Healthcare in Today’s Workplace

Whatever may happen on the government front, healthcare remains an important concern of doing business for employers.

Competitive benefits — which includes a good health plan — is a key tool in recruiting and retaining talent, says Brian Cassidy, managing principal of Phoenix-based CCBG Architects. In fact, he says, for architecture firms and similarly licensed professionals, “the expectation is, if you’re an employee, you get excellent health benefits.” CCBG offers coverage to every full-time employee, paying 90 percent of the premium, and makes it also available to the employee’s family but at the employee’s expense.

Valuing healthcare as an employee benefit is an attitude echoed across the business spectrum, from startup to established business giant.

Says Scott Salkin, CEO of Allbound, “It’s tough as a startup, especially with limited funds and a limited number of employees, often resulting in fewer options and higher premiums. But I’ve always looked at health benefits as a huge competitive advantage, and something you can’t overlook even at an early stage.”

And Jason Riggs, Salt River Project’s director of Total Rewards, shares, “SRP recognizes that our people are one of the biggest reasons we’ve been as successful as we have been. With that said, a top priority for the company is to ensure that we provide a benefits package that is attractive, responsive, sustainable and beneficial to our employees.”

Arrowhead Health Centers, whose success in creating a healthcare program for its employees that improved care outcomes while cutting costs spawned Redirect Health as a separate entity that helps other businesses also achieve those results, offers free healthcare to its employees and their families. CEO Ken Levin explains Arrowhead’s leadership “came to the realization that we could reframe healthcare as being an expense of being in business, to become an asset to recruit and attract the best employees in the marketplace.”

What Workers Want

It follows that companies using healthcare benefits as a recruitment and retention tool consider their employees’ healthcare concerns and needs in putting together their healthcare benefits offerings.

Noting, “Happy employees tend to be less stressed and, as a result, physically healthier as well,” Salkin says, “We’ve managed to offer pretty decent coverage options through one of the larger PEOs, and hope to improve coverage and the amount we’re able to cover as we grow. But we also look at other contributors to overall health — like unlimited PTO, flexible work hours, teamwork, a good culture and pleasant work environment.”

SRP’s medical, dental and vision plans provide broad coverage for employees and their families, including preventive screenings, a Health-Savings Account option and a large network of providers. It also offers a wellness program intended to help employees address health concerns in a proactive manner — from annual health screenings to educational luncheons on health-related topics to providing healthy-choice meals in the company’s cafeterias and even to a financial planning benefit. “This benefit provides employees with a professional resource to help them get a better understanding of their personal finances, which we think can help reduce their stress,” Riggs says.

Law firm Fennemore Craig has found that employees’ healthcare concerns include affordability and quality of coverage. “Our firm’s healthcare concerns include managing cost while helping to protect employees’ personal and financial well-being,” says Steve Good, director and managing partner. “In many ways, these objectives align. However, like most employers, controlling healthcare costs and future increases are a priority. We routinely address aspects of the health plans that deliver the maximum return on investment for both employees and the firm, including network accessibility and discounts, preventive care, wellness, disease management, education, care outcomes and fee transparency.”

When an employee utilizes a network provider, Good explains, the savings is often 30 percent or greater for both the employee and the plan. The firm, therefore, tries to ensure plan participants have access to high-quality, in-network providers in all six of its locations. But the firm also focuses on encouraging plan participants to be compliant with preventive care guidelines for their gender and age. “Where we see shortfalls in utilization of these tools, we increase participation around the importance of the tests in our wellness communications.

“The wellness program is crucial in encouraging our workforce to make little steps that increase their overall well-being,” Good continues, noting it benefits the individual as well as the organization if the needle moves even just a little to prevent chronic lifestyle-related conditions. And when disease does affect an employee, resources within the plan help to encourage best practices and medical care compliance. “Educating employees to help them become more knowledgeable consumers of healthcare includes offering tools to evaluate costs for procedures among multiple providers and allow review of the quality and effectiveness of those providers.”

The full, free healthcare Arrowhead offers its employees and their families is not free to Arrowhead, but David Berg, founder of Arrowhead Health Centers and co-founder and chairman of the board of Redirect Health, estimates the return on investment at four to one “because they’re a more engaged, productive team.” The core of the employee program is the same healthcare delivery system that Arrowhead provides all its patients. “We don’t let the patient’s or employee’s conditions exacerbate to where it becomes an expensive endeavor,” Levin says. And there is neither co-pay nor deductible. “Out-of-pocket expenses are a barrier to early entry to care,” he notes. Removing barriers to following a health plan improves patient compliance, which “is how people get better faster,” Levin says.

Demographics Differ

There is no uniform “what the employee wants” across all workforce populations. SRP’s diverse workforce includes professional roles and fieldwork roles, and Riggs shares, “While our plans are designed to benefit every employee, we do see some differences amongst our employees in regard to how employees approach their benefits.” For example, he says, a professional views the benefits in a different light than does a fieldworker, especially with consumer choice for medical. “We tend to see our professionals use our High-Deductible Health Plan (HDHP) and Health-Savings Account (HSA), whereas the fieldworker may opt for the more-certain Exclusive-Provider Organization (EPO) plan.” 

