“There is a lot of excitement about the clinic because it will be very convenient,”
October 02, 2016 8:00 a.m. Updated 2 days ago
By Jay Greene
United Shore Financial Services is the first large company in Southeast Michigan to sign a contract with a direct primary care provider to bring a doctor’s office right into the workplace.
Salta Direct Primary Care will house medical staff in a 1,300-square-foot clinic at the company’s Troy headquarters. The mortgage wholesaler is believed to be the first company to create such an arrangement.
Under the three-year contract, United Shore will pay Salta $70 per employee per month for however many of United’s 1,800 employees visit the clinic, which United Shore paid $200,000 to build.
Salta will provide a range of primary care, preventive and chronic care services to employees. Employees will contribute a $10 co-pay each time they see Salta’s physician or physician assistant.
“This is our first contract. We have a bunch of companies lined up to work with us in the future,” said John Blanchard, M.D., CEO of Salta and Premier Private Physicians Management LLC, which operates physician offices in Troy and Clarkston. “There has been tremendous interest in the business community with what we are doing since we launched 18 months ago.”
Blanchard said the contract with United Shore can save the company up to 20 percent on its health care bills, depending on how many employees use the on-site clinic. United Shore officials project return on investment of 30 percent over the next several years.
But Laura Lawson, United Shore’s chief people officer, said reducing health care costs wasn’t the primary motivation to add direct primary care to the company’s employee health benefit plan.
The company had been considering working with Salta for some time, she said.
“We do a lot of oddball things that may seem strange for others, but (are) good for us,” said Lawson, adding: “We are a people company, and last year, especially, we had tremendous growth. We added wellness, a weight loss program and a gym (at the corporate headquarters). We talked with companies who did this. It was a no-brainer to go with Dr. Blanchard.”
Of United Shore’s 1,800 employees, 80 percent participate in its health insurance program and a vast majority already have a primary care physician, said Brad Pettiford, the company’s communication strategist.
“Team members are encouraged to visit a primary care physician and, with our (benefit plan), we actually reward them for seeing their primary care physician,” said Pettiford, adding: “We’re hopeful the partnership with Salta will make it even more convenient to see one.”
Direct primary care model grows in state
Salta is one of several direct primary care physician companies in Southeast Michigan with more than 100 physicians in Michigan participating in similar models of care.
Under direct primary care, physicians have an alternative to fee-for-service insurance billing by charging patients or companies a set fee per month for a range of primary care-type services.
Physicians also typically give patients longer visits and allow them to contact them through emails or phone calls in off hours. Patients usually also have health insurance for non-covered services.
Blanchard predicted that Salta projects will grow to 40 clinic offices and more than 160 physicians over the next 10 years in Southeast Michigan. The model primarily is directed at company contracts, although Blanchard said his office accepts single memberships for $209 per month.
Last year, Forthright Health Management LLC, headed by Tom Valenti, began operations in Southeast Michigan with 59 primary care physicians in 15 practice locations. The network offers a hybrid direct primary care medicine program in which patients are guaranteed more time and access to their doctors than typical office visits.
Another DPC practitioner is Plum Health DPC, an office managed by Paul Thomas, M.D., a private practice doctor who graduated from Wayne State University School of Medicine in 2013.
Blanchard said the critical eyes of direct primary care physicians can help drive down health care costs.
“The majority of the cost drivers all happen outside of the primary care office — unnecessary ER and urgent care visits, hospitalizations, high cost diagnostic testing,” he said. “We can affect all those high cost things through preventative diagnosis and enhanced care.”
Salta’s primary care model gives patients additional time with their doctor and encourages email and phone conversations after weekday hours and on weekends. Appointments can be scheduled online through a secure web portal.
If a referral is required to a specialty physician or diagnostic test not offered at the company clinic, United Shore’s health insurance plan would cover those costs after deductibles and copayments.
Hospital and emergency department care, prescription drugs and other services also would be covered by the employee’s health plan.
Covered preventive services include acute, urgent care, disease management, wellness coaching, population health and patient education.
United Shore’s clinic to open in October
United Shore’s first-floor clinic will fully open Oct. 10 with some services offered starting Oct. 3. Staffing United’s clinic will be physician Paul Steffan and physician assistant Julia Zimmerman, two experienced providers. Others would be added later based on demand, Blanchard said.
Lawson said United Shore expects the program with Salta to be cost neutral the first year. She said 30 percent to 50 percent of employees are expected to use the service the first couple of years.
“If all 1,800 employees use the clinic, (the providers) will stay pretty busy,” Blanchard said. “The average doctor sees about 20 to 30 patients each day. Our providers see eight to 10 because of the extended time they spend.”
Blanchard said the clinic can draw blood for lab tests, but samples would be sent to a reference laboratory, which would then bill United Shore’s insurer, Blue Cross Blue Shield of Michigan.
Lawson said she hopes all United’s employees use the clinic as their primary care office when they are sick or need routine tests or shots.
However, at least in the beginning, employees’ spouses and children will not be covered at the clinic.
“They don’t qualify at this time. We want to focus on our 1,800 team members, at least for the first year. We will see after that,” Lawson said.
For United Shore, health care costs have been relatively flat the past four years under Blue Cross, Lawson said. In 2013 and 2014, United Shore used a Blue Cross fully insured plan and its rates increased only 1 percent each year.
In 2015, the company switched to a self-insured plan with the Blues, and its rates were flat.
“We’re still getting a feel for what our annual claims are — it typically takes three years to see trends in self-insured plans,” said Pettiford. “(We) haven’t seen rate increases of 7 percent or 8 percent (as other companies) because we have a relatively young workforce (56 percent under age 35).”
Because health care costs have been relatively flat, Lawson said, United Shore hasn’t had to increase health benefit cost sharing to employees the past three years.
“There is a lot of excitement about the clinic because it will be very convenient,” she said.
Founded in 1986, United Shore is one of the largest independent mortgage lenders in U.S. It includes United Wholesale Mortgage, one of the largest wholesale lenders in the nation.