SelectCare by Mercy offers a new health care delivery model to help private sector employers meet the challenge of rising healthcare costs while providing high-quality coverage to their employees.
SelectCare by Mercy is an innovative, cost-saving model of health care delivery. It was announced Dec. 14 at LCCC’s Spitzer Conference Center.
“When it comes to health care coverage, employers across the country are entering a new and challenging era,” said Edwin Oley, president and CEO of Mercy. “Beginning in 2014, the Patient Protection and Affordable Care Act mandates sweeping changes to the benefit plans of many organizations. Despite concerns about cost and quality, research shows that most employers remain committed to providing their workforces with health care coverage.”
SelectCare by Mercy offers employers with 25 or more employees the opportunity to purchase employee health benefits directly from Mercy, allowing them to provide the highest quality care at the lowest possible cost. The self-funded program encourages a strategic, sustainable approach to health care that utilizes fully integrated clinics, wellness programs, disease management and education to combat down rising costs.
“SelectCare by Mercy is an innovative health program designed to reduce employer costs while also improving employee wellness”, said Oley. “The program furthers Mercy’s mission by making it possible for employers to provide comprehensive, high-quality health coverage, both in today’s challenging environment and into the future.”
A New Paradigm
Janis Yergan, vice president of strategy and business development for Mercy, provided an overview of the new model. The innovative model shows how Lorain County employers can reduce healthcare costs while improving employee wellness.
“This is an opportunity to step out of an old paradigm and into a new paradigm,” said Yergan.
She was joined by John Torinus, Jr., former CEO of Serigraph, Inc., and author of The Company That Solved Health Care. “Health care costs are the number one cause of bankruptcy in this country,” said Torinus. “A payee revolution is going on in the private sector to control healthcare costs in America. The medical care we receive is excellent. But the economic side constitutes enormous chaos.”
Through SelectCare by Mercy, all covered participants engage in comprehensive primary care and have access to advocates who can help them navigate the healthcare system. To ensure a full continuum of care, Mercy has joined with University Hospitals, a nationally recognized academic medical center, to provide world-class services ranging from primary care to advanced medical diagnosis and treatment.
University Hospitals Connection
The SelectCare by Mercy network consists of over 1,800 providers, including providers from Mercy and University Hospitals, to provide a comprehensive, clinically aligned and patient-focused network.
The partnership with University Hospital exemplifies the collaborative approach to providing accessible, high-quality care. In November, Mercy and University Hospitals Seidman Cancer Center announced a partnership that provides Lorain County residents with close-to-home access to some of the most advanced cancer treatments and clinical trials available.
SelectCare can control costs by emphasizing preventive care and patient compliance. The program motivates employees to actively manage their own health through health-risk assessments, follow-up care, wellness programs and open access to primary care, medications, laboratory and other services through employer-sponsored wellness centers. As workforce health improves, both employers and employees become eligible for further plan incentives and discounts.
SelectCare also provides tools to help employers manage plan costs and project spending into the future. The cost of reinsurance becomes more manageable and predictable as workplace wellness initiatives are implemented. Employers with 50 or more employees may be eligible for a multi-year cost-savings guarantee — the only guarantee of its kind in the state of Ohio.
Attacking Health Care Costs
SelectCare attacks the root causes of escalating healthcare costs. Employers have the opportunity to significantly reduce waste and overspending through multi-year discounts and aggressive claims management. By motivating employees to actively manage their own health, SelectCare helps to reduce the impact of chronic conditions such as heart disease and diabetes, which currently account for 75 percent of all health care spending.
Torinus described how he was able to reduce health care cost increases at Serigraph to less than 2 percent while improving the quality of his employees’ health coverage. His highly successful approach emphasized primary care, consumer responsibility and centers of value — proven approaches that also form the foundation of SelectCare by Mercy.
“This will provide enormous benefits for business and individuals in our community,” said Oley. “We provide excellence in medical care, but patients must also have access to these medical services.”
“This is grassroots, ground up, pragmatic,” said Torinus, whose personal hip replacement cost less than half compared to traditional insurance. He called the plan a three-pronged approach to create a marketplace that controls costs, serves patient needs, and provides value. It is consumer driven health care hallmarked by proactive primary care and the creation of wellness centers of value.