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NAWHC DUES BILLING

Currently, NAWHC invoices members for dues renewals on the month the member joined the organization. In an effort to streamline the membership process, we will invoice membership renewals 60 days prior to renewal.  A member may move their renewal date to accommodate their fiscal year or budget timing.  When you receive your invoice, let us know if you want to change the date selected for you. The bundle administrator for the group may also add/delete/change any member listed.  This can be done at any time.

Employers continue to face health care benefit costs that outstrip the inflation rate, while quality, access and satisfaction with the health system is declining.

Many employers have decided to optimize their benefit dollars by offering an onsite or near-site center to their covered populations. This benefit solution is not limited to large manufacturers, as employers of 200+ can obtain the savings and improvements such a facility can bring to your bottom line, productivity and retention rate.

Worksite health programs were initially developed to provide first aid and emergency care to employees working in remote or dangerous locations.  Over time, many employers decided that offering a company nurse or doctor was a good approach to treat injuries and provide occupational health services

to comply with federal and state workplace requirements. The medical personnel, usually an RN, was also available to manage absences, prepare employees for foreign travel and provide a minimal level of acute care services.

According to a recent survey by the National Business Group on Health, close to 50% of large employers, those with over 5000 worker, have onsite or near-site centers, and by 2020, two-thirds will have such facilities. The National Association Worksite Health Centers (www.nawhc.org) has found that 30% of employers of all sizes currently offer some form of health care services at the worksite. Today, the services provided at the worksite run the entire spectrum of health care, including not just medical, but dental, vision, physical therapy, chiropratic, lab and pharmacy services are being offered.

Leading employers are beginning realize that by offering the services that force employees to leave work, they can reduce the cost and better manage the health of their covered populations, while improving productivity, since they’ll have reduced the number of situations and the time off the job by workers seeking medical care.

An employer-sponsored health center can serve as the hub of the worksite wellness wheel in integrating and analyzing ALL the data from vendor and employer-sponsored health related programs and activities. At the same time, the onsite clinical staff  increase the engagement of their workers in the multiple preventive and condition management programs they offer. This type of population health approach effectively identifies unnecessary services, gaps in care, opportunities for savings and quality variations to be addressed.

Employers looking at or offering such facilities should be careful not to let their center become just another fragmentation of the health care system. Worksite centers need to connect and share patients data with a patient’s own physician. It also offers a source of primary and acute care for those 40-60% of employees who don’t have a personal physician.

Patients see their physician 1-2 times each year, for 7-12 minutes per visit – hardly enough time to enable the provider or the patient to communicate or drill down on physical and mental health issues.

However, people are at their workplace 1000-2000 hours a year, which gives the employer a tremendous opportunity to engage, educate, monitor and motivate employees to learn about and address key health issues and conditions.

To enable employers to better understand and expand on the value of “health and wellness” centers, the National Association of Worksite Health Centers (NAWHC) was formed in 2012. The Chicago-based NAWHC (www.worksitehealth.org)  is the nation’s only non-profit association supporting employer sponsors of onsite, near-site and mobile health, fitness, pharmacy and wellness centers. It also offers a new “Guidebook on Measuring the Performance of Worksite Health and Wellness Centers” to enable employers to understand and use credible metrics and approaches to ensure they're getting true value of their investments in their centers.

An onsite health center can serve as a vehicle to achieve many health benefit objectives, including efforts to reduce medical cost trend by avoiding utilization of unnecessary care; improve health of covered population; integrate all worksite health care, preventive and wellness programs; and reduce absenteeism, while improving productivity.

The presence of the center can also increase the visibility and access to other benefit programs and services, now available via a warm handoff between providers and vendors.  The consolidated data now can track patient use of service and referrals and allow vendors to collaborate on a patient’s care management. Onsite fitness centers, often underutilized, can also be integrated into the health center’s physical therapy and cardio programs. Finally, the integration enables easy collection and measurement of the center’s performance and impact on the population’s health and employer’s benefit costs.