Cassidy finds the older employees, especially aged 60 or more, are more concerned with the quality of the plan; younger employees bring a different mindset. “They’re healthier, and a lot don’t have kids or are single.” Common to all ages, however, seems to be a need for ease of use. Additionally, his company plan includes a flex benefit account that allows the employee to prepay some expenses as a pre-tax payroll deduction, but it takes work to understand and use it effectively, so, he says, “Not a lot participate.”

Recognizing that employees’ individual circumstances — and therefore healthcare needs — vary, Good says Fennemore Craig is contemplating a defined contribution approach that puts more choice in each employee’s hands as to how he or she will spend the healthcare dollars provided by the firm. “For some people, that may mean certain networks. For others, a richer prescription program. For others, alternative healthcare options. The desire (and, arguably, expectation) for customization and individualization is especially prevalent among the growing number of millennials in the workforce.”

New Directions in Healthcare

Dental coverage has long been included in healthcare benefits. What has been emerging lately, however, is a recognition that dental is not a compartmented issue but an integral part of a person’s health. In fact, the better care a person takes of his mouth, the better his overall health. People with gum disease, for instance, are more likely to have heart disease, cardiovascular disease or suffer from a stroke, relates Delta Dental President and CEO Allan Allford, who reports nearly 65 million Americans have gum disease.

And the tie-in to overall health makes a valuable contribution to the trend for integrated healthcare. “Dentists are able to detect more than 120 diseases,” Allford notes, naming cancer and diabetes among them. “Those diagnoses lead to a discussion of ‘what’s next’ and helps the primary care physician with those diagnoses.”

Although “being at work is not the primary concern; being healthy is the primary concern,” Allford notes the two go hand in glove and points out, “The better condition employees’ mouths are in, the better condition their overall health will be and the fewer hours they’re going to miss.”

Along with helping employers raise awareness of the importance of oral health, Delta Dental offers programs to incentivize employees to receive more preventive care, such as excluding the costs of preventive care services from deductions for the annual benefit maximum. It also provides employers a report to help them understand how their employees are using their dental benefits such as preventive options and upfront diagnostic measures.

Its range of benefit plans accommodates the varying needs of businesses of different sizes. This includes employers with 25 or fewer employees, long an existing client base but one that Delta Dental is giving increased attention with a small-business unit launched earlier this year. “It’s an opportunity for us regarding educating and growing our market share,” Allford says.

Increasing attention to wellness in the healthcare picture has put increasing attention on stress and its negative impact on a person’s well-being — physical, mental, emotional and spiritual. “The No. 1 reason people are out of balance and actually are sick is stress,” says Sumit Banerjee, founder of Sumits Yoga. “The ancient system of yoga gives people a tool to help with that.” As a market segment, he says, yoga has been mainstream for a while and is doing really well.

Banerjee gives workshops and seminars on mindfulness and meditation on how to cope with stress at work, and also offers corporate discounts for groups to come to the studio. “We encourage people to come; it helps build teamwork,” he says. He notes the workplace is a pressure environment, with stress and crises and deadlines, but there are also a lot of distractions so people have a tough time focusing on projects and goals. “Using mindfulness, principles of yoga and meditation, helps them relax and focus more — which helps increase productivity.”

Ross Weisman says he and his co-founders chose to focus specifically on meditation with Current Meditation, which they opened in Phoenix’s Arcadia neighborhood last year with the goal of making it easier for people to add meditation to their daily routine. The length of the class, how frequently classes are held and how they are actually structured is all designed to make it easy for people to fit meditation into their schedule, Weisman says. “Obviously, you don’t sweat doing meditation.”

Noting that, in addition to the individual physiological benefits of reducing stress and anxiety, benefits show up in the workplace, Weisman points out there is scientific backing that meditation boosts creativity and problem solving, as well as relationship building as people become better communicators.

Weisman sees a strong market for businesses like his. And Current Meditation has begun to expand its own focus to encourage businesses to book a private class for group meditation. To larger companies, Current Meditation will offer the option of going to them, although, having put a lot of care into the studio’s ambience, “We like the idea of them coming to us.”

Physical therapy is another healthcare segment with a rising profile. There is a #ChoosePT movement that is rebranding physical therapy clinics to be a first choice where patients can go without a referral. Arizona is one of the states that allows this direct access, which also helps minimize an individual’s cost of copays and medical bills.

T.O.P.S. Physical Therapy and Osteopractics fits into the healthcare picture by providing injury prevention and rehabilitation services to the general population, explains owner Amy M. Brannon, PT, DPT, FAAOMPT, Cert-DN, Cert-SMT, Dip. Osteopractic. “We pride ourselves on looking at the whole picture of a person, and not just the focal injury point,” Dr. Brannon says. For example, an injury in the elbow can be coming from muscle imbalances in the low back, thus it is important to look at the whole overall patient. “We also have a great ability to help prevent injury, bring patients back from an injury, and make people better than they were prior to the injury.”

