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Sherry Slater | The Journal Gazette
Zack Smith installs vinyl baseboard in the new Activate Healthcare clinic, which opened April 7.

Employer clinics saving time, money

Patients must be insured by firm, but get free care

A local clinic offers free office visits – regardless of income level.

In-stock prescription drugs are free. Same-day appointments are readily available. And new patients are scheduled for a full hour with the doctor.

There’s a catch, of course.

Not just anyone can receive medical care at the Activate Healthcare clinic on Ludwig Road. Treatment is limited to those insured by participating employers.

The 2,200-square-foot clinic is the pet project of Kent Prosser, business manager for Plumbers & Steamfitters Local 166. After three years of research, Prosser is confident he’s found a better way to deliver health care – even though it requires the delicate act of partnering with various employers to cover the costs. That model, a local insurance broker said, is a new approach.

“Instead of outsourcing medicine, we’re bringing it in-house,” Prosser said. “I think this is the answer for what ails our health care system. This isn’t a Band-Aid station. This is a family practice.”

If the clinic can deliver the savings Prosser expects, the result could be more work for Local 166 members and the contractors who hire them. Those contractors would be able to submit lower bids on construction projects if their costs were reduced.

Other examples

The basic clinic concept isn’t new.

For years, some larger manufacturers have employed nurses to patch up workers hurt on the job. General Motors’ Allen County truck assembly plant and BAE Systems are local examples.

But such operations are limited in scope. Prosser stressed that he wanted to create a clinic that delivers more than occupational health care.

That more expansive idea also appealed to local education officials.

Fort Wayne Community Schools in 2012 opened two clinics for anyone on the system’s health insurance plan. That includes 7,730 employees, spouses and children. Last year, the clinics logged 10,882 patient visits.

The investment has paid off. Officials estimate FWCS reaped $500,000 in savings last year alone, spokeswoman Krista Stockman said. The first year’s savings are estimated at a more modest $166,000.

Officials calculate savings both in reduced prices for medical services performed and in staff time that wasn’t spent waiting in a crowded doctor’s office. Employees typically spend 20 minutes or less in an FWCS Health and Wellness Center, minimizing time away from work, Stockman said.

Steve Gillie, a benefits consultant for Old National Insurance, worked with Prosser to create the clinic used by the trade union.

What’s groundbreaking about this newest clinic is the shared concept – multiple employers paying to support the same facility, Gillie said.

The amount Activate Healthcare charges each participant each month goes down with the number of patients – up to 3,500.

About 1,450 Local 166 members and their dependents live within driving distance of the clinic.

Dotting the Is

The clinic is under the same roof as the union’s offices, but the local doesn’t own it.

Local 166’s Health & Welfare Fund owns the clinic. That legal entity is responsible for paying rent for the clinic and hiring Indianapolis’ Activate Healthcare to manage it.

The Health & Welfare Fund receives money from union members and the contractors who employ them.

The Plumbers & Steamfitters Local 166 Building Corp., a legal entity, owns the building and 14-acre property on Ludwig Road.

Local 166, a third legal entity, also pays rent to the building corporation for the office space used by the union’s staff, including Prosser.

If it sounds complicated, that’s because it is. Prosser spent months consulting lawyers and other advisers – including Labor Department officials – to ensure the legal structure is sound.

As the trail is blazed, more employers are expected to follow the same path.

This is the 16th clinic that Activate Healthcare manages – all are in Indiana. The majority of them are used by multiple employer groups.

The 5-year-old company is opening locations in Ohio and Michigan this year, said Debra Geihsler, a principal in the business and former hospital CEO. Peter Dunn, former CEO of Steak ’n Shake, is the other principal.

Making the case

Some patients might balk at leaving their primary care doctors, but that’s not an issue for everyone.

Local 166 surveyed students in the union’s apprentice program and found that 70 percent don’t have a family doctor. They visit urgent care clinics or emergency rooms for bronchitis, backaches and belly pain.

While the rate among apprentices is especially high, they aren’t the only ones who don’t seek routine care.

About 20 percent of adults 18 and older either don’t have a health care provider or consider a hospital ER to be that provider, according to the 2012 National Health Interview Survey.

Approaching health care in that way leads to staggering costs.

The average emergency room charge for treating strep throat was $313, compared with $33 at urgent care centers, according to 2011 data from Anthem Blue Cross Blue Shield.

Although urgent-clinic costs are lower, those visits don’t allow doctors to establish ongoing relationships with patients and coach them on ways to become healthier.

Dr. Lisa Falotico, who practices at the plumbers’ clinic, said her schedule has been fairly full of patients in the center’s first three weeks.

Falotico, a doctor of osteopathic medicine, is trained to perform chiropractic manipulation in addition to treating typical ailments. The medical staff consists of Falotico, a nurse practitioner and two nursing assistants.

Falotico, who is in her third year of practice, was attracted to the clinic’s promise of providing care without being on a stopwatch.

“In general practices, it’s all about how many patients you can see,” she said.

Patients spend 19.3 minutes on average with general and family practice doctors, according to the 2010 National Ambulatory Medical Care Survey.

Falotico didn’t have an average for her clinic but said new patients are scheduled for one hour to allow her to get a complete medical history and address their concerns.

“We try to schedule everyone with enough time,” she said.

But the clinic can’t handle everything.

Geihsler doesn’t see the clinic care model as a threat to traditional providers, including hospitals, because patients will still need those providers for pregnancies, infant and toddler care, hip replacements and other specialty treatment.

A rewarding option

Prosser is encouraging his 800 union members – and their 1,000 insured family members – to use the clinic with both out-of-pocket savings and cash rewards.

All clinic visits, including those for physical therapy, are free.

Many people now pay a $500 individual or $1,000 family deductible – and then have to pay 10 percent of the costs of an office call, he said.

The clinic stocks 100 to 150 generic medications under lock and key. No narcotics are kept there, however.

If a patient needs a prescription that’s in stock, he can have the drug at no charge.

For drugs the clinic doesn’t have in stock, patients are charged $10 for a generic prescription and $20 to $30 for a name-brand medication.

If a generic is available but the patient insists on the brand-name drug, he must pay the full cost of the prescription.

Prosser is pragmatic.

Even though the clinic, which opened April 7, promises to be popular with members, he wouldn’t have pushed for it if it didn’t make sense financially.

Construction and equipment cost about $450,000. But that’s a drop in the bucket compared to the $6.8 million in claims Local 166’s health care plan paid last year. By focusing on prevention, Prosser expects to reduce future claims.

His members and their spouses are being offered $100 each to come in for a physical followed by a 20-minute wellness consultation. Anyone who meets health goals over a year earns another $100.

The hope, Prosser said, is to create a healthier group by treating high blood sugar before it becomes diabetes and high blood pressure before it leads to heart attack or stroke.

Patients win – and so does the bottom line.

“As business manager,” Prosser said, “I don’t think I can offer a better benefit to my members.”

sslater@jg.net

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