Docs court employers with health management

Three years ago, the physician practice American Health Network was concerned that the boom in employer on-site clinics would hurt its business. So it launched a program aimed at managing the health of employers’ workers that has recorded impressive results.

Carmel-based American Health’s Employer Health Management program sends nurses to all of an employer’s locations once a month to meet with employees and their spouses. Every employee and spouse who participates is assigned to a specific nurse who checks blood sugar, blood pressure and body mass index, and chats about each person’s health issues.

“The real impact comes from the personal relationship with the nurse,” said Mary Delaney, director of the employee health program at American Health. “That is what is missing in health care.”

She noted, for instance, that efforts to help an employee stop smoking are likely to be futile unless they also address the stressors in a person’s life, which lead him or her to smoke. And that can only be done via a relationship that develops in recurring conversations.

Or, she noted, diabetics with depression spend, on average, twice as much on health care as diabetics without depression. So American Health’s nurses try to identify mental health issues that might be complicating a patient’s chronic diseases.

American Health is now serving 13 employers with roughly 8,000 people on their health plans. They include Goodwill Industries of Central Indiana, Pearson Ford, the Indiana Sports Corp., First Merchants Bank, Howard County government and the public schools of Wabash.

The biggest financial impact so far came at Goodwill, which was the first large employer to sign up with American Health. Goodwill encouraged its employees to participate in the health coaching, giving them 20 minutes paid time off to meet with a nurse once a month at their workplace.

Also, Goodwill’s health plan with Minnesota-based UnitedHealthcare charges employees no co-pay to go see an American Health physician, making it easier for employees to get further medical care when one of American Health's nurses recommends it.

An analysis conducted by UnitedHealthcare found that Goodwill’s total medical and pharmacy claims dropped nearly 27 percent from what they were projected to be in the first 12 months of American Health’s program.

That meant Goodwill spent $100 less every month for all 1,200 people covered by its health plan.

“We can make some huge inroads,” said Dr. Ben Park, CEO of American Health. He said the program, which is staffed by 22 American Health employees, has yet to turn a profit—although it is on course to break even this year.

However, Park said it is helping American Health adapt to a trend in all of health care, in which nurses are handling more coaching and routine patient care. Physicians, meanwhile, are shifting to focus on fewer, but more complex, patients.

It's also another effort by health care providers to work directly with employers–rather than exclusively through health insurers–to help improve patients' health. For example, Indianapolis-based hospital systems are trying to sign direct contracts with employers to help manage their workers' health more effectively. And Indiana-based operators of on-site clinics have opened more than 80 clinics around Indiana and in nearby states.

Employers have even started banding together in small groups to open clinics that serve all their employees. That has made the clinic concept affordable, even for smaller employers.

“It’s easier for other employers to join in now” with existing clinics, Bryan Brenner, CEO of First Person, an Indianapolis-based benefits adviser to employers, told IBJ last year. “We’re beginning to see a little bit of activity on that.”

In one case, OneAmerica Financial Partners Inc. credited its clinic with reductions in outpatient procedures and emergency room visits of more than 20 percent.

American Health’s roughly 200 physicians in Indiana and Ohio have also started staffing on-site clinics, if employers request it and if American Health thinks it's appropriate. Park said American Health's greater involvement with employers is helping it adjust to changing trends in health care.

“It has allowed us to have a conversation with employers that we were not having before,” Park said.

This story has been updated to reflect new information provided by American Health Network.