Sharing, “We have the honor of working with many fire and police men and women. They have become the foundation of our business and have excelled in their professions based on getting better, faster,” Dr. Brannon says the practice has expanded to working with the general public but its niche is working with industrial athletes and desk jockeys. “We work with various businesses in understanding what their needs are, and helping to provide injury prevention screenings to minimize the loss of time at work from injury.” They also look at the mechanics being used, and try to provide input as to where movements can be changed or improved to help minimize injury. “T.O.P.S. takes time out to go visit work locations and observe the movements being performed, which not only helps us to treat those who are attending PT, but also helps to provide input on how to make changes.”

Telemedicine has become, in a short span of time, a foundational part of many healthcare programs. The innovative sector is, itself, experiencing innovation. Local company Akos is designed as a community of physicians dedicated to making healthcare better through smart technology, seamless design, a patient-centric operating model, grassroots strategy and the collective power of a preferred provider network, explains Swaraj Singh, M.D., founder of Akos who also has previous experience creating an app-based healthcare service. “Akos brings together top clinical talent, high-quality customer service, and top-notch technological resources to power a new type of telemedicine practice,” he says. “This new formula of telehealth makes Akos a disruptive driver in healthcare, more specifically in the telemedicine industry.”

Unlike traditional telemedicine models, Akos uses a grassroots strategy and the collective power of a preferred provider network to help patients navigate their healthcare concerns from start to finish. To access Akos, patients download the free app to their smartphone or tablet and provide a brief medical history and symptoms before speaking with a virtual care coordinator. From there, a care coordinator will assess the patient’s symptoms and connect the patient to the board-certified physician, in their area, who best meets their needs. If the care coordinator determines the condition cannot be treated through virtual care, the patient will not be charged by Akos and instead, will be directed via a virtual care coordinator to an Akos preferred healthcare provider nearest to the patient for immediate care. “The structured triage enables faster healthcare delivery,” Dr. Singh says.

Akos also works with employers to discover what works for them. “This personalized approach allows us to customize programs,” says Dr. Singh, explaining his Return to Work Program for employers streamlines the way work-related injuries and illnesses are handled, minimizing cost of ER and Urgent Care visits and reducing claims and risks, which, in turn, helps employers lower E-MOD ratings and insurance costs.

“According to the American Medical Association, telemedicine platforms, like Akos, allow physicians to treat 70 percent of clinical encounters seen today, virtually,” Dr. Singh says.

Healthcare Solutions Centers, which has been providing innovative and customizable on-site and near-site clinics to businesses with 200 or more employees since 2003, “is embracing technology to enhance the patient care experience,” says company president Frances Ducar, FNP-C.

The clinics provide a comprehensive and unique approach to healthcare by integrating preventative care, biometrics, wellness, on-site lab draws, discounted radiology and access to a provider 24/7 through its patient-friendly telemedicine app. “Telemedicine also allows healthcare to reach across state lines, making the employee’s physical location irrelevant. Patients are also able to access their healthcare information at all times through the patient portal app, which provides an interactive and empowering healthcare xperience,” Ducar says. “These applications, as well as the convenience of the clinics, allow for the breaking down of traditional barriers to healthcare by making busy schedules a non-issue to receiving quality care.”

Free for the employees, Healthcare Solutions Centers’ services are designed to be convenient and comprehensive and to save the employer money, especially if the company is self-insured. Notes Ducar, “Out-of-pocket costs to the company are avoided and there is a vested interest in prevention of catastrophic health events. HCS also utilizes an innovative data analytics tool to find gaps in care and uses predictive modeling to identify potentially large claims before they happen.” By using this analytics software, HCS is also able to view claims data from all health plan members — not just those using clinic services — create financial modeling that combines year-to-date trends and performance with predictive cost trends for the future, and can help identify risk and engagement opportunities within the employee population. “The businesses we serve need accurate and timely reporting, now more than ever. Analytics helps us plan, strategize, adjust and prove our value, and save our clients dollars while keeping their benefited members healthy,” Ducar explains.

Redirect Health, which was spawned as a disruptor out of the concept’s success with a local business, was founded in 2013 to apply those methods to other businesses, helping employers build affordable, high-quality healthcare plans using a self-insurance model. The company’s healthcare-first approach focuses on eliminating what it identifies as  the waste, excess and inflated pricing of traditional health insurance while providing real, quality healthcare. The model allows employers of all sizes to cut healthcare expenses, build quality benefits packages and gain a competitive edge in attracting top talent, while its concierge-style care logistics team helps members access the care they need.

With its business program expanded to 28 states, Redirect Health has identified a new market opportunity and is now piloting iEverydayCARE in Maricopa County to improve access to healthcare for individuals and families. It offers another option to employees who may be opting out of their company’s plans due to what they feel are high deductibles, high co-pays and increasing monthly premiums.