The Alliance awarded Traci Rothenburger, with a Health Transformation Award on Oct. 1, 2020, in recognition of significantly improving her employees’ access to high-value health care by creating an on-site direct primary care clinic. The Alliance created a case study capturing Traci’s journey so other employers can follow in her footsteps. This article is a condensed version of the case study.
PROVIDING PROPER CARE WITH NORDIC PRIVATECARE
Transforming health care takes vision, determination, and often a “why not” attitude. In this case, it began in 1991 with a part-time secretary working in occupational health. Over the next 13 years, Traci Rothenburger, now Clinic Manager at Nordic PrivateCare, would apply her administrative, organizational, and people skills to improve her coworkers’ lives while helping her employer control their health care costs.
Traci began in occupational health at Seats Incorporated, a subsidiary of the family-owned Nordic Group of Companies, Ltd., and soon expanded that program to include wellness and health programs, and eventually opened an on-site clinic. She was then recruited to its sister company, Flambeau Inc., she replicated and built upon that model, opening another on-site clinic, Nordic PrivateCare.
She designed it to meet the total needs of the patient, which is care that Flambeau’s workforce had been missing using the typical approach to health care – where patients only have a few minutes with their primary doctor.
Traci said her biggest challenge in creating the new clinic was finding providers they could utilize that offered high-quality services at low costs.
“I think the biggest success story for us was contracting with a broad scope of providers and services,” she continued, “between SmartChoice, Quest Diagnostics, St. Clare, and Reedsburg Hospital, we developed those relationships to make it all work together while remaining a cost-effective benefit for our employees.”
Jason Sauey, President of Nordic Group of Companies, Ltd., said his chief concern was not knowing if their workforce was large enough to support the clinic – which Flambeau proved to be – but it took longer than they expected for that to become apparent because Nordic PrivateCare wasn’t immediately thought of as a big benefit by Flambeau’s employees.
“It was an odd circumstance. We couldn’t seem to get it to catch fire at first, but over time, as people started to use it and word-of-mouth spread, and it came together pretty well,” he explained. “It’s been a long time coming, but it seemed that people simply had to experience it to truly appreciate its value.”
INCENTIVIZING EMPLOYEES WITH QUALITYPATH
The clinic’s eventual success was, in part, thanks to properly incentivizing employees to use its services.
“We use QualityPath quite a bit, so we really ask the patient to come and to talk to us first before undergoing a surgical procedure or having a test performed. And when they go, we pay their mileage. If they need to stay overnight, we pick up the room expense for them, too.”
QualityPath by The Alliance offers a bundled price for several tests and procedures, which significantly reduces the out-of-pocket expenses for patients. It also includes built-in patient navigation, a warranty on select surgeries, and less paperwork.
Traci said they also incentivize through their wellness program, which uses a points-earned system, and that employees pay per week towards specific goals. If they complete the program, they get all the money back – which is a nice investment towards their health and wellbeing.
ON-SITE, ON-DEMAND, COMPREHENSIVE CARE
Now that employees know the clinic’s many benefits, Flambeau is reaping the rewards by using it as a recruiting tool – not only to bring people in – but to improve the health of their current employees by providing a better quality of care. The patients that use the clinic receive more personal care, too.
“It’s more about spending time with our patients and employees than anything,” said Traci. “We like to have our patients come in and be seen and treat the whole person – not just the symptoms or the part that’s hurting them at that point in time.”
And when patients do come in for treatment, Nordic PrivateCare offers a wide array of services to take care of them, from prescription fulfillment to urgent care and everything in between.
“We have massage therapy, chiropractic services, behavioral health, on-site radiology and imaging services, and we actually just added orthopedic consultations as well,” Traci remarked.
And if that’s not comprehensive enough, the clinic recently introduced an ER program so if somebody needs to be seen, they can call the clinic day or night, seven days a week. The result? Their ER utilization has dropped off significantly.
CONTROLLING COSTS WITH DIRECT PRIMARY CARE
Jason emphasized that the main reason for the clinic was not to mitigate high costs simply for the benefit of company, but also for its employees.
“If we can keep our costs down, it helps make sure that their deductible and their contributions are reduced as well,” he said. “As a private employer and having a self-insured plan, we’re going to feel the full brunt of the cost of our experience – and that’s a good thing – I far prefer that to purchasing [traditional] insurance,” he continued. “And although it’s difficult to be completely deterministic about the effect that the clinics have on our costs, I’m confident they’ve helped us slow the rise, if not reduce them.”
He then explained that their primary cost metric estimates they’re spending under $7,000 per employee per year in health care, which is a lot lower when compared to most other employers.
“From everything I’ve seen, that’s far less than almost every survey I look at – which has most of them running around $12k-$14k a year. Between the convenience, the quality of care, the level of connectivity between the providers and the patients, and the cost management aspects, it’s a win-win for us and our employees.”
PROVIDING PROPER CARE DURING THE PANDEMIC
The clinic also offers telehealth services, which have come into national focus during the COVID-19 pandemic.
“By performing virtual medicine from the clinic, we’re cutting costs and providing accessible care to the people that need it – we want to make sure we’re offering care during the pandemic,” she stated.
Despite its virtual success, Jason believes that Nordic PrivateCare’s on-site services aren’t going away anytime soon and that that there’s no real substitute for great in-person care.
“Traci is what makes the clinic so great,” he said. “She engages and does the outreach and shows that she personally cares for not just our employees but her employees. When we make that connection with our people it has a great impact.”
ROOM FOR IMPROVEMENT
Jason said that future plans for the clinic remain more or less the same, but added how they’re constantly monitoring their employees’ attitudes and the health policy landscape.
“There will continue to be changes in the health care environment, and I don’t necessarily think there are forces out there making it easier for employers, so as we continue to have new situations, new circumstances, and new laws, we’ve got to be on top of it by responding quickly and effectively to keep the clinic relevant and helpful to our people.”
Another goal for 2021 include increasing the clinic’s utilization by bringing more of their employees’ families into the clinic.
FIND A LEADER, START SMALL, AND FAIL FORWARD
When asked if she could offer advice to other employers thinking about starting an on-site clinic, Traci said to just jump in and do it – start small, and rest will follow.
“QualityPath is actually how it all started for us. Whether it was that or contracting for imaging or contracting with hospitals to do some of our smaller services, it was just starting small and expanding upon it.”
Jason’s advice for employers was simple: find someone like Traci.
“I think the biggest thing is to find a good person who you can have great confidence in to lead it. What impresses me most about Traci is that she’s always staying alert and learning, and as she learns, she’s finding ways for us to improve our offerings and how we deliver our services through our clinics.”
Jason also added that it might be difficult to make an on-site clinic work if you’re a small employer. He estimates that at least 120 employees are required to make it work, and if you’re smaller, going the shared-site clinic route might be more appropriate.
“Beyond that, I think it’s just about experimenting; don’t be afraid to try new things. If you learn that something’s not working, fail fast and move forward doing something different. That’s the most important thing: continue to experiment, and if you find something that’s working, do more of it.”
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