Health care solutions for the little guys

As small businesses contend with rising health care costs, a number of providers are offering solutions to monitor and control expenses through programs rooted in preventive care.

Take WellNet Healthcare Group’s Point to Point Healthcare platform. The software allows self-insured small businesses to track employee health claims — in compliance with federal health privacy rules — in real time to identify opportunities for savings.

Loading...

Comments

• Weigh In
• Corrections?

Personal Post

“We are able to target the high-risk individuals and get them health with a tailored disease management program,” said Jason Kovar, co-president of WellNet’s health plan division. “We can reach out and say, ‘I see you haven’t refilled your prescription.’ ”

The technology is the centerpiece of the Bethesda health management company’s medical benefits program, offered in five states, including Maryland, as of April.

Employers can pay a fixed monthly premium to WellNet, much as they would for conventional insurance. If medical claims fall below that fixed premium in a given month, the difference is paid out at the end of the year. If claims go above the fixed rate, insurance included in the plan covers the difference.

Businesses can set their own deductibles and co-pays. The cost varies by a company’s health care needs.

“Small-sized groups can break away from carriers, and manage and measure their health care,” he said. “Getting to the data, seeing where the problems lie, tailoring a disease management approach can save companies money.”

Kovar estimates the program can help employers reduce their costs by as much as 25 percent a year.

WellNet is just one option, though. The competition for the small-business market grows every day.

UnitedHealthcare, for instance, has created a new wellness program that attempts to give small firms access to the same services, such as health coaching and gym reimbursement, available to larger companies. The initiative is aimed at fully insured customers with two to 99 employees in the Washington area.

The program employs some carrots to get people to use the services. Members signed up for the gym, for instance, will have their attendance tracked every time they swipe into the club. Those who go at least 12 times per month are reimbursed $20 per month. The insurance company also offers at-home screening kits to test for heart disease and diabetes.

“These kits empower people to consult with their physicians in order to detect diseases early and develop an appropriate treatment program,” said Stephen Reidy, vice president of UnitedHealthcare’s Mid-Atlantic Healthplan.

Reidy pointed to a recent Wellness Council of America study that estimates that a $1 investment in a wellness program saves $3 in health care costs.

Meanwhile, the cost to mid-sized employers providing health benefits rose 6.9 percent on average last year, the sharpest price increase since 2004, according to a survey by Mercer. Many of the companies polled by the research firm said the growing population of patients suffering from chronic conditions was placing upward pressure on costs.