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Most of the health needs of the working family population can be met in an optimized primary care setting. But only about 5-7% of total healthcare spending is spent on primary care; 90-95% of healthcare costs result from downstream care. Therefore, the secret to decreasing overall healthcare costs is maximizing the value of primary care to manage downstream costs, where most healthcare money is spent.

It’s well understood, moreover, that the quality of specialists and hospital care has no direct correlation with cost. This means self-funded employers are generally paying much more than they need to pay for care of uncertain quality due to poor downstream care management.

How can we make sure employees get the quality of care they deserve at a reasonable cost? We spoke recently to Scott Wham, Director of Compliance and Innovation at leading brokerage OneDigital where Scott is in charge of finding innovative healthcare solutions to control costs. He’s seen the whole gambit of solutions and believes there is already one that business leaders can utilize to solve the issue of poor downstream care management. Together we discussed the main issue plaguing patients and employers and how the most innovative companies are using direct primary care as the antidote.

Patients Typically Trust Physician Recommendations Too Much

Patients are not generally healthcare experts, so they normally rely on their physicians to provide them with the best recommendation. As Scott put it, “Physician recommendations can be based on a variety of subjective variables.  The expectation that a lay individual is going to effectively cross-examine the advice of a physician to identify whether a recommendation or referral is evidenced-based is unreasonable.  That is why it’s essential for health plans to incentivize utilization of providers with a track record of practicing evidence-based medicine.” Essentially, Scott believes that effective primary care steerage to providers practicing evidenced-based medicine can enable a health plan to realize substantial cost-savings.

With the alarming increase of doctors’ patient panels in fee-for-service medicine, physicians often don’t have the time or incentive to do the necessary research to refer patients to the highest value provider. In fact, according to Scott’s analysis, many doctors default to the same referral patterns, even if those referrals don’t have the best outcomes and prices.  Scott noted, “A physician might consistently refer to the same specialist—for instance, an orthopedist—due to a variety of subjective variables.  Perhaps they know the orthopedist will see their referred patients quickly, or perhaps the orthopedist might share an office building, or maybe they’re just golf buddies, or they are both members of the same health system.  None of these variables speak to whether the orthopedist practices evidence-based medicine and achieves the best outcomes.  Unfortunately, we know through analyzing claims data that it’s far too common that a given specialist is not practicing evidence-based medicine, and the costs to patients and employers alike can be extravagant.”

According to a study by McKinsey, the cost to deliver the same care in a single local market can differ by over 100 percent, even after holding the prices that providers charge constant and risk-adjusting based on patients’ health status. The variations in cost had no discernible impact on the quality of care. What does this mean? The colonoscopy provider your employee went to last month that charged $5,000 probably wasn’t any better than the one that charges $1,000 just 5 miles away.

Direct Primary Care is the Most Efficient Referral Management Solution

So what’s the solution? How should self-funded employers steer patients away from high-cost specialists who aren’t providing better outcomes and towards the best-value providers that optimize both cost and care? At SolidaritUS Health, we’ve seen dramatic cost-saving results through our direct primary care model. Direct primary care is the most efficient cost-savings tool for self-funded employers due to its ability to control downstream referrals and decrease the need to seek outside care. As Scott put it, “Direct primary care has the ability to act like a Waze or Google Maps for healthcare – it’s not just showing you the cost for the discreet services, it’s helping you find the most efficient route to greater states of health.”

What’s Direct Primary Care?

Increasing in popularity with self-funded employers, direct primary care is not the traditional fee-for-service model. With direct primary care, employers pay a monthly fee per employee to give them access to concierge medicine. With SolidaritUS Health direct primary care, employees get 24/7 access to a personal physician who can meet most of their healthcare needs and provide a host of medical services with no co-pays or deductibles.

The direct primary care model is centered around a trusted physician-patient relationship through which the rest of care flows. Physicians are incentivized to create better health outcomes, rather than increase the size of their patient panels or the volume of billable services. This enables them to truly form trusted relationships with their patients and provide high-quality care–both in the primary care setting and through medically appropriate referrals– that result in improved patient outcomes.

