Banking & Finance, Health Care, and Technology

Health insurance navigation system lowers company costs

Mary Free Bed pilot program cut costs for first two companies involved.

September 28, 2018
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A new local health insurance navigation system is showing promising results for the two piloting companies.

C2health, a program of the rehabilitation hospital Mary Free Bed, is meant to help companies reduce health care costs through the assistance of nurse navigators.

The program provides the company with an on-site nurse to help employees and their spouses make the best decisions for their individual needs.

The program was born after Dave Muir, president of Grand Rapids-based Paragon Die and Engineering and board member of Mary Free Bed, wanted to find a solution to rising health care costs and annually deciding how much his employees versus the company would pay.

“We seem to be just OK with it going up and up and up every year. At some point, it’s not sustainable,” Muir said.

“How fair is it to 80 percent of the population if only 20 percent can afford it?”

He noted about one-third of all health care expenses are unnecessary, and he wanted to help his employees find and cut unnecessary costs, intending to drive down overall costs.

And Muir wanted his own employees to have access to similar services as the growing concierge medicine, which includes personalized care in exchange for expensive retainer fees.

Muir partnered with Mary Free Bed Chief Medical Officer Dr. Michael Jakubowski and CEO Kent Riddle to hire the first nurse navigator and start a pilot program at Paragon in May 2016.

Working on-site, he said the nurse builds relationships with employees, earning their trust and allowing the nurse to best assist them based on their medical needs.

Typically, he said companies have to rely on HR or other staff who are untrained in the system.

“It gives me, as an employer, some peace of mind that my employees are being handled better than they would be without this,” Muir said.

“Without it, they were fumbling through, and we were fumbling through to help them as best we could, and we still couldn’t, so now I know they’re in the best hands they could be.”

He said the program is unique because it takes a “holistic” physiatry approach and allows clients to use any insurance carrier, not just one.

“We don’t want to limit who our employees can see,” he said. “We want to actually help guide them.”

Nine months after Paragon started the pilot, Mary Free Bed began a secondary pilot for its own employees.

Since they started, he said both companies have averaged about an 8 percent decrease in health care costs, though it is uncertain exactly how much of that decrease was caused by the program.

“(C2health) is the main reason; we just don’t know how much of it,” Muir said.

Last year, he said Paragon was able to reduce, rather than increase, costs of the company and employees for the first time since he started at Paragon in 2002.

He said bringing on more clients in the next phase will allow the program to further develop details and a statistical estimate of savings from using the program.

There are 2,500 people overall involved in the program, and Muir said c2health leaders want to bring on another 10,000 people in the next six months.

He said there is an opportunity for new companies to join the program and those interested should contact the program.

“We’re looking for companies to help us develop what this could be,” he said.

He said there are “a couple of big companies” close to joining.

Per-employee program costs vary for each company, depending on a number of factors, Muir said.

For now, he said it would be easier for the bulk of client companies to be based in West Michigan.

“We may be able to shake up the health care system a little bit by making sure it’s getting used appropriately,” Muir said.

Whether or not this is part of the solution: “We’ll have to see.”

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