Determining the best employee healthcare vendor and partner can be a difficult decision. Two employer healthcare experts weigh in on advice and questions to ask to make your decision easier.
More than 156 million Americans get health care through their employer, which means employers have the leverage and scale to bend the curve on our broken system. And employer health vendors like Marathon Health have the playbook to help them do it.
Providing easy access to an advanced primary care team is a proven way to improve employee health and decrease costs. As more employers opt into this model, the expectations are high for the employer health companies to actually deliver.
So, how should an employer decide what’s important to them and who to partner with to achieve it? We asked long-time employer health experts Kristin Vargo and Stephanie Eckerle to weigh in on choosing the best employee healthcare vendor.
1. Write down your expectations from an employee healthcare vendor
Create a cross-functional committee to align on a vision, set common goals, prioritize those goals and figure out the investment you want to make. “This isn’t just an HR benefit,” says Vargo. “This one requires collaboration from across the organization, including HR, Finance, Legal and front-line leaders. Everyone really does have to buy into the vision and when that happens, it’s pretty special.”
2. Ask the vendor about their recruiting strategy
The most important – and most valuable – relationship will be with the care teams who treat your employees. Similar to a mentor-mentee relationship, there’s got to be a good culture fit with your population. Some great questions to ask:
a. What’s the retention rate among all clinical employees and especially the providers? If turnover is high, your employees aren’t going to have a great experience, nor will they receive continuity of care which is a critical ingredient to why this model works.
b. How does the vendor take care of its people? Do they invest in training and leadership development? What are their employee satisfaction scores? Have they won any awards? For the fifth year in a row, we’ve built a culture where our employees, who we call ambassadors, can be successful. We feel strongly that if we take great care of our people, they’ll take great care of our patients.
c. Does the vendor have an MD or provider-led model? Philosophy of care and overall cost are two considerations to what’s best for your population.
d. Does the clinical staff operate as a patient centered medical home or are they more focused on urgent care? PCMH is what you’re looking for – that means the care team feels ownership and responsibility for their patients and will be proactive in building relationships and driving engagement.
e. How will the care team interact with your population? For example, will they walk the shop floor? Circulate in the break room? One of our favorite comments we hear in patient surveys is, “I can’t tell if Dr. Smith works for us or Marathon Health.” Yes!
3. Vet the employee healthcare vendors
There are a handful of employer health companies with 15+ years providing this solution, but not all are created equal. Throw in the local health systems that may provide something similar and the list gets even longer. This is a long-term play and not a quick win – more like a marriage than dating, so you really want to find someone that you’ll enjoy working with for years to come.
Face it, there are going to be bumps in the road no matter who you select, so pick someone that you trust to work with collaboratively. “Kinda like hiring someone for your team – there’s no perfect candidate. But if you start with someone you just love being around, you’ll get through the hard times better,” Vargo promises. Oh, and you should specifically ask about this stuff:
a. Cybersecurity – what’s their process to keep your employees’ information safe? What does their team look like? Have they passed security audits? Do they have certifications from third parties?
b. Litigation history – has the vendor or any of its providers ever been sued for negligence or malpractice? Any other legal issues on their resume?
c. Clinical licensing – what’s their practice for ensuring updated licensing for all of their credentialed staff?
d. Ask for a form contract upfront and read it. Seriously, we know it’s dense, but spending time with this content upfront will highlight the areas to dig into.
e. Ask for SOW upfront – see rationale from the previous tip.
4. Do an RFP
Big public companies and municipalities are usually required to go through long and complex procurement processes which is totally understandable. Even if you don’t have to jump through all those hoops, it’s still a good idea to document your requirements upfront and ask the vendor to detail out their capabilities. This can be done in writing or through conversation, but having the outline in advance will ensure you get your questions answered.
5. Read the fine print
Most employee health vendors request a three-year contract. It truly does take time to build awareness and engagement among employees and see the behavior changes necessary to drive better outcomes and savings. Again, this is a marriage, not a date. So, don’t be scared by the three years. But do ask about auto-renewals.
a. Can we terminate the contract? When and under what conditions?
b. What are the dispute resolution clauses?
c. What costs does the employer assume and what is covered by the vendor?