At SolidaritUS Health, our physicians have the gift of time to build personal relationships with their members. Our doctors provide a very broad scope of healthcare services in a primary care setting, but we do not impede our members’ access to downstream care. Instead, we direct patients to high-value providers.

As SolidaritUS CEO Mark Blum explains it, “We improve health outcomes by removing the barriers to access and assuring that our patients get high-quality care when they need it, in the right setting and at the lowest cost.”

SolidaritUS has seen an astounding 40% reduction in overall medical claims and a 26% reduction in overall health costs without any restrictions on patient access to downstream care. We achieve this in two ways:

  1. By providing such exceptional access to a broad scope of primary care services that inappropriate use of downstream or specialist, hospital, and emergency room care is minimized.
  2. By developing high-value specialist and hospital relationships that optimize savings when downstream care is medically appropriate.

Price Transparency Empowers Patients to Make the Best Decision

For innovative employers that wish to align their employees’ incentives to select high-value downstream care, SolidaritUS Health has introduced price transparency tools that empower patients to make the best value decisions and share in the savings. For example, when SolidaritUS physicians refer their patients to surgeries or specialist care, these patients can look online and compare prices, health outcomes, and payment options for different specialist providers. They can also talk to their personal SolidaritUS Health physician directly about their preferences. This transparency along with the reduced demand for inappropriate downstream care translates directly into cost-savings for employers.

Lower Costs, but Better Health too?

With cost savings results as great as SolidaritUS’, one may wonder whether employees are actually receiving better care. However, SolidaritUS has not only seen considerable cost reductions, but great improvement in health outcomes, as well. In a 6-month period, 50% of diabetic patients with A1c greater than 7.0 and 60% of patients with hypertension and blood pressure greater than 140/90 saw significant improvement. This shouldn’t be surprising: when patients have unlimited access to primary care, their behavior and lifestyle changes too. This creates better health outcomes long-term and improved prevention and management of chronic conditions. Healthier patients are able to be more productive at work, take fewer sick days, and be happier. This means you can improve your employees’ health and your overall healthcare costs at the same time.

Want to learn more about SolidaritUS and how you can cut costs while improving health outcomes?

Contact us today to learn more about what SolidaritUS can do for your business, talk to your broker today, or enroll directly here.

 


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Is there a Better Healthcare Solution for Your Employees?

February 10, 2020

As every business and household knows, the cost of healthcare is always on the rise. Employers and unions who are seeking to provide more options and get better health outcomes for their employees are turning to direct primary care as the solution to rising costs. This year, according to the Milliman Medical Index, the cost of healthcare for an American family of four covered by an average employer-sponsored preferred provider organization (PPO) plan was an astounding $28,386. To put that into perspective, the median household income in the U.S. is  $61,937—nearly 50% of household income goes to healthcare costs! Unfortunately, this also means that many individuals and families don’t have the savings or available funds to get adequate care when they need it.

Health care used to be about getting well, but now the affordability of health care is one of the greatest stressors for working Americans. Employers and Taft-Hartley plans can provide much more value to working Americans while creating healthcare savings for themselves by selecting a solution that engages patients in the care they need that will significantly lower costs.

How Engaging is Your Current Employer-Sponsored Health Plan?

If you want to know if you should consider other health plan options for your employees or union members you only need to ask one question. Can they access really good health care, right now? Accessibility and engagement go hand in hand. A surprising fact is that accessible healthcare can also be cost-effective.

Dollar for dollar, the best spend on improving health is spend on expanding accessibility to full scope primary care.

Currently, access to primary care in most parts of the country is inadequate. Many people do not currently have a primary care physician at all, relying solely on urgent care or hospitals. With the COVID-19 pandemic, urgent care facilities and hospitals are swamped with cases, so they have even less capacity today for providing non-emergency care. On this map, you can see that there is a large portion of the United States that lack primary care options.