Tomorrow’s onsite center will serve as the integrator and hub of an employer’s health data and activities. In doing so, employers, with the cooperation of local providers and the support of their vendor partners, will finally be able take control of their health care spend, while assuring their workforce easy access to quality providers, at little of no costs. This will enable employers to achieve population health management and reduce cost, while improving health, productivity and their firm’s bottom line.

Larry Boress is Executive Director of the National Association of Worksite Health Centers and can be reached at lboress@nawhc.org.

A new study comparing different levels of exercise shows the value of ANY type of fitness efforts. Read about it in this story.

 In the article below, it's noted that many workers don't even know if their employer offers behavioral health services.  Make sure you have your EAP or coaches available for warm handoffs when someone visits the center and their provider identifies the need for a referral. This article below provides some insight and direction.

A new article looks at the wellness trends for 2017:

Social Well-being - helping employees have opportunities to feel good about themselves by giving back to the community

Expanding the definition of "total well-being" - looking a wellness beyond physical health, but at mental, emotionla, financial health

Sleep Health - examining the impact of poor or limited sleep on productivity and helping employees address their individual problem

Reducing Use of Prescription Drugs-  developing programs to identify conditions where drugs aren't needed or to help individuals talk to their physicians about drug selection and use

Mindfullness - sharing information on mono-tasking, taking intentional digital breaks, and building face-to-face social connections.

Measurement - using measure to validate welllness programs.
Do these match what you will do?  

http://www.workforce.com/2016/12/16/will-wellness-look-like-2017/

The National Committee on Quality Assurance (NCQA) rated 1,012 private/commercial, Medicare and Medicaid plans as part of the NCQA Health Insurance Plan Ratings 2016-2017. 

105 (10%) received a top rating of 4.5 or 5.0 out of 5. A comparably small number, 27 (3%), earned the lowest ratings of 1.0 to 2.0.

See all Health Insurance Plan Ratings at this link:  http://healthinsuranceratings.ncqa.org/2016/Default.aspx.

_{Center sponsors experience reduced costs, improved employee health, productivity and engagement.}

CHICAGO – Jan. 6, 2015 – Employers are increasingly finding the use of onsite and near-site centers as a successful strategy in controlling health care costs, enabling easy access to medical services, improving employee health, enhancing engagement in worksite programs– and ultimately increasing productivity, according to a survey of 255 employers by the non-profit National Association of Worksite Health Centers (NAWHC), with support from PwC US. NAWHC conducts an annual survey of employer sponsors of onsite centers to enable them to benchmark their operations and policies.

“Especially in light of health care reform, onsite centers are increasingly being recognized by employers of all sizes as a valuable benefit to reduce costs and absenteeism, while serving as the hub to integrate all worksite programs, and increase employee health and satisfaction,” said Larry Boress, NAWHC executive director. “Onsite centers are not just for jumbo employers. We found an increasing number of employers of all sizes are running these themselves or finding willing partners among local providers and vendors.”

According to NAWHC and other industry research, the greatest return for center value is among employers who experience high emergency room use for non-emergency conditions, show high levels of lost time from unscheduled medical issues, or have covered populations that show low utilization of existing primary care, preventive screenings or condition management programs and services.

NAWHC survey findings:

• A majority of respondents of all sizes said the financial objectives for their onsite centers are being met, with 64% seeing a reduction in medical care costs, almost 70% realizing reduced time lost by employees leaving work to see outside medical providers, and 63% had reduced use of the emergency room.
• Employers offering centers are seeing enhanced integration of health management services, higher employee engagement in health management programs, and increased effectiveness of health promotion efforts.
• While most employers do not charge for center services, many are unaware of the need to charge employees with Health Savings Accounts a fee reflective of market prices.
• Over a third of employers with centers do not consider their onsite centers as part of their benefits plan, and there is uncertainty in how to value a center for purposes of the ACA’s excise tax computations
• Telemedicine is an emerging trend for many using onsite centers, especially in the areas of acute care, wellness and behavioral health.
• Acute care, emergency or first aid, preventive and wellness are among the top services offered at employer centers.
• Over 30% of onsite centers now provide primary care services and this number is expected to grow in the future.
• Nurse practitioners/RNs and physician assistants are the main providers for these centers.
• Over 35% of employers self-manage their centers and do not contract with a vendor or provider to operate the facility or hire providers.
• While most employers contract with third-party vendors to manage their centers, an increasing number of employers are finding partners among local physician groups and hospitals
• Lessons learned in developing centers, included the need to promote a clinic’s confidentiality and privacy; having providers who relate to and understand the workplace and its culture; offering services for free or lower than outside services; using vendors with state-of-the art ROI tools; ensuring clinic activities are integrated with all wellness programs and vendors; and offering easy access to clinic.

The survey included employers throughout the U.S. Of the 255 respondents, 75% said they offered some form of worksite health program or providers are their locations, while 43% indicated that they have an onsite or near-site center. Among the responding employers, 8.34% said they had less than 500 employers, 11.67% indicated 501-5,000, 27.5% 5,001-10,000, 20% 10,000-25,000, and 15.83% had more than 25,000 employees. Respondents represented a variety of industries including manufacturing (30%), financial services (12%), health care services (12%), government (8%) and technology (5%). An executive summary of the survey can be found HERE.

Download this article HERE.

_{Jonathan Spero, MD, InHouse Physicians, December 7, 2011}

A recent survey from Mercer found that work site centers are becoming an increasingly popular way to control health care spending and even enhance employee productivity.
 
Until recently, work site centers were largely popular only at Fortune 500 companies, however, the trend is now spreading to local governments and mid-size companies of 250 or more employees.
 
Generally, the care received at the center is free to the member and there is an added convenience factor for employees.  Work site centers to date have primarily experienced their return on investment for the employer by providing more efficient care at the worksite center rather than paying claims from community physicians.  However, the next generation of centers are in the process of being rolled out and offers a more compelling value proposition and much greater associated health care savings.
 
The following are key concepts of this next generation of worksite centers and how they will drive significant reductions in health care costs for employers.

Concept #1

• At Risk Model

Worksite vendors are more increasingly willing to deliver these services with some portion of the compensation being at risk. The greater the savings to the employer, the greater the potential bonus for the vendor. In this model both the client and vendor have incentives that are congruent.

How these vendors are measuring savings or return on investment varies.  The most accurate way to determine the saving generated from the on-site center is to compare the annual cost of health care (pmpy) for members eligible to use the center (“study group”) vs. members who are not eligible to use the center (“control group”).  This provides the employer with a direct comparison of the two groups’ costs and a direct measurement of the savings.

Concept #2

• Gaps In Care Analysis

Before the center even is launched, the employer benefits from powerful analytic software tools that can filter through the previous year’s claims data to determine gaps in care for 
 
individuals and identify “high risk” members that require additional intervention.  These high-risk members can be invited to visit the center and enroll in on-site programs designed to ensure quality care and improved outcomes.

Concept #3

• Patient Centered Medical Home

The clinicians at the worksite center can build a medical home model program.  The medical home model understands that chronic diseases require input from multiple providers and specialists and are often difficult to manage for providers as well as the patient.  The worksite clinician can act as a coordinator of care ensuring quality, cost effective, evidence based medicine is delivered.  In addition to educating the patient on their condition, the “coordinator” communicates to all physicians involved in the care of the patient.  This program acts as a very effective disease management program with member engagement levels routinely above 80 percent.  The worksite center enrolls members who are at high risk based on the analysis of gaps in care mentioned above.  Common diseases that are coordinated include diabetes, heart disease, asthma, arthritis, and chronic pain.

