Washington State Physician Group Joins in Offering Small and Mid-Sized Employers a New Way to Lower Healthcare Costs

Spokane's Rockwood Clinic adopts innovative health plan delivery model, designed to quell rising health insurance premiums

Aug 19, 2014, 06:58 ET from Physician Care Direct

SPOKANE, Wash. and CARY, N.C., Aug. 19, 2014 /PRNewswire/ -- Rockwood Clinic and Physician Care Direct today announced the introduction of the Employer Health Ownership Plan™ (EHOP™) powered by Physician Care Direct for businesses in Rockwood's catchment area of eastern Washington and North Idaho. A new approach to health insurance, the EHOP is designed to make healthcare more affordable for small and medium-sized businesses while improving the health of employees and the communities they live in.

The announcement comes as small and medium-sized businesses (SMBs) are struggling to manage rising costs and the side effects of the Affordable Care Act. Just 57 percent of SMBs offered health coverage in 2013, compared to 99 percent of larger firms, according to data from the Kaiser Family Foundation. Cost is the number one force driving small businesses out of group insurance. From 1999 to 2013, the annual cost to cover a single employee with group insurance increased from $2,196 to $5,615 (166 percent).

"Small and medium-sized employers in our region are being forced to choose between paying for health insurance for their workers and staying profitable," said Michael Patmas, M.D., MMM, CPE, Chief Executive Officer of Rockford Clinic, whose over 300 clinicians represent a significant percentage of the primary care providers in Spokane and the surrounding communities. "At Rockwood, we're convinced we can do better by leveraging innovative care delivery and payment models like the EHOP. This is a sustainable solution where employers and providers are joining forces to lower healthcare costs and help keep employees healthy and productive."

Equalizing healthcare costs between large and smaller employers
To help lower the cost of health insurance, most large employers have adopted "self-insurance," meaning they assume part of the financial risk of paying for unhealthy employees but also share in the savings when more employees stay healthy and avoid excessive high-cost medical care. By contrast, most SMBs are traditionally thought to be too small to self-insure, so their health insurance premiums remain the same during each contract period, regardless of whether their employees are healthy or unhealthy.

The EHOP enables smaller companies to self-insure and convert approximately 60 to 70 percent of their healthcare expense to a variable expense. The plan also emphasizes population health management and the direct purchase of primary care services.  This improved access to primary care can address 85 percent of patients' healthcare needs. The combination gives smaller employers better control of their healthcare costs, perhaps for the first time.  Employers also benefit from transparency about their healthcare spending, enabling smarter purchasing decisions that were previously out of their control. 

Employee participants in the EHOP pay few if any out-of-pocket costs for primary care. Having comprehensive primary care available at no or little cost enables employees to better manage their health and reduce healthcare expenses.

Participating primary care providers benefit by gaining fair payment for the delivery of more comprehensive care including phone consultations, longer office visits, and better access to plan data.

"The traditional approach to health insurance fails to improve the health of the underlying population and to control health plan costs. Only timely primary care can improve the health status of Americans and lower costs," said William Lawson, M.D., CEO of Physician Care Direct.  "We are excited that the Rockwood Clinic has chosen to lead the Spokane region in embracing health plan innovations that truly address the healthcare value equation and help smaller employers manage a challenging economic and regulatory environment."

About Rockwood Clinic

Rockwood Clinic, part of Rockwood Health System along with Deaconess and Valley Hospitals offers primary, specialty and urgent care from many locations around the greater Spokane Area and North Idaho. Serving more than 160,000 patients a year Rockwood is dedicated to access to health care services, improved coordination of patient care among providers, and focused on quality and customer relationships. For more information log on to RockwoodClinic.com.

About Physician Care Direct

Physician Care Direct partners with employers and health systems to make healthcare more affordable. We deliver the Employer Health Ownership Plan™ (EHOP™)—an innovative health plan solution that starts with personalized primary care, then adds physician and hospital networks for a comprehensive solution.  Now businesses of all sizes can offer their employees meaningful healthcare benefits while controlling and reducing costs. For more information, visit www.physiciancaredirect.com.

Media Contact:
Todd Stein
Amendola Communications for Physician Care Direct

Jill Fix
Rockwood Health System

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SOURCE Physician Care Direct