(Source: Ro Co)

As we move forward as a nation, now concerned with our health more than ever, it’s important for employers and unions to give better healthcare options to the families that are counting on them. They can save money and improve lives by partnering with organizations like SolidaritUS Health to provide clinics in underserved areas and offer telemedicine options to make high-value primary care even more accessible to employees.

 

Is Your Employer-Sponsored Health Plan Adding Needless Cost to Your Business?

In a recent study, 71% of individuals said that they were worried with the rising costs of their health plans. Nearly half of those surveyed reported that their health plan options were a deciding factor in choosing an employer. The percentage is even higher for those deciding to stay on a job because they like their health plan options. It’s clear that healthcare is extremely important to finding talent and retaining valuable employees.

Another cost of inadequate health benefits is employee absenteeism. Illness and injury are some of the most common reasons for absenteeism. Not only will providing employees with better access to healthcare decrease turnover, but it will also reduce overall costs dramatically.

“Conservatively, unscheduled absenteeism costs employers $3,600 per hourly employee per year and $2,650 per salaried employee per year.” – Proactive MD 

Employees are clamoring for better health plan options. Access to high-value primary care is the answer, but how can businesses and unions arrange for this type of care and incorporate it into their health plan? They utilize direct primary care.

 

What is Direct Primary Care?

The direct primary care model has been around for some time. If you are not familiar with it, check out our direct primary care article for an in-depth explanation.  At a high-level, however, direct primary care is a healthcare option that provides access to a primary care physician with no patient out-of-pocket costs. Ample evidence shows that when patients engage actively in primary care, which is relatively inexpensive, expensive downstream medical costs fall dramatically. This model is growing rapidly because it gives working Americans and their families access to immediate care they value for things like check-ups, wellness and nutrition, chronic illness management, and much more.

How is This Different from Traditional Primary Care?

Generally, 80-90% of the typical health care needs of a working family ​can be met in a primary care setting. However, there are so many barriers to getting quality primary care, that patients underutilize it. With traditional primary care:

  • Patients still pay co-pays
  • Labs and common prescriptions are often an out-of-pocket cost
  • Urgent care is often not available
  • Waiting room times are longer
  • Appointments are shorter
  • Physicians are overwhelmed by the ratio of patients to doctors

All together that makes for an extremely impersonal and impractical experience for most working individuals. Direct primary care first focuses on removing the barrier of cost by having no patient out-of-pocket, coinsurance, co-pays, or deductibles.

Doctors are freed from the burden of time and costs associated with billing insurance companies. This way, they can spend virtually all of their time caring for patients, learning their healthcare needs and goals, and partnering with patients to achieve them. In addition, the best direct primary care solutions increase the availability of things like common tests, vaccines, prescriptions, and personalized health guidance by incorporating them into the overall plan.

Why Do People Need Better Primary Care Options?

A staggering study by the West Health Institute and NORC at the University of Chicago showed that between 1/3-1/2 of working-age people between the ages of 45-59 and ¼ of those 60+ went without needed health care due to cost. While cost is one of the largest factors to foregoing health care, fear is another one. Many people don’t have time to build a relationship with their physician, so they feel anxious about asking questions or even seeing a doctor they don’t know or trust.

The third biggest concern and reason why many people choose to avoid going to the doctor, is that they don’t fully understand health risks. With so many people having little to no primary care options available, there is a big gap in education when it comes to health. Things like, “how long should a cold last?” or “what are the long-term impacts of smoking?” are likely not top of mind.

According to the CDC, 7 out 10 deaths in the United States are caused by chronic disease. Although roughly half of the chronic illnesses diagnosed are preventable. Through better access to health care specifically preventative care and educationindividuals can improve life expectancy and avoid catastrophic medical events and diseases.

A Better Health Plan for All

Business and Taft-Hartley trust leaders often consider the impact on health costs as a deciding factor for choosing benefits. We’ve seen firsthand that better access to preventive care and primary care can decrease healthcare costs. Direct primary care provides employees with access to better, more personalized care. Individuals are healthier and happier, creating better outcomes for everyone.

