Director of Member Services and Innovation
Kathryn Otto McLeod, director of member services and innovation, leads the team that works directly with Alliance members to understand their needs and to ensure that The Alliance evolves to respond to changing needs. She joined The Alliance in 2014 to develop new value for Alliance members through products and vendor partnerships.
Before joining The Alliance, Kathryn held leadership positions in sales, account management and product development at a variety of regional health plans, including WEA Trust, Dean Health Insurance and Physicians Plus Insurance Corp. She also applied her skills to economic development as the director of health care initiatives at THRIVE, a regional economic development organization.
Kathryn has an executive master of business administration degree from University of Wisconsin-Madison and a bachelor’s degree in business administration from Cardinal Stritch University. She holds licenses in health and life insurance.
The traditional health care model can be hard to access, tough to navigate, and unnecessarily expensive. But there’s another way you can approach primary health care that makes your employees healthier and helps with your bottom line — advanced primary care.
Different, Better Care
When people’s health concerns are confined to rigid appointment times, often scheduled weeks in advance, and their doctor only sees them for 10 minutes at a time, it’s hard for patients to paint the whole picture about those concerns. In fact, 85% of doctors say they lack time during appointments to meet their patient’s needs. This shortage of time can cause doctors to over-test, which costs the patient more time and money, or they can misdiagnose or overprescribe, impacting the patient’s health.
On the other hand, with advanced primary care, patients enjoy more time with their care provider, see them more quickly, and may spend less time traveling to appointments.
When patients have the freedom to schedule appointments at flexible times and see their providers either in person or online, they are more likely to seek care at a clinic rather than urgent care or the emergency room.
Advanced primary care can handle most of the health care needed, but there are times when care does need to be referred outside of the clinic. In those cases, an advanced primary care provider will guide a patient to lower cost, higher quality options and stay connected with the patient throughout the outside appointment. This gives patients access to an advocate through the health care process versus being lost in the system on their own.
In this model, providers have more time and resources to provide better care, the patient receives more convenient care for less money, and the employer saves on their overall health care costs. Everybody wins.
The Four Best Benefits
There’s no shortage of perks for offering advanced primary care to your employees and their families, but here’s our top four:
1) Employers can see their overall cost of health care lower by as much as 15-30%, with savings beginning in as little as 12 months. (In 2014, Brakebush Brothers opened an on-site clinic. Today, their health care costs are less than what they were in 2014.)
2) Employers don’t need to make the hard choice of increasing cost-share to employees in order to control health care utilization. With employers paying for the cost of accessing the clinic, there are no concerns about over-utilization of the services. Also, the use of urgent care and the emergency room goes down when patients have the option of advanced primary care due to the ease of access and reduced costs.
3) Recruiting and retaining employees can be made easier by offering access to advanced primary care at no cost to employees.
4) Referrals to lower-cost, higher-value specialists and procedures extends the value of the advanced primary care, even for care that happens outside the clinic.
For more information on how we can help you offer this to your employees, contact the Member Services team.
With the new year comes new benefit plans. The Alliance wanted to provide some helpful tips on what can help employers, and employees, get off to a great start.
For employers that are new to working with The Alliance or those that would like a refresher on what we do, we would recommend contacting your Account Executive to cover the following topics.
What does it mean to be a cooperative?
Learn about your ownership in the company, as well as benefits like stocks and patronage checks.
What is the advantage to working with The Alliance?
We like to discuss our vision for health care and how our reference-based contracting can help you offer your employees and their families quality care at the right price. We also like to connect you with other like-minded employers in your area.
What kind of data intelligence can The Alliance provide?
At The Alliance, we provide employers with detailed reports on utilization, ROI, steerage to high-value health care, a breakdown of spend, and a review of appropriate ER usage to help control costs to name just a few.
If members are new to working with The Alliance, we may not have sufficient data to analyze. We can provide sample reports to give you a sense of what you can anticipate receiving in the future.
How does The Alliance help employers contain costs?
In addition to our network, we can also discuss advanced primary care and how we help employers offer these services to employees. One of the ways we accomplish advanced primary care is through onsite or shared-site primary care clinics. Employers can pay a monthly fee per employee instead of fees for each service that can help save costs for the employee and employer. And by offering longer appointment times, these clinics allow employees to get all their needs taken care of in one appointment. The Alliance can even work to connect employers in an area who may be interested in a shared-site clinic.
We can also can help steer employees to high quality, lower-cost providers and bundled services that offer more transparency in pricing and include the total cost for an episode of care.
What kind of services can The Alliance provide beyond a network and the cost containment strategies above?
We have your data, once you work with us, so we’re happy to customize our services to fit your needs. And we regularly take feedback from our members to develop new analytic capabilities and enhance our offerings.
Does The Alliance have any tips for employees?
Encourage them to navigate the provider directory to get familiar with how to use it before they need services. If they have questions, they can visit our Frequently Asked Questions page call us at 1-800-223-4139.
Introduce employees to our concierge service for pricing services. This can help them anticipate and budget for health care costs.
Remind your employees to show their new id card to providers to ensure proper billing.
And make sure they understand their benefit plan design and any incentive programs you have in place.
What if I’m new to self-funding?
There’s a lot to learn, and we’re happy to provide education around what that shift means and who does what. Here are some suggestions on who to call for what:
TPA: Billing Questions, like stop-loss, and helping employees with questions about how their claim is adjudicated and tracking deductible spend.
The Alliance: How to get a doctor in-network. If you find a doctor that isn’t in our network, we’re happy to negotiate on your behalf to get them in-network.
And don’t forget our events which offer great educational and networking opportunities! If you have any questions, please reach out to your Member Services team!
High-value care can help you pursue better outcomes for employees while reducing the total cost of care. So how do you tell if primary care is high value?
Self-funding your health benefit plan can be rewarding for employers. Yet experts say common pitfalls still undermine too many employers’ best efforts.