Concept #4

• Clinical Engineering

Traditionally employers have relied solely on the carriers to negotiate agreements with providers.  However, these agreements are not necessarily in the best interest of the employer or the patient.  Not only can more favorable pricing be negotiated from quality providers but also, the agreements have no quality guarantees associated with them.  Worksite vendors have a unique opportunity to identify high cost procedures and hospitalizations and negotiate case rates directly with providers and hospitals with built in quality performance guarantees.  Significant savings for employers and members as well as improved patient outcomes are the results of these arrangements.

Concept #5

• Price Transparency and Patient Advocacy

Worksite clinicians, now armed with comprehensive pricing and quality metrics, can effectively act as patient advocates assisting members with making informed medial decisions.  Patients, with the assistance of the worksite center, can comfortably choose a cost saving option for a diagnostic or clinical procedure knowing that they are receiving quality health care for the right price.

Concept #6

• Predictive Modeling

Worksite centers have the ability to attach current member health risks to future costs allowing the centers to develop targeted wellness programs that zero in on future cost drivers.  In addition, the center can provide useful health care budget estimates to the employer’s benefits department when planning for next year.

Concept #7

• Telemedicine

The worksite center is often not available for remote employees and dependents.  Telemedicine, quickly becoming a mainstream method of care delivery, can address this issue.  Telemedicine, via telephonic and two way video communication, can allow patients to receive medical evaluation and treatment.  Not only can this be offered to members that do not have access to the on-site center, but also members with access to the center have a resource for after hours care.

Concept #8

• Wellness 

The center offers year round, on-site, integrated wellness programs that cannot only drive participation, but are very effective in modifying healthy lifestyle behaviors amongst members.  Clinicians are being cross-trained as certified health coaches and up to 15% of the visits to the center are being utilized as purely health coaching sessions.
 
In summary, employers are looking for employee health solutions that offer a one-stop shop for effective health care cost containment.  The next generation of worksite centers promises to offer just this.  The on-site center builds trust and relationships with members, which facilitates engagement in wellness, disease management, and patient advocacy programs driving improved outcomes and lower costs.

Download this article HERE.

Tuesday, November 8 2011

Washington (Reuters) - Public Employers can find savings on health care costs and still deliver high-quality benefits, according to study released on Tuesday.  

Benefits for public employees, especially pensions, have been under attack for more than a year.

Fiscal conservatives say cities and local governments, suffering from a collapse in revenues from the recession that began in 2007, should cut spending on their employees. 

Conversely, public employees say one of the few upsides of working in the lower-paying public sector is that they are assured of benefits, such as health care. 

At the same time, health care costs are rising, making it harder for governments to contain costs. 

"While public employers are under pressure to contain employee benefit costs, they are also motivated to provide benefits that help them maintain a healthy and productive workforce and attract the best employees to public service," said Anne Spray Kinney, a director of research and consulting for the Government Finance Officers Association. 

GFOA, along with Colonial Life & Accident Insurance, looked at how local governments are addressing the challenge.

They found that by providing an on-site clinic, public employers can drive down health care costs, saving $1.60 to $4 for every dollar invested. 

This also provided a "soft-dollar savings such as increased productivity," because employees did not have to take time off from work to travel to doctors' offices.

But the survey found that this only works well for large organizations with at least 800 people. 

In the same light, larger organizations can cut health care costs 10 percent by turning to self-insurance, with the employer assuming "the risk for providing health care benefits, rather than transferring it to a third-party insurer."

Groups with more than 200 employees showed the greatest cost benefits.

Another area in which governments could save is cooperative purchased of health care, even though most use such arrangements for purchasing other goods.

"Only about a third of governments use cooperative purchasing for health care, but of those that do, most recommend it enthusiastically.  This suggests untapped potential," the survey said. 

These arrangements can include pooling purchasing power or negotiating with vendors and can knock 5 percent to 20 percent off governments' health care costs, the survey found.

Increasing premiums, co-pays or deductibles were also popular among employers, but many were hesitant to do so, the survey said, because of "the negative impacts on employees and raising premiums could disqualify an employer from other benefits granted under the health care reforms law passed last year."

Read this article HERE.