 


 

Get To Know SolidaritUS Health Direct Primary Care

We design our health plans with your people and their families in mind, and that is why we provide the best direct primary care solution available. Our custom solutions have demonstrated dramatic savings for employers and individuals while improving overall health.

What are Members Saying?

What Else Does SolidaritUS Provide for Its Members?

All of the following items are built-in to our health plan so members pay no additional or out-of-pocket costs.

  • Preventive Care – includes comprehensive physician exams, biometric/blood pressure screenings, depression/anxiety screenings and counseling, and basic vision screening
  • Urgent Care
  • Telemedicine – with their personal doctor
  • Chronic Disease Prevention and Management
  • Medication Management
  • Personalized Health Action Plans – personalized planning to help patients reach their health goals.
  • Nutrition and Fitness Coaching
  • Family/Group Health Education Programs
  • In-Clinic Treatments and Procedures – includes EKG, spirometry, range of dermatological procedures, nebulizer treatment, basic wound care, etc.
  • In-Clinic Blood Draws and Specimen Collection
  • 40+ of the Most Common Labs
  • Dispense Approx. 40+ Commonly-Prescribed Medications
  • And Much More

SolidaritUS has made it possible for businesses of all sizes and types to give their employees access to this level of healthcare. You can contact us today to see how we can build a plan for your business.

Built for Unions Too

Employers aren’t the only ones who are concerned with employee health and providing increased value to their people. Helping union leaders provide superior health care to their members was exactly how SolidaritUS came to life. SolidaritUS is union-owned. The business was built on the same values and principles of caring for members as if they were part of our own family. By working with Spirit Aerosystems and UAW union leaders, we crafted a health plan to meet the needs of employees and their dependents. Member satisfaction is at 4.5 out of 5 and we are proud to be able to provide personalized care to union labor forces.

If you’re seeking to add value to your members and give them better access to personalized healthcare let’s chat.

 

 


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What is Direct Primary Care? – How SolidaritUS Health is Better Care

February 4, 2020

Direct Primary Care is Changing Healthcare

Direct primary care has increased in popularity over the years because patients are fed-up with not understanding what their health plans cover and the ever-increasing costs of care. Back when doctors still made house calls, you could pay your doctor directly. We are starting to see a shift, with direct primary care, to get back to that more personalized care experience.

Direct primary care is an arrangement between the patient and healthcare provider. It cuts out complicated insurance policies and procedures and allows patients uncomplicated access to care. You get access to a personal physician who can meet most of your healthcare needs whether you have insurance or not. Instead of paying co-pays or deductibles, direct primary care has no out-of-pocket costs, at all, because patients pay a monthly fee for quick and timely access to a host of medical services they can use at any time.

Direct Primary Care is Personalized Care

By only paying a monthly fee, there’s no need to worry if you cannot afford to go to the doctor for things like a cold, vaccinations, health advice and coaching, and chronic condition management. With SolidaritUS direct primary care you can also receive a variety of labs and prescriptions with no added cost.

You Get More Time
Wouldn’t it be nice to see your doctor when your appointment is, instead of waiting in the waiting room for hours? Direct primary care puts the care back into health care with increased time with your doctor. With SolidaritUS you’ll spend no time in the waiting room. Our smaller patient-to-doctor ratio means that you can always see your personal doctor when you come in and they will have time to focus on your needs, questions, and health goals.

There are better health outcomes when you can build a personal relationship with your doctor. When they have more time for you, they get to know you and personalize your treatment.

Doctors Get More Time
Direct primary care health centers seek to limit the number of patients under the care of each doctor, giving physicians more time to get to know and understand their patients’ health care needs and goals.

Primary care physicians in the mainstream fee-for-service insurance system typically look to maximize the number of billable patient appointments they can schedule each day. This means spending less and less time with each patient.

The average number of patients under each traditional primary care doctor’s care has ballooned to 3,000 to 4,000 patients per doctor.

