, PhD, Richard Bruno, MD, MPH, Yoonkyung Chung, PhD, Robert L. Phillips Jr, MD, MSPH, “Annals of Family Medicine: Higher Primary Care Physician Continuity is Associated With Lower Costs and Hospitalizations,” 2018, 493

 

The Small Businesses Healthcare Revolution

A recent study found 79 percent of small business owners worry about the costs of healthcare. Fifty-nine percent also believe that an increase in insurance premiums will make it challenging to continue providing healthcare benefits for employees. Another 47 percent lament that the costs of health insurance limit their abilities to offer raises or bonuses.

When it comes to business operations, small businesses (those with nine employees or less) work differently than larger companies. Limited financial and human resources force them to operate from a different perspective. Owners must find creative solutions for day to day operations, customer service, human resources, and company culture.

Success hinges upon their ability to build a highly functioning team of qualified individuals who wear multiple hats. Recruiting and retaining the best talent is often tricky because smaller budgets mean smaller salaries. Employees in these situations value a company culture that makes them feel provided for and appreciated. An integral part of that culture is a benefits package with meaningful health coverage.

The Problem with Traditional Options

Businesses with less than 50 employees don’t have to provide healthcare, but most employers know that health benefits are what potential employees are looking for. A survey by the Employee Benefit Research Institute acknowledged that workers overwhelmingly consider health insurance to be the most critical workplace benefit.

Because of health insurance’s financial burden, some small businesses choose self-funded plans where they pay health claims out of pocket rather than a fixed insurance premium. This choice can be risky business as it exposes the company to the risk of extensive bills in the event of a catastrophic employee health crisis. To avoid the potential for bankruptcy, many companies take on the additional cost of stop-loss insurance to mitigate the risks.

Small group plans are often expensive, non-customizable, and come with yearly premium increases. And because employees are all part of the same risk pool, even one indisposed employee leads to higher prices.

For the small businesses who want to offer a health plan, a high deductible health plan (HDHP) is one option. While coverage is available, employees often feel they can’t afford to use the plan because of out-of-pocket costs. Having to meet a high deductible before coverage kicks in is difficult for most families. A recent survey found that nearly 25 percent of Americans skipped medical care over the past year because of costs.

Affordable Solutions for Employers and Employees

Because Direct Primary Care (DPC) is a no-claims healthcare membership, DPC protects employers’ health plans by diverting claims for acute care, chronic disease management, and urgent care away from health plans and into the DPC environment. For example, employers who incorporate DPC into their level funded or ASO plans reduce their odds of exceeding claims allowances and increasing rates the following year. Because there are no claims for care provided by DPC providers, employers can give their employees affordable access to primary care to maintain health and manage chronic diseases without the impact of those claims hitting their plan. Additionally, diseases managed in the early stages through DPC can potentially save the company from more expensive shock claims due to those conditions not being managed.

Small employers can stand out from competitors by offering affordable DPC to 1099 employees, part-time workers, full-time staff, and dependents. To attract and retain the most qualified contractors and employees, companies must think outside the box to provide top-notch healthcare. DPC gives the uninsured benefits they want while protecting their employer’s bottom line.

Employees Want to Know They Matter

With DPC, members pay a low monthly fee for unlimited primary care visits instead of paying monthly insurance premiums. There are no expensive copays or deductibles to meet, and plans also include telemedicine, virtual visits, and prescription discounts. DPC can also be offered alongside a self-funded plan or HDHP as a gap solution.

Providing affordable and easily accessible healthcare is a logical step toward improving employees’ health, who may be more likely to embrace preventive screenings and care. One could also conclude that healthier employees with an option like DPC are less likely to be burdened by financial stress. Feeling valued, enjoying minimal healthcare costs, and self-care are likely to boost attendance, productivity, and profits for any small business.

According to the U.S. Small Business Administration, there are nearly 30 million small businesses in the United States, employing 47.8 percent of workers. To learn how to bring direct primary care to this enormous market, download more information on Healthcare2U’s Small-Group Bundle.

 

3 Reasons You Should Be Having as Much Fun as Possible

Research suggests the best way to navigate a pandemic, work, family stress, and social unrest is to have as much fun as you possibly can. It may sound counterintuitive or even selfish, but not doing so can be detrimental to your health and mental well-being. Recreational deprivation is linked to criminality, obesity, lack of creativity, anxiety, and depression. Here we’ll explore three reasons you should have as much fun as possible.

Play Teaches People to Cope Without Violence

Stuart Brown is the founder and president of the U.S. National Institute for Play and author of Play: How it Shapes the Brain, Opens the Imagination, and Invigorates the Soul (2009). As a researcher at Baylor College of Medicine in the 1960s, his study of 26 young male murderers helped him identify the vital importance of play in children and adults’ lives.

Brown and his colleagues found that a history of physical abuse and play deprivation played a significant role in these young men’s lives. His further studies revealed regular play was virtually absent throughout the lives of highly violent, antisocial men, regardless of demographic. They concluded the subjects would have been better able to cope with life’s vicissitudes without recourse to violence had they been allowed to play with other children growing up.

