Skip to main content

Bellin Health: Costs Down, Market Share Up

News  |  By Jim Molpus  
   September 22, 2016

To manage the health of a customer group with incentives that align for the system and customer today, the Wisconsin health system has been aggressively marketing a broad-based portfolio of health services to area employers.

This article includes exclusive excerpts from HealthLeaders Media's FirstLook broadcast "Bellin Health: Build Your Direct-to-Employer Business," a behind-the-scenes video case study that will be broadcast Oct. 20.

The most effective play in football history may be the Green Bay Packers' "power sweep," Vince Lombardi's simple running play that relied on guts and repeated execution instead of misdirection.

Bellin Health, a 167-bed community health system a few miles from Wisconsin's Lambeau Field, has a health strategy power sweep of its own: Go directly to the employers.

"We are not waiting for payers to come to us, and not waiting for some literal act of Congress to change the payment system, but instead we are going out and working hard on managing the health of populations," says Bellin Health CEO George Kerwin.

Even now, the industry's drive to population health has a strategic hole in it; how to better manage the health of a customer group with incentives that align for the system and customer right now, and not at some aspirational future date.

Bellin's answer has been to aggressively market a broad-based portfolio of health services to area employers from small to large.

The evolution started with its own employees, where over a decade Bellin has been able to bend its own health spend by more than $25 million, including a 1% cost premium cut last year.

Bellin's board members, many of whom run area companies, took notice and asked for the same services, which include plan design, wellness incentives, health coaching, and a variety of access points, including on-site clinics.

The strategy also hurdled another population health obstacle: losing volume.

Done properly, a health system should see a decline in inpatient and acute volume, which usually correlates to lost market share. But by partnering with area employers, Bellin has been able to balance the volume shift while also growing market share.

Market and Revenue Growth
Bellin's overall market growth has been at 4%. Annual revenue growth from employer partnerships is posting gains of more than 10% in recent years, while also improving the payer mix, says Randy Van Straten, Vice President, Business and Community Health. From a base of zero, Bellin now has more than 2,500 employer relationships for services, 125 with direct onsite services and 20 as high-level strategic partners.

Bellin had, and sold, its own health plan a decade ago, but now is able to work directly with employers to customize a health plan carve-out, Van Straten says.

"Basically what employers are buying are service levels configured to their needs," Van Straten says. "So it may be health risk appraisals, or health and wellness programs. We are now building compete on-site primary care clinics right on site at the employer to not only manage their prevention but to manage their chronic conditions and acute care services."

Bellin isn't reliant on any one tool to improve access.

  • A manufacturer with a blue collar workforce can offer on-site occupational therapy before the first shift.
  • At a school district, a physician's assistant may be available before and after classes.
  • A service company with many locations can provide virtual consults and centrally located fast care clinics.

"Especially when you are working with a population that has set hours, if they can't get off work to go see you, they are not going to get healthcare," says Brad Wozney, MD, medical director, Bellin Health. "So you need to make sure they can access care any time they need it."

The overall goal is to cut premium increases for each customer by half the national average, which in many cases Bellin has been able to match and exceed, Van Straten says, because Bellin is able to influence care before it gets to the hospital.

"It's about the navigation platform to get people at the right care at the right time at the right price," Van Straten says. "Really, it is about removing barriers of care to make it easy for employees and family members to get the care when they need it."

Valarie Wunderlich, director of benefits and compensation for 700-employee Northeast Wisconsin Technical College, says her school had three goals when it put out its health plan for RFP five years ago:

  • "One was cost containment. We had to see how our plan design was affecting our overall health costs,"
  • "Second was we wanted to build an overall culture of health and wellness."
  • "Our third pillar was education. Bellin has really helped us to educate our employees on receiving the right level of care at the right time."

To meet the goals, Bellin placed an on-site "Campus Care," clinic with a physician's assistant who handles preventative and acute care. NWTC had a high spend on musculoskeletal issues, so an on-site physical therapist was added. An on- site personal trainer works with employees and managers to build wellness into the daily routine, Wunderlich says.

Premium Cost is Key
On site, [a] PA looks at preventive as well as acute care. We also have physical therapy. Musculoskeletal is a high claim area for us so we wanted PT to bring down those costs. We also brought in a personal trainer to look at it from a preventive standpoint."

Through the program, NWTC has seen increases in important wellness metrics, including 40% participation in reasonable alternative standards compared to a national average in the single digits, she says.

Of course, the primary metric is premium cost.

"Our health plan has seen a total increase in premium of 5.9% in six years with some plan design changes which is significantly beating trend of 6.5%/year," Wunderlich says. "We attribute these savings due to on-site services, increase in overall health of our population and plan design that encourages consumer behaviors."

Kerwin says Bellin's team embraces results like NWTC's, even if it may mean fewer dollars coming into the hospital side.

"If this is really effective, you are going to drive down volume in the emergency room. You are going to drive down illness, and surgeries, and all the other acute things that are profitable in our industry," Kerwin says.

"We understand that. We know that it is happening. We feel it is our responsibility to adjust accordingly."

Pages

Jim Molpus is the director of the HealthLeaders Exchange.

Tagged Under:


Get the latest on healthcare leadership in your inbox.