6. Ask for the guarantee
Performance guarantees are a huge part of value-based care, but be specific when it comes to definitions and metrics. This is especially true if you’re transitioning from one employee healthcare vendor to another because a lot of them measure things differently. For example, some calculate patient engagement based on hours used in the clinic divided by hours available. That’s a great signal of capacity and overall usage, but it doesn’t equate to engagement.
Marathon Health loves to offer performance guarantees and divides them into the four categories below. But keep in mind, not all of these are 100% dependent on the vendor – it’s critical that the employer is bought into the vision and demonstrates that commitment internally through communications, walkarounds and leaders sharing their experience with the health center.
a. Patient Experience
b. Care Team Experience
c. Health Outcomes
d. Financial Savings
Download our Performance Guarantee Guide!
7. Show me the data
The ability to see how the health center is performing and how your employees are engaging over time is critical. During the vendor evaluation process, ask to see sample reports and find out how often this detail will be shared. The best practice is monthly, quarterly and annual reviews. Few other things to touch on:
a. Employers should expect to own their data – ask the vendor’s perspective on this.
b. What is the full list of data you will get? Make sure it’s de-identified. This is huge to stay in compliance with HIPAA.
c. What is the full list of data that the vendor will require of you? This typically comes over in the form of an eligibility file and includes information like name, email, address, mobile number and social security number.
d. Can the vendor integrate its data with other health vendors you may be using?
e. How does the data get transferred? Stating the obvious, but you do not want to deal with a data breach so make sure the vendor’s processes are precise.
8. Get clarity on medical records
Lots of considerations, but here are the big ones:
a. Who owns the medical records? For primary care, the patient can have access at any time so make sure that’s available.
b. The provider has an obligation to maintain the records.
c. If there is a provider transition for any reason, you have to notify the patient in writing. Does the vendor have a clear process established for this?
d. Some employee healthcare vendors have their own records retention requirements – ask about this upfront.
e. Who governs the EMR?
f. How is patient data shared with Health Information Exchanges (HIEs)? This is really valuable data in the event the patient needs to be seen by a specialist, visits the ER, or has an in-patient admission. Proper HIE integration ensures that the employer health center provider will get quick updates on this activity and can step into QB the care continuum appropriately. This visibility is also a great way to reduce gaps in care.
9. Understand health center design responsibilities
Employers cover the build-out cost for an onsite health center but the vendor can and should provide expertise on overall design considerations to ensure medical standards and patient privacy. Marathon Health is the only vendor in the country to offer shared Network locations in popular shopping centers – those build-out costs are covered entirely by Marathon Health, another reason why this solution has become so popular to employers over the last five years.
Some special considerations depending on your employee population:
a. If the center is going to offer mental health, substance abuse and/or EAP services, you might consider a separate entrance or waiting room so employees seeking this care feel comfortable.
b. If you’re going to do Occupational Health at the health center there are very strict requirements – like water shutoffs in the bathroom – to keep in mind.
c. Who will have access to the onsite health center? “This is one that requires really clear boundaries,” says Eckerle. The employer has no access rights during patient hours. “Of course the CEO and other leaders will want to see the health center in action, but be mindful of how your presence may be construed by the patients seeking care. Confidentiality is important and while having the leaders use the health center will go a long way in driving overall engagement, they shouldn’t be lurking or hanging out all the time,” she explains.
10. Ask for referrals from the employee healthcare vendor
But don’t just get the names of current clients that love them. Ask for one or two who left and find out why.
Within the next five years, every employer will offer a solution like this. The sooner you start, the sooner you can add another rich benefit for your employees and reap the reward of increased health and lower costs.
We’d love to talk to you, so reach out at any time!
Learn more about Kristin and Stephanie
Kristin Vargo is the Regional Vice President of Business Development at Marathon Health and the loudest cheerleader at her daughters’ softball games. She’s spent the last 20 years helping employers navigate health care, both on the benefits consultant side and the employer health vendor side. Follow Kristin on LinkedIn
Stephanie Eckerle is a Partner at Krieg DeVault where she specializes in onsite employer health care clinics. She also serves as a Director for the National Association of Worksite Health Centers (NAWHC). In her free time, she’s taking her daughters to hockey and tennis lessons and running the school newspaper. Follow Stephanie on LinkedIn