Self-Funded Employers

(cjs56) #1

Jed Constantz webinar on self-funded employers located on family medicine education Consortium is pretty good. Look under Projects and then under Webinars.

Mr. Jed Constantz presents:
The Business Case for Family Medicine and Primary Care

(Robin Dickinson) #2

What exactly is a “self funded employer”?

(cjs56) #3

I believe this is the same as a “self-funded insurer.”

The company insures their own emplyees through a risk fund.

On the Family Medicine Education Consortium, look under News and Resources and then videos, webinars and podcasts. There you will find

“Engaging Employers to grow your practice” as well as a couple of other educational items.

Most is common sense but you can always learn something.

Advice is given to join the Business Coalition on Health (in your respective community) as well as the so-called “City Club” , Service Club, etc.

Reference is made as to make sure the employer is aligned with the physician’s goals as the physician is looking for a long term relationship.

I believe the video said…3 year comittement between physician and employer.

If there is a high employee turnover, that is a warning sign that it would be more difficlt for a DPC physician to work with that employer…since…

health measures are advised to be done by the physician…that the employees have their diabetes under control, did not have to go to the E.R. or Urgent care, did not miss as many days from work…all the basic common sense things.

It is harder to track health improvement data if there is much employee turnover.

DPC physician is looking to go back to the employer after a year or two and say…look…

I saved you money doing this…I saved you money doing that…

and the employees’ health improved because of this.

These are things that I have seen in the East…I believe Mr. Constantz had worked in Upstate N.Y. as well as Blue Cross of Massachusetts.

I am not so sure these things would fly in California since the market is so entrenched with insurance giants.

But, it could if there were smaller businesses.

Hope that is clearer.

(cjs56) #4

Thanks. Keep searching those videos and webinars on You Tube.

(Dochost) #5

Basically, the company funds its insurance plan totally. (instead of contracting with, say, Aetna.) They pay a lower rate if they don’t use it as much (ie, healthier employees, less use of urgent care/ER for non emergencies); they can buy stop loss/gap coverage if someone gets a catastrophic diagnosis so they won’t be on the hook for a million dollars. They can start a self funded plan any time. They can partner with other insurance companies to run it as well.

If you are partnering with a company, you do want to ask about employee turnover. One, it will be a paperwork tsunami if you have to keep adding and deleting people. And two, as it was noted above, you aren’t going to see any savings if you can’t have continuity with your doctor.

DPC pairs well with this type of plan, as you are all in the same boat–you want to have great care at a reasonable cost!

I must say, I just signed up with a company who is headquartered in WI but has a plant in Ohio near me. They TOTALLY get DPC and are all in. It is very refreshing and gives me hope for the future!