Unions Create Coalition to Deliver High-Quality Primary Care to 40,000 Members

Union members who work in the skilled trades put their bodies through the wringer, often leading to lower back pain, sore knees and hips, among other musculoskeletal ailments.

These same workers also frequently struggle with high blood pressure, high cholesterol, and obesity, yet often don’t seek out medical care, says Jim Coyne, Business Manager at Plumbers UA Local 130 in Chicago.

Society depends on these skilled workers to safeguard the nation’s infrastructure, but they can only perform their trades while in good health. In 2019, Coyne began searching for a solution to connect his members with affordable primary care while reducing healthcare costs.

“My guys often don’t even know they have high blood pressure or high cholesterol. They don’t know if they have a Vitamin D deficiency,” Coyne says. “I want my members and their families to have a good life, and to do that, you’ve got to be healthy.”

Coyne toured the country, visiting other unions to learn about innovative ways to improve healthcare access and quality. He ultimately decided to partner with Marathon Health to open a dedicated union wellness center for Local 130 members and their families. Within a few months, he came up with the idea to expand access to other unions in the region.

“I did this open house and invited these other crafts. We had long conversations, and two years later, we formed a coalition,” Coyne says.

Today, nine unions in the Chicagoland area and Northern Indiana make up the Marathon Health Union Wellness Centers coalition, which includes close to 40,000 members and eight wellness centers strategically placed close to where a majority of the members live.

Pictured above: The care team at Union Wellness Center in Warrenville, Illinois, takes pride in helping members improve their health. Left to right: Jay Chaudhari (Physical Therapist), Heather Schmitz (RN, Health Center Director), Roshni Patel (Medical Assistant), Nicole Corsetti (PRN RN), Dr. Maria Tuason (Physician)

Unions Improve Healthcare Access, Lower Costs

Union members and their families now enjoy exclusive access to primary care visits, physical therapy, medications, wellness programming, lab draws, immunizations and other services—all at no cost. “When a patient shows up, they don’t pay anything out of pocket. There’s no deductible,” says Dr. Trevor Pfaendtner, physician at UWC-Lemont. “We don’t charge for any services, and we don’t submit anything to Blue Cross or Medicare. It’s all self-contained.”

Members can pick up medications during the visit, also at no cost, eliminating a trip to the pharmacy and increasing medication compliance. “We have between 50 and 80 different medications onsite pretty much at all times,” Dr. Pfaendtner says. “We have antibiotics, blood pressure and cholesterol meds, anxiety meds, diabetes meds and many others.”

The Marathon Health model prioritizes making care more convenient by eliminating cost and travel barriers, while focusing on creating long-term patient-provider relationships and improving outcomes. Members can book same- and next-day appointments, rather than waiting an average of 26 days for a primary care appointment in the traditional health system. Members also only spend an average of four minutes from the time they walk into the Union Wellness Center to when they step into the exam room.

Each Union Wellness Center includes a minimum of five Marathon Health providers, including a physician, physical therapist, nurse and medical assistant. Some clinics have several additional providers, depending on the local member population. The providers work together as a team to address each member’s total health.

To give members time to address health concerns and build trust with their provider, physical exams are booked for 50 minutes, followed by a 25-minute follow-up visit. “It’s a nice and relaxed atmosphere and it lets me practice the way that I want to practice and develop those relationships,” Dr. Pfaendtner says.

Union Wellness Center Care Team Treats Common Conditions + More

Members and their families visit the Union Wellness Centers for all of their primary care needs, yet Dr. Pfaendtner says he frequently treats a couple of recurring issues. “We see high blood pressure over and over and over again. Every time we do our data analysis, the top diagnosis codes are always high blood pressure,” Dr. Pfaendtner says. “A lot of times, while the membership is very physically active while they’re working, getting formal exercise outside of their busy schedules can be difficult.”

If a screening reveals elevated blood pressure, Dr. Pfaendtner can provide medication during the appointment, again removing the need to visit an outside pharmacy. But he says the Marathon Health approach goes much further by addressing the root causes of the issue. He commonly provides nutritional counseling and works with members to create personalized exercise plans.

“We’re saving people’s lives,” Coyne says. “We had one guy whose blood pressure was 260 over 170. The doctor told us that’s basically the walking dead. But we got him some help and he’s here to live another day.”

Due to the nature of the union work, Dr. Pfaendtner says he commonly sees a lot of job-related sprains and injuries. To treat these conditions effectively, every Union Wellness Center employs a dedicated physical therapist on staff.

“Our physical therapists stay pretty busy and it’s nice we can just refer within the office,” Dr. Pfaendtner says. “If somebody comes to me for a physical and they say, ‘My back’s been bad for 30 years,’ I’ll say, ‘Go see our physical therapist or try these meds that we have on site.’ If it comes down to a referral outside of the office, we certainly have that capability.”

Word of Mouth, Patient Outreach Drives Union Member Engagement

Because the Union Wellness Centers are exclusively for members, union leadership and Marathon Health providers rely on nontraditional marketing to promote health services and encourage members to schedule a visit. “We do some patient outreach, but I would say across the board, our No. 1 thing is just good word of mouth,” Dr. Pfaendtner says.

Marathon Health providers routinely attend union events, join patio parties, host vaccine clinics and ultimately try to have a presence whenever possible. It helps the providers get in front of the members, promote their services and most importantly, build relationships.

“Working with these guys is more about building a relationship and addressing the problems that really need to be addressed,” Dr. Pfaendtner says. “If we can get somebody’s blood pressure under control, maybe that saves them a heart attack at age 50. So that’s really rewarding for me.”

Dr. Pfaendtner says his own upbringing and life experiences have made it easy for him to connect with the union members. “They’re a really fun group, just very down-to-earth people,” he says. “I grew up in a pretty middle-class upbringing and my brother’s a blue-collar guy, so it’s like hanging out with my brother all day. I’ve been training for this my whole life.”

The unions also incentivize members to engage with wellness center services, typically by lowering insurance premiums or offering HRA payments for members who get a lab draw and annual physical. “The biggest thing is giving them a good experience while they’re here, and again, building those relationships,” Dr. Pfaendtner says. “That helps with the preventative stuff, because if they trust you, then they’re more likely to say, ‘Okay, I’ll get the colonoscopy’ or ‘I’ll get the flu vaccine.’”

A combination of word-of-mouth referrals and positive member experiences continue to drive utilization. Coyne says total visits increased 56% from Q3 2022 to Q3 2023, while physical therapy appointments increased 62% over the same period. “When you offer free primary healthcare with no copay and no deductible, people are going to try it,” Coyne says.

Union Wellness Centers Improve Member Health

Despite being open for only a few years, Coyne and Dr. Pfaendtner say union members have made significant health improvements, from overcoming diabetes and hypertension to healing painful ailments and identifying cancer.

“We had a guy who slipped and fell and hurt his shoulder. He went to the ER because he wasn’t at work and they told him to see an orthopedist and all this other stuff,” Dr. Pfaendtner says. “He came to me, and I said, ‘You have a dislocated shoulder. Here’s some pain meds. Go see a physical therapist.’ He jumped right into physical therapy and was back to work in a few weeks, and it saved him a ton of money.”

Beyond improving health outcomes, member satisfaction with the Marathon Health benefit continues to increase. The Union Wellness Centers currently enjoy a near-perfect net promoter score of 99, which measures how likely a member is to recommend the wellness services to other members.

“It’s pretty amazing what we’ve accomplished and having a well-known partner like Marathon Health is going to make it that much of a better narrative in the future,” Coyne says. “I’m overwhelmed with joy at what we accomplished here.”