SolidaritUS Health family physicians care for 1/4 to 1/3 as many patients – there are never more than 1,000 patients under the care of each SolidaritUS doctor. That “gift of time” enables physicians to get to know their patients, understand their individual care needs, and develop customized care plans that enable their patients to achieve their personal health goals.

Direct Primary Care isn’t Insurance

Direct primary care covers most common health care needs, but it will not cover advance care needs such as hospital visits, specialist care, and other items. At SolidaritUS, we clearly list all of the services included with enrollment as a member (see chart below). We also urge our members to seek insurance coverage to protect them against the high cost of specialist or hospital care that cannot be provided in a primary care clinical setting, in the event it is needed.

Another benefit of the SolidaritUS direct primary care model is that, unlike physicians in the mainstream fee-for-service insurance system, our doctors are partners, navigators, and advocates for their patients. When it is appropriate to refer patients out, our doctors are there to explain the options available to you, to help you understand the medical benefits and costs of each one, and to help you choose the best option for you.

SolidaritUS Health Care Services Include:
24/7 access to care to get answers to your health care questions via phone or text and telemedicine.
  • 40+ Commonly-Prescribed Medications
  • 40+ of the Most Common Labs
  • Immunizations
  • In-Clinic Treatments and Procedures
  • Preventive Care
  • Non-Emergency, Episodic Sick Care
  • Urgent Care
  • Chronic Disease Prevention and Management
  • Medication Management
  • Specialist Care Coordination and Referral Management
  • Healthy Lifestyle and Risk-Reduction Coaching

*See full details on our enrollment page.

Direct Primary Care Has No Deductibles

Many people currently have high-deductible health insurance plans through their employers. That deductible cost can be daunting. We think there should be no need for you to pay out-of-pocket to meet that deductible for things like check-ups or refilling a prescription.

By combining SolidaritUS health with your high-deductible plan, you can make sure you are covered no matter what you need, but more importantly, you won’t need to worry about your deductible to see your primary care doctor.

Benefits of Direct Primary Care

  • No out-of-pocket or surprise costs
  • Longer appointment times
  • Shorter time in the waiting room
  • Access to care when you need it
  • Vaccinations, prescriptions, and labs with no added fees*
  • You don’t need insurance to sign up

At the end of the day, you should make the healthcare decisions that make sense for you and your family! Direct primary care is a growing option because people truly love the experience of personalized healthcare. You may have more questions, and so we want to make sure we are available to answer them. Call us today!

If you’re ready to sign-up, you can enroll today here.


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Special Message to SolidaritUS Health Members in the Chippewa Valley

June 1, 2020

Dear SolidaritUS Health member,

The COVID-19 pandemic has changed lives of all Americans in ways few could have imagined a short time ago. Never in recent memory has incomparably quick access to care and counseling from an experienced physician — a personal doctor who has time to get to know and care for you and your family — been so important.

That’s exactly the kind of health care you selected when you enrolled in SolidaritUS Health. You chose unparalleled access to same-day/next day urgent care appointments and ongoing access to a personal SolidaritUS Health physician through scheduled appointments and medically secure teleconferencing, email, text, and mobile phone. You chose availability of a broad scope of primary care services, including preventive care, episodic sick care, health coaching and counseling, vaccinations, nearly 1,000 lab tests, and approximately 50 of the most commonly prescribed medications — all with no out-of-pocket costs to you or your family.

Our commitment to providing you unparalleled access to world-class care stands unaltered by the novel coronavirus pandemic. In fact, we have increased the range of our health care services in response to our members’ needs, and we will continue to do so.

George Ritsch

At a time like the present one, we could not be more pleased to introduce you to Dr. Enitza George, MD. Dr. George joins Dr. Jodi Ritsch, MD, as a member of the SolidaritUS Health physician team serving our members in the Chippewa Valley.

Many of you have had the privilege of knowing and receiving care from Dr. Ritsch, who has served patients in the Eau Claire community for many years, providing top-quality family care at the Mayo Clinic, in private practice, and now as anchor of our physician team at SolidaritUS Health.

