Business owners, HR departments, and individual staffers know that the health insurance benefits provided to employees are costly and getting more expensive.
Companies may seek more affordable insurance providers or pass increased costs onto employees. And even when employees have insurance, they may not be getting the quality care they need through overloaded hospital systems or they may be concerned with using their plan due to high deductibles.
The Centers for Disease Control and Prevention (CDC) reports absenteeism costs U.S. employers $225.8 billion annually, or $1,685 per employee. Promoting safe and healthy work practices boosts profitability and productivity among employers of all sizes.
Additionally, a Harvard Business Review report shows that more employees are working while sick, which can still cost employers about $150 billion to $250 billion in lower productivity, or 60 percent of the total cost of worker illness.
When companies are looking to lower their health insurance costs and improve employee access to healthcare, they should consider a direct or concierge primary care practice as part of their wellness package.
Delphi Enhanced Primary Care in Bedford offers membership-based primary care with a smaller patient panel. As an independent practice, they offer medical services often at a substantially lower cost than hospital system clinics, as well as navigate members to high quality low cost solutions for services like labs, imaging, and other procedures.
“Access and affordability are the key,” says Nick Vailas, founder of Delphi and Bedford Ambulatory Surgical Center. “Would you want to pay an extra $100 for access, which means better care, care when you need it? Is it worth $100 to you? And I would say, ‘absolutely.’”
Today, 70-80% of primary care doctors are employed by hospital systems and large corporations — a trend even more pronounced in the New England market due to hospital dominance. Most health plans require you to designate a primary care physician (PCP) and often mandate that PCP make any specialist referrals. Those referrals are often made within the same hospital system, regardless of if that is the most affordable or best option for the patient.
The national average wait time for a PCP appointment is 20 days and when a patient finally gets an appointment, they only get an average of 13 minutes with their provider.
Delphi’s membership fee of $100 a month, if you sign up annually, goes to capping the patients per physician at 600, meaning your employees can get a same-day or next-day appointment that fits into the schedule. At their appointment, patients get an hour instead of minutes with their doctor to fully discuss their care. Their primary care provider will have the time to be an advocate for them, not only referring them to the services they need but also finding an option that is more affordable for employers who pick up the insurance costs.
“Your primary care physician is also your advocate in this complex healthcare world,” Vailas says. “And you need that. You need an advocate if you are being admitted to a hospital or need a referral. Long ago, when you had a physician-patient covenant, a very strong one, your physician knew who you were, knew your life, and knew your socioeconomic dynamics. They would have far better insight into treating you appropriately than probably anyone else. And we’ve gotten away from that.”
In a case study out of Florida, a company that had 318 members (employees and relatives) on a self-funded healthcare plan reduced healthcare spending by 54% by shifting to a model similar to that of Delphi Enhanced Primary Care. The company was able to reinvest the dividends saved through the health plan into lowering employee contributions and improving plan benefits and member experience.
“In regards to the economics: physicians in private practice are bringing the best value to health plans, people, patients, and employers because they’re not influenced by big corporate hospital systems,” Vailas says. “Alternative private practices bring the best value, meaning price and oftentimes patient experience, to the marketplace. They stand a better chance of getting better pricing for services, especially diagnostics such as MRIs, CAT scans, and labs, because the price variability between those entities in private practice versus those in hospital systems is enormous. It’s so enormous, it’s almost unbelievable.”
By enrolling in Delphi Enhance Primary Care, patients get a primary care provider, a nutritional health and wellness assessment, a bone and joint assessment, mental health analysis, vaccine administration, and an advocacy platform.
With access to a primary care provider who has the time to dig into the details of a patient’s medical history, chronic conditions can be better managed and overall well-being can improve.
There are several ways that employers can get connected to the benefits of Delphi Enhanced Primary Care. The first is directly paying the membership fees for their employees. Businesses can set up a health reimbursement account where employees who opt-in to Delphi membership can submit receipts to cover the cost. Or the business could provide insurance plans with a health savings account (HSA) and encourage employees to use the HSA to enroll as members using tax-exempt funds from the HSA.
Employees who enroll as patients are still responsible for visit expenses such as copays or deductibles. However, as an independent practice, Delphi’s costs will be less than a traditional hospital-affiliated practice.
“It is a great comfort for $100 a month; you get not only a physician that you can call your own, at your beck and call,” Vailas says. “There’s also a team of people that will help you navigate the healthcare system, make appointments for you, specialists who bring the greatest value to the marketplace, which is cost and patient experience. No doubt in my mind, patients are better off in the hands of people in private practice.”
Employers interested in offering direct primary care to their staff can learn more about Delphi at delphihc.com or by contacting care@delphilc.com or 603-255-5579.