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NE State Employees Now Have More Primary Care Options

Primary Care Options Expand for NE State Employees

Via Lincoln Journal Star

Lincoln, NE – Nebraska State employees are now eligible to enroll in Direct Primary Care, offered to them as part of their employee health benefits package.

This offering follows the passing of the State of Nebraska Direct Primary Care Pilot Program Act, signed by Governor Pete Ricketts. Implementation of the Program was led by Strada Healthcare – the Direct Primary Care leader of Nebraska – in conjunction with UnitedHealthcare and the Department of Administrative Services.

The facade of Strada Healthcare headquarters
With locations across Nebraska, Strada Healthcare is the largest Direct Primary Care network in the State and is a national leader in Direct Primary Care.

This Act benefits local State employees by providing them another, more affordable and convenient way to access their primary care.

The main function of Direct Primary Care is to remove insurance from primary care transactions. As such, the model works to significantly reduce health insurance claims and increase prevention and wellness.

And according to Joel Bessmer MD, Chief Medical Officer of Strada Healthcare, primary care providers can treat up to 90-95% of care for a patient, something many don’t realize.

Chief Medical Officer Joel Bessmer, MD with a patient

Joel Bessmer, MD, Chief Medical Officer, founded Strada Healthcare as part of his mission to make primary care more affordable. He believes – and has proven – that Direct Primary Care can do just that.

Dr. Bessmer states, “As healthcare has gotten more expensive – as health insurance has gotten more expensive – so much of our middle class has been priced out of healthcare because they know it’s their dollars they’re going to spend to go see the doctor. And that’s what we love about Direct Primary Care – it allows for low monthly payments upfront so that we can help protect those patients from ever having to meet their deductible.”

In the Direct Primary Care model, the patient contracts with a primary care provider directly. For an affordable flat monthly fee, the patient has unlimited access to that provider, 24/7. This allows cost transparency, and the patient absolves themselves of out-of-pocket costs for primary care, like copays or meeting deductibles.

“One of the ways to reduce healthcare costs is to facilitate the relationship between the patient and their provider,” said Nebraska State Governor Pete Ricketts in the Act’s 2018 signing ceremony. “The patient can have better communication and more proactive healthcare, and that’s how you lower costs overall in the Direct Primary Care program.”

State Senator Merv Riepe, Governor Pete Ricketts, Dr. Todd Johnson, Dr. Joel Bessmer, and Dr. Steve Lazoritz at the 2018 Direct Primary Care Pilot Program Act signing ceremony.

(Left to Right) State Senator Merv Riepe, Governor Pete Ricketts, Dr. Todd Johnson, Dr. Joel Bessmer, and Dr. Steve Lazoritz at the 2018 Direct Primary Care Pilot Program Act signing ceremony.

Even more, Governor Ricketts confirmed that the State of Nebraska will cover 79% of the Direct Primary Care cost for State employees.

According to Todd Johnson, DO, the first-ever Direct Primary Care provider in the State of Nebraska, patients can often get wholesale pricing on medications, imaging, bloodwork – 50-90% off the retail price.

“The most common comment I have from my patients is ‘Wow this is amazing, why isn’t everybody doing this? Why haven’t we done it before?’” says Dr. Johnson. “And it’s not complicated, it’s simple. It’s membership-based healthcare. Pay your membership, just like Netflix – you get a movie – or you get to see your doctor, or call your doctor, or FaceTime them or text them.”

State Senator Merv Riepe, who was instrumental in the introduction and passing of the Act, encourages State employees to opt-into Direct Primary Care and pair it with a catastrophic plan, also offered through the State’s benefit package. In other words, enroll in a high-deductible health plan to wrap-around Direct Primary Care. This is a protection in the case of a catastrophic medical emergency.

The high-deductible health plan allows for lower premiums, paired with the low fee for Direct Primary Care.

“Direct Primary Care is absolutely a solution for many of our healthcare problems,” says Dr. Bessmer. “We encourage the provider to spend more time with their patients. Because instead of today where we have a sick healthcare system – and quite honestly doctors are rewarded when the patient is sick – this flips that continuum upside down and says ‘The more you can do to get your patients healthy the less they’re in your office. The more you interact with them and help them get healthy, the better off everybody is in this system.’”

