Our client, a community health system in the eastern U.S., was experiencing significant competition in its primary market from nearby tertiary health systems. These tertiary systems were particularly aggressive in attempting to poach the commercially-insured population of a local large, self-insured employer with about 9,000 covered lives. Our client needed a strategy to align with the employer to retain commercial market share at both the hospital and its physician practices.
How HSG Helped
HSG facilitated meetings with hospital leadership, physician leadership and relevant representatives of the local employer to discuss the employer’s healthcare challenges:
- workdays missed due to illness;
- getting patients established with a PCP to receive preventative care;
- costs of health benefits rising faster than inflation.
These results were integrated into a plan to respond to the employer’s needs, which included:
- priority scheduling at the client’s employed physician practices;
- on-site placement of a nurse practitioner for minor issues; and
- development of disease management programs for diabetes, which was a major cost driver within the population.
The employer’s satisfaction with the client’s response has been outstanding, and discussions are continuing about other ways our client can support the employer. In turn, our client has seen its market share for commercially-insured patients stabilize and begin to grow despite increased competitive pressure from outside systems in its market. The client/employer relationship is evolving from the initial agreement toward a model which can be used for direct contracting or a narrow network product in the future.