Physician-Employer Engagement: “Direct-to-Employer” Arrangements

Physician-Employer Engagement has become a popular method for physicians to provide healthcare services to employees of companies. This approach is often referred to as “Direct-to-Employer” arrangements.

Physician-Employer Engagement: “Direct-to-Employer” Arrangements

Introduction

Physician-Employer Engagement, also known as “Direct-to-Employer” arrangements, has become a popular method for physicians to provide healthcare services to employees of companies. This approach allows physicians to work directly with employers to provide healthcare services to employees, rather than through traditional insurance reimbursement models. In this blog post, we will discuss the benefits of Direct-to-Employer arrangements and what to consider before entering into such a contract.

Benefits of Direct-to-Employer Arrangements

One of the main benefits of Direct-to-Employer arrangements is the ability to offer more personalized and accessible healthcare services to employees. These arrangements often include on-site clinics, telemedicine services, and wellness programs that can be tailored to the specific needs of the company’s workforce. This can lead to increased productivity, reduced absenteeism, and improved employee satisfaction.

Another benefit of Direct-to-Employer arrangements is the potential for cost savings. By working directly with employers, physicians can negotiate pricing and services that are tailored to the needs of the company. This can lead to lower healthcare costs for both the employer and the employee.

Considerations Before Entering into a Direct-to-Employer Arrangement

Before entering into a Direct-to-Employer arrangement, it is important to consider several factors. First, it is important to understand the legal requirements and regulations related to providing healthcare services directly to employers. This includes understanding state and federal laws related to licensure, insurance, and privacy.

Financial considerations are also important to keep in mind. Physicians should understand the costs associated with setting up and maintaining an on-site clinic or telemedicine service, as well as the potential revenue streams and payment models.

Finally, operational logistics should be carefully considered. Physicians should ensure that they have the necessary staffing, equipment, and technology to provide high-quality healthcare services to employees. They should also consider how they will communicate with the company’s human resources department and how they will manage patient records and data.

Conclusion

Physician-Employer Engagement, or Direct-to-Employer arrangements, offer several benefits to both physicians and employers. By providing personalized and accessible healthcare services to employees, physicians can help improve productivity, reduce absenteeism, and increase employee satisfaction. However, it is important to carefully consider the legal, financial, and operational logistics before entering into such a contract. By doing so, physicians can ensure that they are providing high-quality healthcare services while also maintaining a profitable practice.

If you are interested in learning more about this type of engagement, check out this checklist provided by the American Medical Association. The checklist covers important aspects such as legal requirements, financial considerations, and operational logistics. It is important to have a comprehensive understanding of Direct-to-Employer arrangements before entering into such a contract.

The Millennial Manager’s ‘Dilemma’

I had the distinct opportunity to serve as a judge for CSULB’s College Bowl 2020, side-by-side with top industry leaders from Kaiser, AltaMed, medical informatics field, the VA, and others.

An attendee asked a great question which I’d like to share with my network.

QUESTION

“Given the undergraduate healthcare administration students are all looking into careers as managers and administrators in healthcare, what are the biggest issues that you see with hiring millennial managers today, how are you and your management team breaking these obstacles, and what characteristics separate a “manager” and a ‘millennial manager’?”

ANSWER

I don’t see a distinction between a ‘manager’ and a ‘millennial manager’. With that being said, yes, there are challenges surrounding the matter. Being a millennial myself, I think one has to work harder in boardrooms to be taken seriously. As a director (managed care) responsible for negotiating on behalf of over 20K pts, several years ago, while most executives (external as well as internal) were supportive (and appreciated a ‘new/fresh face’) I encountered counterparts who were somewhat — seemingly — condescending …. such that during a lunch meeting, a side-joke was made regarding how I’m “… a baby”.

I learned not to react to both implicit and explicit biases surrounding my relative youth. And look where I am now. C-suite serving over 100K across multiple markets.

College Bowl 2020 at California State University, Long Beach

And look where I am now. C-suite serving over 100K patients across multiple markets.

Do not be discouraged. And try not to see yourself as anything different from your role based on your age alone. Stay to metrics to demonstrate objective performance. Realize that your job as a leader is to set a clear direction, provide resources for team success, and let the team perform while removing barriers which will inevitably surface. Always reflect on the impact and ‘affect’ you have on any place of work (ie.: during your interactions, do folks walk away with a positive or negative net experience). Know that leaders are to inspire their staff and business partners in a given environment).

About 90% of my workforce, across the decade I’ve been in leadership from provider to payer, has been comprised of ‘baby boomers’.

Know where to throw your weight before throwing your weight around. Listen more as opposed to talking. Know your customers (internal) and have regular 1:1s with your team members to build that relationship. Do not take an authoritative approach as this will backfire on you. Make it about the team, not you. Be responsive to their needs and they will be responsive to yours.

We do not, and should not, discriminate based on age. No matter the age (baby boomer, millennial, or otherwise).

We do not, and should not, discriminate based on age. No matter the age (baby boomer, millennial, or otherwise). We look for leadership skills and ability to align with overall organizational objectives and strategies.

Do not be self-conscious re: your age as this will show right away.

The ‘biggest issue’ is a general lack of experience (naturally). Focus on building experience and lead your career based on metrics you have enumerate on your resume. You can always reach out to me for guidance/direction when you get stuck.

I invite my network to add any pointers I might have missed.

Employer Performance Standards for Behavioral Health: A Guide & Sample Standards to Implement

Sample Employer Performance Standards for Behavioral Health Developed by Catalyst for Payment Reform

In 2018, based on input from eight purchasers and a subject matter expert, Catalyst for Payment Reform developed a tool for purchasers to assess how well partners are meeting their needs when it comes to access, quality, and integration in mental healthcare. The tool includes evaluation questions and clear specifications for what a purchaser should expect to see moving forward in these key areas.

Sample of standards developed includes:

80% of providers in a network should accept new patients at any given time.
Patients should be offered an urgent mental health appointment within 48 hours.
Health plan updates provider directory on a daily basis.
Member satisfaction with care provided should be 85% or higher.
Quality must be a requirement for receiving a high-performance provider designation.
Health plans should conduct site visits or audits of 25% of providers every year.