On the flip side, highly successful and creative people demonstrated a history of regular social play—a vital part of healthy development. Children learn social competency, curiosity, resilience, and emotional intelligence through play experiences throughout their lives.

Social Fun Mitigates Anxiety and Depression

Socializing and participating in physical activities are healthier coping strategies to manage depression or anxiety than drinking alcohol or dwelling on negative feelings. Exercise and physical activity can also give you the chance to meet or socialize with others.

Dancing, team sports, or working out with a friend can all release feel-good endorphins, natural cannabis-like brain chemicals (endogenous cannabinoids), and other natural brain chemicals that can elevate your sense of well-being.

Finding creative ways to take your mind off worries is paramount to ending the cycle of negative thoughts that feed depression and anxiety. Spending time laughing with friends new and old can lighten any mood, whether in person or through technology.

Playing Games is Good for Your Brain

In addition to regular physical exercise and a healthy diet, researchers have found fun activities can help reduce the risk of future cognitive decline. Participating in activities that stimulate the mind, such as reading, writing, and playing games, can improve brain health. Did you know exercising your brain can help prevent beta-amyloid deposits from developing? These harmful proteins are common in those who develop Alzheimer’s disease.

When you stimulate your brain, you also trigger sensory responses that help you stay engaged and pay attention. This response is yet another way playfulness and being engaged with others can help prevent Alzheimer’s disease.

Here are some brain-stimulating activities you can incorporate into daily life to promote long-term brain health.

  • Virtual game nights
  • Online video games
  • Book clubs
  • Write poetry or short stories
  • Handwrite cards and letters to people you love
  • Take a pottery class
  • Learn how to sew
  • Adult coloring books
  • Painting and drawing
  • Holiday craft projects
  • Build something
  • Take a class
  • Learn a new language
  • Listen to or play music
  • Dance
  • Visit a museum
  • Try new recipes
  • Learn a new word each day
  • Talk to family and friends

As you can see, there is no shortage of stimulating and engaging activities to incorporate into your life. Not only can it help strengthen relationship bonds, but it can also promote your physical and mental well-being.

The holidays are a fun time to connect with new and old acquaintances, pick up a new hobby, or take some time for self-care and reflection. Set yourself up for your most creative and productive year yet by making fun a top priority.

Tailored Healthcare Solutions Protect Employer Profits [Direct Primary Care Takes Center Stage During Open Enrollment]

A well-structured health plan isn’t accidental. Ideally, benefits brokers work with employers to offer a wide range of choices that fill in coverage gaps and address budget concerns for businesses and their employees. Clients want brokers who confidently recommend tailored healthcare solutions because how employees consume healthcare directly impacts their health plan’s overall expenses.

Knowledgeable brokers have learned to layer options like Direct Primary Care (DPC) into health plans to soften the blow of insurance claims and escalating premiums and deductibles. But often, benefits administrators don’t fully understand the power of the tools included in their company health plan and how to instruct employees to utilize them effectively. By communicating DPC’s benefits to their clients before open enrollment, brokers can set companies up for greater success with their health plans and help protect profits.

In turn, a well-equipped benefits administrator can educate employees to use their health plan more effectively and economically — saving the company and the employee more money in the long run.

 Equip Benefits Administrators

Because employees may have been offered traditional health insurance or possibly no health coverage in times past, they do not understand how to use benefits when presented with a choice like direct primary care. Statistically, people who effectively utilize primary care have better long-term health outcomes, so education about the DPC benefit is critical.

Those employees who fail to understand the power of primary care may end up using an urgent care clinic or going to the emergency room for ailments that can easily and more affordably be addressed by a primary care physician. This reactive approach can lead to delayed acute and chronic care, the onset of serious illnesses, and overall declining health. This practice is very costly due to expensive out-of-pocket fees for the patient and can eventually lead to “shock” claims that impact the employer’s bottom line later. The absence of proper care leads to greater absenteeism and presenteeism, which leads to lost productivity and lost profits.

Open enrollment is the perfect time to encourage employer groups to express the importance of having a relationship with a primary care physician and how affordably they can do that with direct primary care. To help employers and benefits administrators understand the benefits and ease of use DPC can provide for them, Healthcare2U has created an eBook titled, “How to Train Your Employees to Protect Profits Through Their Direct Primary Care Membership.” It’s available for download here.

 What Clients Will Learn

By providing simple staff training at open enrollment, employers can train employees to protect profits through a direct primary care membership. In this eBook, they will learn:

  • How to overcome escalating challenges for employers and their employees
  • Why primary care is considered the foundation for health
  • How to deliver a primary care solution for a mobile workforce
  • Ways to educate employees to utilize health plans effectively

Another bonus employer groups will find in the eBook is a video they can email to staff to explain the power of their direct primary care benefits.

Tailored Healthcare Solutions Protect Employer Profits

 Remember, Communication is Key

As your go-to direct primary care organization, Healthcare2U has made it easy for you to communicate how DPC can protect clients’ earnings by mitigating insurance claims. By emailing clients a link to this informative eBook, they can better understand how to train their employees to protect their bottom line.

Employers can then pass on the information to their staff through this short educational video. With these resources available year-round, benefits brokers and employers can help steer employees toward better health outcomes and significant savings for everyone.