TAMPA — If any employer would know how to manage its own workers' health care expenses, you might think it would be a hospital.
But at a time when costs are soaring so high that many employers are cutting or even eliminating coverage, even health experts need help.
That's the case at Moffitt Cancer Center, which three years ago hired Tampa consulting firm MedVision to look at how its 3,100 employees were using their health benefits.
Today, the most visible result of that analysis is a new clinic where workers can get basic care. MedVision discovered that many employees were putting off going to the doctor because they didn't want to take so much time away from work. As a result, simple ailments sometimes became costlier problems.
The clinic "is here, it's free, it's accessible. The easier we can make it for employees to access primary care, the better," says Michele Talka, director of compensation benefits at Moffitt.
Talka said that and other changes recommended by MedVision have controlled costs enough that Moffitt could limit employee premium increases this year. That despite the fact that it has hired some older workers with pricier health issues.
Last week, MedVision invited local employers to the Tampa Club downtown to hear about its services, and 43 people sat in rapt attention.
Among them were Margaret McGarrity of the Sarasota County Sheriff's Office, which is considering breaking away from the county health plan and putting its 976 employees in a self-insured group.
"We're just in the exploration phase, but we're looking at all our options," McGarrity said.
Little wonder. At a time when politicians are struggling with health reform and clearly nervous about Medicare cuts, employers are having to find their own ways to contain costs. And their workers can testify that for all the political uproar, managed care already is a fact of life.
The cost of employer-sponsored health care is up 5 percent this year, according to the Kaiser Family Foundation. Workers paid an average of just over $3,500 for family coverage this year, while employers contributed more than $9,800 per worker. At this rate, the cost to employers will rise to more than $28,000 per worker in a decade, according to the Business Roundtable.
Enter the health care consultant industry, which promises savings — or at least better controlled increases — by analyzing spending patterns.
At the Tampa Club presentation, Biologics, which specializes in the cost of cancer care, said it saved one client $19,000 when it discovered a patient was billed for a higher dose of medication than she actually received. In another case, switching a colon cancer patient from a brand-name drug to a similar generic drug netted a savings of more than $15,000.
MedVision works exclusively with self-funded employer groups such as Moffitt, Manatee County schools and Sarasota County government. MedVision president Dan Ross, who started the company in 2005, has more than 20 years in the employee health industry, 17 of them spent at Cigna.
The single biggest way to control costs, he said, is spending more on wellness.
"Our goal is to prevent people from getting sick and to keep people from getting worse," he said.
In Florida, he said, the biggest costs MedVision sees surround cancer care.
"In (employee) groups where a lot of women are over age 40, breast cancer is costly," he said. "We look at what percentage of women are getting mammograms and we can almost always improve those numbers" of women getting regular screenings to catch tumors early.
Research shows that many patients with chronic illnesses such as diabetes, high blood pressure and arthritis often don't take their medication as prescribed. They may stop it if they start to feel better or the side effects become intolerable. That can lead to serious, even life-threatening complications.
So MedVision might recommend bringing in nurses to coach those patients on the need to stick with their treatment. In other cases, data analysis might reveal high use of expensive brand-name drugs for which there are generic substitutes.
Moffitt, for instance, no longer pays for pricey acid reflux reliever Nexium, only covering the generic version. Other than insisting on generics, Moffitt has not eliminated treatments from its coverage, she said.
Talka notes that using MedVision's services enables Moffitt to make these changes while preserving patient confidentiality.
"We don't care who has diabetes. We just want to know how many cases we have,'' she said.
"If someone hasn't filled their blood pressure prescription in six months," Talka said, "then disease management nurses will reach out to them to discuss what's going on."
But reaching out is all they can do. Employee participation is strictly voluntary, she said.
"We can't make people get medical care."
Contact Irene Maher at email@example.com or (813) 226-3416.