You don’t have to be an 800-pound gorilla to create a better health plan for employees … but it sure helps

Self-funded companies can do a lot to improve employee health through wellness programs and creating “micro health delivery systems” (my term) with goals tailored to the firm’s employee population.

The catch may be that only employers that are very large, very innovative and want to get very involved in health care may be able do that.

At the World Congress Executive Forum on Self-funding and Alternative Models for Health Benefit Financing, Feb. 7 in Washington, D.C., two such companies spoke.

Jeff Ellis, VP and CFO (benefits) at MGM Resorts International, one of the largest employers in Las Vegas, has been able to negotiate directly with select providers to create a “sub-network” carved out of the United network that it rents. (Smaller, more exclusive networks give employers more leverage over physicians and give participating physicians more tangible benefits by being in-network. Networks normally prohibit employers from directly cutting contracts with providers.) It’s only able to do that because it’s United’s largest customer and has the ability to dictate terms most companies cannot.

MGM drastically increased reimbursement rates for physicians and eliminated preauthorization but required that physicians see acute care cases within 24 hours and engage in an accountable care organization model.

It can get employees to eat healthier food, because as a hotel/restaurant business, it feeds workers once or twice a day. Ellis said the biggest benefit of its wellness program is early detection and diagnosis, which eliminates sudden deaths from heart disease and other silent killers.

Andrew Hunzeker, CFO at Lincoln Industries (a leading provider of chrome and high-performance metal finishing), discussed the company’s wellness program. Elements include:

• In-house physician assistant,
• Exercise classes Mondays and Wednesdays;
• Various sports leagues;
• Stretching instruction;
• Annual mountain-climbing trip for the folks who pass fitness goals.

He said the wellness program has reduced workers compensation claims, saying 80 percent of on-site injuries involve people who are not fit. His WC premiums have dropped, a fact he attributes partly to the company’s requirement that workers stretch before work. He said that having an on-site “in-your-face” wellness coach is more effective than e-mail or telephonic coaching.