Employer Health Benefits, Worksite Clinic

Self-Funded Employers: Our Urgent Need for Novel Approaches to Novel Times

We continue to experience an ongoing sense that things are headed off-the-rails. Pressure continues to build. What’s going to happen with our economy, with the pandemic, with the election, with the social unrest? Who knows. What we do know is that all of the above will retain a sense of uncertainty for the foreseeable future.

Though uncertain, business leaders do have a sense for our direction. Costs will rise. Absenteeism will rise. Pressure will increase. The urge to lockdown, stay put, and contract will only become stronger. All of which stems from fear. Many of us will live in this place in very real ways. Most will also try to maintain status quo as they navigate it but that will only result in contraction. There is uncertainty, yes, but we can still see the thematic direction clearly and it is not encouraging.

The Novel Coronavirus has created an urgent need for novel ideas and approaches.  Innovation is critical. Clearly, there is need for smart thinking on back-to-work strategies, employee safety, and broader risk mitigation efforts. However, in the fight to manage the urgent issues around COVID-19, we can’t lose sight of the very big, very expensive issues surrounding the total health of our employees.

Hiding in the Shadow of COVID

In the shadow of COVID-19, chronic health conditions still wreak havoc on the people with whom we work and medical costs continue to rise. COVID-19 will only accelerate both. We can no longer wait. We can’t keep hoping for the same old approaches to make a difference. The pace and scope of costs will only increase from here. 

What are we waiting for? Look around you. Who is showing up to help? Where is the work? The effort? The push? Where is the sense of urgency? What’s the plan? For those advising you, what new strategies are they advocating to help mitigate the risk of COVID-19 as well as the tsunami of pent-up medical demand sitting on the horizon? It would seem that “wait and see” is no longer a viable option.

For self-funded employers sponsoring onsite or nearsite clinics there can be no tolerance for me-too, wait and see, or “shrug” strategies when dealing with COVID-19 or the ongoing health needs of employees. You’ve got to have partners stepping up with solutions to the immediate health challenges as well as the equally urgent, and expensive, downstream impact points. Your investment in a clinic gives you a unique weapon in this ongoing war. Are you leveraging it properly?

The 4th Wave

COVID-19 is accelerating our evolution into the 4th Wave of employer sponsored health clinics. Key solution expectations should include:

  • Consultative approach to overall health spend – including overall pharmaceutical costs. Bring serious expertise and help us solve serious problems.
  • Comprehensive telemedicine options. Telehealth is now a permanent and necessary fixture in any comprehensive health solution.
  • Direct contracting whenever possible. Your partners should be guiding you toward the direct acquisition of products and services. Bundling for episodes of care, narrow networks, and wholesale pharmacy benefits are a good place to start.
  • Broad population health. Chronic care, behavioral health, weight and lifestyle medicine. What are you doing to improve access and remove barriers? Critical to this approach is actionable data, clarity, and transparency.
  • Comprehensive pharmacy solutions. At work, at home, and specialty. Fresh approaches exist if you’re willing to listen. 
  • The clinic should be moving toward a “nexus of care” model in which it plays trusted quarterback for the health of your employees. This includes close coordination with other care points, particularly pharmacy and specialists.
  • Targeted solutions for unique challenges. Mobile workforces, WFH (work from home) strategies, dispersed workforces with different points of healthcare access just to name a few.

Our world is going to dramatically contract this fall as schools open, Americans continue to push to get back to work, the election cycle intensifies, COVID cases rise, and the normal challenges of operating our enterprises: finding & keeping customers, managing expenses, dealing with compliance, etc. increase pressure on all aspects of our organizations. Smart leaders will hit the challenges head-on with new ideas, nimble approaches, and an embrace of innovation. Government programs will not be enough and no amount of cutting will offset our desperate need for change.

Looking Beyond the Obvious

For those of us living in the world of self-funded employer health, we must look beyond the known and obvious to something truly novel if we are going to effectively navigate the rapids ahead. If you’re not talking to them now, find the innovators. If you’re not reviewing proposals for new approaches, do it now. If you’re looking at vendors offering the same ideas for novel times, change-it-up right now and find strategic partners bringing fresh approaches. If you don’t know where to find them, let me know. This is your strategic imperative.

Then, you need to listen. If you don’t, the months ahead will hold more and more uncertainty and you will continue to fight a defensive battle rather than seizing the offensive initiative. The fever pitch of our current environment is going to intensify and your ability to move through it successfully will require something new. Good intentions aren’t enough. Deliberate, effective, and persistent action while executing on new ideas will be critical.

Do you have the will and vision your organization needs for the times ahead? We’ll soon find out.

Schedule a free claims analysis now.

Let’s Talk now


Betsy Bigler | Mar 7th, 2024
INDIANAPOLIS, March 7, 2024 – Northwind has announced the addition of Tony Purkey as Senior Vice President, Client Strategies. “Demand from our self-funded employer and union clients is driving rapid growth,” said Phillip Berry, CEO. “Tony Purkey joins Northwind at a time when we need high-integrity leaders with expert knowledge in employer-sponsored health and the … more »

continue reading

Voices Lost in the Noise

Phillip Berry | Jan 31st, 2024
In the health benefits world, the mad scramble toward January renewals/starts has subsided and attention has turned to the annual cycle of review necessary to gauge progress. How did we do? The plan review process generally centers on analytics to gauge progress or regress and to identify “areas of opportunity.” Good. The right data with … more »

continue reading