Employers and employees warm to lower cost, convenient, and more satisfying primary care bolstered by technology
“Primary care is dead!” I was absolutely shocked to hear that proclamation from one of my colleagues the other day. Shocked because it came from the mouth of a fellow primary care physician. In his mind, primary care is being ceded to midlevel professionals and primary care physicians had better get ready to reinvent themselves.
While I think that is an extreme point of view, one can’t help but notice some of the new practice models showing up around the country. One that has caught my attention recently is the resurgence of employer-based clinics or practices that specialize in working with corporate clients to provide acute and primary care services to their employees. This renewed interest in employer-based clinics comes at a time when more and more companies are providing their employees with high-deductible health insurance that is linked to health savings accounts. As employees feel the pinch of paying out of pocket for healthcare services (at least until the high deductible of their company-provided insurance is met) they are becoming a lot more receptive to new models of care.
Here in the Seattle area, an organization called Vera Whole Health is experiencing success and a reputation for saving their clients money by providing lower cost, more convenient and more satisfying healthcare. Vera has partnered with local health systems including Virginia Mason and Group Health to create what they call a robust network of patient centered “medical neighborhoods”. Vera Whole Health provides onsite or near-site medical clinics. Their philosophy is to provide as much time as employees need with their provider. Appointments may be a half hour, or even a full hour long, and include a lot of emphasis on what they call a “transtheoretical behavior change model” that helps employees become highly motivated and empowered to change unhealthy behaviors.
While that may sound like a lot corporate jargon or fluff, Vera has been racking up some impressive savings for their corporate customers. They claim 10 to 25 percent net savings for self-funded employers; 7 to 13 percent premium reductions for fully insured employers; a 100 to 268 percent return on investment; and up to 60 percent savings on workers compensation. Some of Vera’s notable customers include the Bill and Melinda Gates Foundation, Seattle Children’s Hospital, Trident Seafoods, and the City of Kirkland.
Much like a facility called the Living Well Center, an employee health clinic on Microsoft’s Redmond, Washington, campus (managed by Premises Health), the staff at Vera Whole Health put an emphasis not only on high touch, but also high tech. Vera uses Xbox and Skype for Business to provide telemedicine, teleconferencing and collaboration services for staff and patients. They are also very focused on using the Microsoft SQL stack to integrate EMR, claims, and patient satisfaction data to provide performance metrics on outcomes, costs, and utilization effectiveness.
Vera is expanding their service area to Arizona and other western states. As they do, they plan to use Surface devices (already standard issue for clinical staff in Microsoft’s Living Well Center) for their providers and coaches to improve staff productivity and patient experience.
The approach taken by Vera Whole Health and a host of other innovative companies in the employee health/employee clinic realm won’t alone solve the need for more affordable, convenient and satisfying primary care. However, as a care model, I have to admire what these organizations are doing to breathe new life and some innovative new ideas into primary care. Perhaps there is still hope for a new generation of primary care clinicians—those willing to reinvent themselves.
Bill Crounse, MD Senior Director, Worldwide Health Microsoft
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