NE State employees can get more information about Direct Primary Care by visiting https://www.stradahealthcare.com/nebraska/.

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Why All Self-Funded Employers Should Integrate Direct Primary Care in their Benefits

*** View our infographic on the bottom of this page to learn more!

Why All Self-Funded Employers Should Integrate Direct Primary Care in their Benefits

The sometimes-unpredictable cost of claims accrued over the business year is a huge consideration for self-funded employers. To account for this unpredictability, many self-funded employers have stop-loss coverage. You can make healthcare spend more predictable when you eliminate an entire category of claims.

Self-funding is the option for many employers because it benefits their bottom line. Instead of a guaranteed expensive insurance pay, you bet on saving money when you pay for the claims directly. It’s an even better wager if you integrate Direct Primary Care (DPC) in your offerings.

 

Self-funded employers become more competitive in the labor market with Direct Primary Care.

DPC offers more affordable healthcare and also guarantees employees better healthcare access. And the real kicker is that it’s unlimited, too. There’s typically an increase employee satisfaction with their health benefits when DPC is integrated.

They’re also more productive – they can text, call or video chat with their provider anytime from anywhere. That means instead of taking PTO when they have a concern, they can first text their provider to see if they can get their question answered or get the proper prescription that way. They’ll decide with their provider – with a same or next-day appointment – if it’s more serious and they need to come in.

Yes, employees more productive and happier when they have an option for Direct Primary Care. Let’s get back to cost savings and predictability for employers.

 

Self-funded employers can eliminate an entire category of claims with Direct Primary Care.

Direct Primary Care is a healthcare membership. In the membership, patients contract directly with their provider for a low, flat, monthly fee for access. In the traditional insurance fee-for-service world, resources may be wasted, and patients can be nickeled-and-dimed. In DPC, patients have unlimited access to their provider. The membership covers most of their healthcare needs.

For an employer, this eliminates 100% of primary care claims for exchange of the predictable monthly fee. Urgent care claims can significantly decrease, too.

When we actually encourage patients to see their provider often, they develop better relationships with them. All because their access is unlimited. This access allows the provider a deeper understanding of the patient’s history, genetics, lifestyle and more. The main focus becomes prevention and lifestyle change, versus a 10-minute appointment and quick prescription write-up.

This means a significant increase in long-term health, not only managing but reversing chronic conditions, and an overall, long-term decrease in healthcare costs (for you and them).

And, through Direct Primary Care, patients often get access to negotiated cash prices for services like imaging, labs, tests and even specialists. The prices are usually a fraction of what they could get it for with insurance.

DPC requires no copays and patients don’t work to meet a deductible for primary care.

 

How to encourage employees to opt-into your high deductible health plan.

Those who are proponents of Direct Primary Care believe that insurance shouldn’t be involved in every healthcare transaction. Taking insurance out of primary care saves money, decreases paperwork, and fosters patient-provider relationships. That applies to the self-funded high-deductible option you provide, too.

Direct Primary Care works best with a wrap-around high deductible health plan (HDHP). Consider the Direct Primary Care as the everyday health “coverage.” Paired with DPC, the high deductible health plan acts as catastrophic coverage – something you hope they won’t ever have to use. When employees understand that Direct Primary Care saves them money and gives them more convenience, they’re going to choose it. And since you’ve paired DPC with a HDHP, that means they’re opting into the HDHP, which saves you money, too.

 

Start with an employee education program.

As aforementioned, employee education is extremely important for uptake and success in a DPC program. It’s hard to dump that on HR, so it’s a great idea to partner with a DPC organization that can handle the administration services, too.

That should include employee education and enrollment, payment processing, hotlines to answer questions, key performance indicator (also written as KPI, measures success in particular activities) reporting and analytics, and more. You also need to choose a DPC organization with experience, a wide network of providers, and relationships with specialists and imaging services to get the best cash prices.

You might consider partnering with Strada Healthcare, the Nebraska-based national leader in Direct Primary Care, with affiliated clinics across the country. Learn more about how we help businesses succeed in their health offerings here.