Dr. George brings our Chippewa Valley members additional years of experience as a family physician and personal wellness coach, with a special focus on nutrition, lifestyle management, and sports medicine. “Being healthy is more than not being sick,” says Dr. George. “SolidaritUS Health gives me the opportunity to care for my patients’ physical, mental, emotional, social, environmental and even spiritual wellness.”

Over the next several weeks, Dr. Ritsch and Dr. George will be reaching out to our members, individual-by-individual and family-by-family, to renew relationships or get to know you for the first time. They are hoping to answer any questions you may have and provide up-to-date medical information about managing your care during the unfolding pandemic.

But you don’t have to wait for a call. You can schedule a telephone, video conference, or in-health center appointment with Dr. Ritsch or Dr. George by calling (715) 318-0050.

We’re in this together. Please stay safe.


Mark Blum, President
SolidaritUS Health


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May 20, 2020

To former Spirit Employees,

The physicians and staff of SolidaritUS Health have developed a close bond with so many of you since we launched world-class direct primary care and unparalleled patient service for you and your families just 22 months ago. Our hearts are heavy with the news that several hundred Oklahoma Spirit employees have had to be laid off.

We urge you to exercise your right to continue your Spirit health coverage after May 31 by enrolling in COBRA, which will include continued access for you and your family to your SolidaritUS family doctor and the full scope of primary care services that SolidaritUS Health provides.

Yet, we remain concerned that, after May 31, those of you who opt not to pay COBRA premiums will lose all access to the continuing care you and your loved ones need. In response to this dire situation, we have created an option to allow former Spirit employees who have opted out of COBRA enrollment to continue to receive the same level of SolidaritUS Health direct primary care that you and your family enjoy, today, for a monthly fee of $87 per person. If you wish to elect this option, you may enroll online.

For this monthly fee, SolidaritUS will provide you the full array of SolidaritUS Health direct primary care services after May 31, including preventive care, episodic sick care, urgent care services, chronic disease management, health coaching, a range of in-clinic procedures and treatments, access to approximately 1,000 lab tests, immunizations, and about 50 of the most commonly prescribed medicines — all provided by your personal SolidritUS Health doctor without any out-of-pocket copays or deductible costs for you.

Be mindful that SolidaritUS Health is not insurance; no direct primary care is a substitute for having an insurance plan that provides you coverage for emergency room, specialist and hospital services you may need. Again, we urge you to enroll in COBRA coverage, if you can. Unlike COBRA coverage, or other health insurance, direct primary care is not designed to cover all benefits and services mandated by the Affordable Care Act and state insurance laws for traditional health insurance plans.

Nonetheless, the broad scope of primary care services SolidaritUS Health offers will meet a great deal of the typical health care needs of a working family. If you do not exercise your right to pay for COBRA coverage, we hope the option to enroll in SolidaritUS Heath we are offering can be a source of security to you and your family in knowing that your basic health care needs can continue to be met until you are recalled or you land your next job with employer-sponsored health coverage.

We’ve been able to arrange two choices of methods for you to pay the individual SolidaritUS Health member fees of $87 per month, either:

  1. The preferred option: Automated monthly payment (ACH) from your bank account.
  2. A recurring monthly credit card charge.

You may choose either option online when you enroll.

There are no great choices in a time of disruption to production such as Spirit AeroSystems and all of you are experiencing at this time. We have created this option for continuing SolidaritUS Health direct primary care as individual enrollees exclusively to provide you an affordable bridge for meeting your family’s basic health care needs until the full health coverage benefits you deserve can be restored. Learn more about enrollment options by calling Rick Dade of the SolidaritUS team at 301-325-6655.

In solidarity and good health,


Mark Blum, President
SolidaritUS Health



SolidaritUS Health Inc.
1025 Connecticut Avenue, NW, Suite 907
Washington, DC, 20036



SolidaritUS Health Inc.
1025 Connecticut Avenue, NW, Suite 907
Washington, DC, 20036



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