As employers continue trying to figure out how to reduce their business’s and their employees’ health insurance outlays while providing quality care, some companies are taking bold steps and experimenting with new models of coverage.
General Motors is the latest large employer to take a stab at experimenting with its health insurance model for its workers. It’s doing so by contracting with the Detroit-based Henry Ford Health System to provide health services to 24,000 of its salaried employees and their dependents.
Under the plan, employees who sign up for the plan will be required to get all of their health care services through the Henry Ford hospital system. If they stray from the network, they will have to pay high out-of-network prices for the care. GM is self-insuring the program.
GM will still offer its traditional PPO plans to its employees, but those who choose the new GM ConnectCare plan can save between $300 and $900 a month.
The hope is that with a more direct approach, the auto giant can reduce employee health care costs and improve care.
A few other large employers – including Boeing, Intel and Walmart – have also been contracting directly with health care providers. The latest development is part of GM’s effort to move towards a value-based health care payment system
Health insurance experts say that these employer-direct contracts also reduce exposure to varying levels of quality and costs. This is a function of having just one health care delivery provider, which makes costs and quality of care more predictable.
Through GM ConnectedCare, employees will have access to a network of more than 3,000 primary and specialty care doctors. GM has contracted with Blue Cross Blue Shield of Michigan to manage all of the claims as a third party administrator.
With all health care handled by one network, there are a number of synergies that can occur, particularly better communications and file-sharing to avoid duplication.
Some of the main features of GM ConnectedCare are:
- Employees will be able monitor their health with regular wellness exams.
- A mechanism to help employees monitor chronic conditions.
- Preventative screenings for diseases like colon cancer, breast cancer and depression.
- Seeing a specialist within 10 days of appointment with primary care doctor.
- Walk-in clinics for minor illnesses and injuries.
- Same-day appointments.
- Electronic medical records systems.
- Online and mobile access to Henry Ford Health System’s MyChart.
- Priority scheduling.
- Physician-matching based on patient needs, likes and dislikes.
On the operational side, Henry Ford Health System’s value-based care platform provides:
- Integrated electronic medical records systems, with network physicians using a common IT platform, which helps avoid duplicative tests and reduce errors.
- Patient engagement tools, to help at-risk patients receive the support, ongoing management and any interventions they need with robust clinical support programs.
- Innovative physician alignment, to engage health care purchasers in value-based solutions that properly align improved patient outcomes with rewards.
A growing number of large employers are contracting directly with providers to take care of their employees, according to a survey by the National Business Group on Health. Some 11% of large employers said they will do this in 2019, up from 3% this year.
While this is a novel approach that holds some promise for reducing employee outlays for health care, only very large companies with thousands of employees would have deep enough pockets to take it on.
The move by GM reflects a growing concern among employers about the rapid rate of inflation for health care and that they can no longer continue saddling employees with higher and higher deductibles.
Some companies have also entered into direct contracts with providers to handle certain high-cost conditions, such as cancer, cardiovascular disease, fertility treatments and orthopedic needs. Some 18% of companies said they are negotiating these deals for 2019, up from 12% this year, according to the survey.