Doing what he can to stay healthy is important to Doug Schroeder, President and Secretary/Treasurer of the Bricklayers & Allied Craftworks of Minnesota, North Dakota, and South Dakota. Schroeder realized early on that if he didn’t manage his health properly, he would be on the same path as his father and grandpa who both passed away at a young age.
His personal experience helps guide his management of the Bricklayers & Allied Craftworks Health and Welfare Fund, which among other benefits, provides comprehensive medical coverage to the union’s multiple member organizations that include masonry, tile, restoration, precast installer contractors and their families. Approving benefits for the fund is a lengthy process, involving board endorsement and a democratic vote by the membership.
Tough task of keeping a union healthy
“When you manage our health and welfare fund, it’s complex and can become intimidating quickly,” adds Schroeder. “It’s really more about creating a relationship between the board of trustees and the vendor, and understanding how we can work together to mitigate expenses and improve communication to the membership.”
When the union was looking for a new health insurance carrier starting in 2016, its board of trustees knew that costs would play a major factor in the decision, yet they also wanted to help more members engage in preventative care. Having a broader base of in-network providers, especially for their North Dakota members, was critical. In addition, the board was looking for solutions to manage claims more effectively.
When the board of trustees met with HealthPartners’ sales team, including Chris Parrucci, HealthPartners Business Manager for Labor and Public Sector Accounts, Schroeder recalls how the team’s presentation struck a familiar chord with the board.
“The sales team told our board how we were not managing our members’ diabetes as well as we could be,” says Schroeder. “The board mentioned how HealthPartners’ disease management program could help these members be more cognizant of this health condition, ensuring they are checking their glucose, taking their medication, seeing a primary doctor regularly, and managing their weight.”
For Schroeder, that’s how he has lived his life since age 18 - seeing his doctor regularly and taking his medication as prescribed to manage his hereditary condition.
“I’m always looking at this issue through a different set of glasses than most,” explains Schroeder. “I had my appointment set for my colonoscopy before I was 50. It’s just something I do. But that’s how you stay healthy. For our union, we struggled with why our members may not see a doctor regularly. No one wants to hear negative information such as your health condition isn’t improving. Yet at the same time, you can control your health care costs if you do these things more frequently and schedule your appointments.”
Under the microscope: workforce health trends and costs
Parrucci describes how the HealthPartners team starts by helping employers understand the power they have to impact both the well-being and the health care costs of each individual, and thus impact the total cost of care for their group.
“We analyzed three years of the Bricklayers’ health care claims prior to moving to HealthPartners to highlight opportunities to improve management of total cost of care,” he explains. This analysis involved identifying ways to promote preventative goals for certain groups as well as identifying those individuals at risk for illness and disease.
“We looked at everything, including the design of the network, back-end management of claims and administrative fees to see where we can be more productive,” describes Parrucci. “We also manage member campaigns for the more at-risk individuals through our disease and care management teams.”
It was this personal approach, full of details and meaningful ways for members to take an active role in their own health and well-being that stood out to Schroeder and helped the union make the decision to move to HealthPartners.
“Chris really drilled down to where we were at with our costs and how we could reduce them,” says Schroeder. “He came with lots of personal information, and was always asking if we wanted more details. Our health and welfare fund is multifaceted and no one person is making a decision at the table. Yet Chris was able to make it easy to understand for everyone and offer ways to optimize our members’ experiences, improve communication, and provide greater in-network reach to some of our more challenging areas in North Dakota.”
Parrucci 's approach is to shift the cost savings conversation away from one primarily focused on discounts for services, such as hospital stays and clinic services, to a more comprehensive discussion. Talking about care access and affordability is critical but it’s also key to focus on preventing a person from being admitted to the hospital in the first place.
We take our total cost of care approach a step further, and write it into our contractual agreement, guaranteeing that employers will save at least five percent on their health care costs.
How the Bricklayers cut costs and improved health
Since moving to HealthPartners, the Bricklayers far exceeded the five percent savings guarantee, with 12.77 percent saved over three years, in addition to experiencing a 5.5 percent increase in member enrollment.
“We definitely saved money with HealthPartners’ cost guarantee,” says Schroeder. “We’ve experienced a better-executed claims process too and a quicker, seamless way for members to participate through the HealthPartners’ app. We’ve had some success with people who are living with diabetes through HealthPartners’ disease management program. More people are actively engaged in health care and they are seeing their primary practitioner.”
Raising the bar on health
Yet Schroeder recognizes that there is always room for improvement. He often talks to Parrucci to look for ways to change incentives, alter communication methods to better reach the membership, and communicate these needs with the board of trustees.
“With our health fair cancelled due to the pandemic, we are looking at how to use those dollars in meaningful ways for our members,” indicates Schroeder. “We bounced around ideas with HealthPartners about the kind of program we can pull together. Part of it involves providing incentives to our members and managing the complexity of communication. We utilize the app for notifications, as well as our website and newsletter. And we keep telling our membership that the information exists whether it’s on a computer, phone or in the mail. We’ve had these conversations with Chris, and we know we need to do everything we can to reach people.”
And it’s not as though they can rest on their laurels. If there is something that’s not working, the unions’ members are very vocal – with Schroeder adding that if there is something to report, he’ll hear about it. But he hasn’t received any negative feedback and relays that the process is working well.
Health decisions should never be off the cuff
Schroeder knows from his own experience that health care decisions need to be well-informed. Prior to having rotator cuff surgery, he conducted his own research, querying people he knew who had the same surgery to understand the care options available. He was able to work with HealthPartners to ensure he was seeing an in-network doctor with a high quality of care rating, and he was able to get answers that validated his own research. It proved to be a very positive experience.
“That pre-operation call with HealthPartners backed up my decision, indicating that this was the right procedure, the right set-up, and combination of things I should be doing to benefit myself,” he adds. “It was also nice to know that everything I was doing would help keep my medical costs down.”
And that’s part of the process HealthPartners follows to help ensure each member or patient gets the right care. As an integrated care delivery organization and a health insurance company, HealthPartners collaborates closely with providers to help them achieve more favorable outcomes for the patients they serve. In the end, this collaboration with providers drives better health outcomes that result in a lower cost of care.
“Other carriers have moved away from working with providers in this manner because it’s difficult to manage,” says Parrucci. “We have entirely different discussions with them because, as a health system ourselves, we understand the challenges they face.”
Overall, TCOC isn’t a simple conversation, but it’s a needed one as we look at all the variables that impact health care costs across individuals, providers and employer populations.
For Parrucci, at the heart of it is building a relationship upfront, establishing trust, and changing the dynamic of the conversation to help employers understand how to manage the total population health of their organizations.
“It’s about looking beyond a spreadsheet to an all-encompassing approach that identifies the most effective and appropriate care no matter where people are in their health care journeys,” he says.