The doctor is in-house: Somerset County, Integrity partner on business-like health care model

By Anjalee Khemlani
Somerset County | Jun 12, 2018 at 9:51 am

Borrowing an idea from corporate campuses, Somerset County launched an initiative in mid-May that provides free primary care visits and prescription drugs to county employees and their dependents.

The program is in partnership with Integrity Health, which held a ribbon-cutting for a new health care facility in Somerville tied to its first countywide partnership.

The Princeton-based entity has created a model that requires no copay, modeled after corporate entities that provide health care facilities on-site.

The idea, said CEO Doug Forrester, is to help save the county, which is self-funded, on its health care spend in the long run, as it does with school districts in Long Branch and Toms River — by changing the way employees utilize the health care system.

Integrity’s facility, which has been open since mid-May, provides “in-house” access to primary care. This emulates the model some large corporations employ to prevent expensive emergency room visits that occur either because employees put off visits until their need is dire, or because they simply do not realize the savings involved in having a dedicated primary care doctor.

Having no copay to encourage more primary care visits is not a new concept, and is, in fact, a trend among health insurers nationally.

“The traditional model of health care, and it hasn’t changed very much, it’s big networks get big discounts,” Forrester said. “And, while it’s fine, and that has a place … what’s particularly notable about public-sector entities is they are known for having generously-defined health care coverage. And they are known for having employees who stick around for a long time.”

By comparison, the average private sector employee changes health care every 18 to 24 months because of changing jobs or because employers are shopping around for better coverage.

“That tends to move against coordination of care, preventative measures, wellness, over time. But the perfect environment to capture the value of best practice and care coordination over time is the public sector, because public employees tend to stick around for 18 to 20 years,” Forrester said.

And, in helping the county save money, the company still makes a decent return on its investment.

“It depends on the utilization, but if things go as projected, we will see an ROI at about three to one,” he said. “It can be greater than that. But we estimate it will be at least that.”

But neither party put an exact number on the savings to the county — which has a reputation of being well-run.

Freeholder Mark Caliguire said the county is very attentive to its fiscal health, as well.

“We mind our P’s and Q’s and we have a ‘AAA’ bond rating, we have a budget with less employees than we had in 2008, we are in good shape and we can do it,” he said.

County Freeholder President Patrick Scaglione said that, from his background in the corporate sector, he saw how useful the on-site option was, and how much more people utilized a convenient location from work.

“The other thing is, every year, there is a 5 to 15 percent rise in health care costs, and we were thinking about how to manage that,” Scaglione said.

By allowing employees a place to visit free of charge and during the work day — during their lunch or other breaks in the day — the county is making it easier to avoid costly emergency room visits.

And, at a time when government bodies are trying to curb costs in other ways, Somerset County believes the investment will help.

“We found out that the investment we would have to make right at the onset wasn’t as significant as we thought it would be,” he said.

Plus, the county was building a new office building, so it was the perfect time to explore the option, Scaglione said.

“This appears to be a very economical way to do it,” he said.

The contract is currently for five years, but Scaglione said the county is committed to keeping up the partnership.

Caliguire agreed, adding that it is a voluntary system that employees can choose to use or not. But, regardless, the county anticipates savings.

“It’s going to be great for our employees and our retirees, and it’s going to be effective and efficient for the taxpayers of Somerset County,” Caliguire said.

Anjalee Khemlani | akhemlani@roi-nj.com | AnjKhem