SelectCare is the hospital’s new health care plan, and officials from the Lorain hospital are hoping it will change the way health care is delivered in this county by making viable an option that traditionally was enjoyed by only the largest of employers.
Jania Yergen, vice president of strategy and business development for Mercy, said SelectCare offers employers with 25 or more employees the opportunity to purchase employee health benefits directly from the hospital, essentially cutting out a lot of the administrative cost associated with the industry.
The result will be high-quality care at the lowest possible cost. Companies will only pay for the care employees receive and reasonable administrative duties. Yergen said Mercy will employ a third party to administer the program.
“With SelectCare, employees and their families are empowered to manage their own health, which in turn improves cost predictability for employers,” she said.
The new plan was announced Friday at a press conference just before local business leaders attended a lunch-and-learn session featuring John Torinus Jr., former CEO of Serigraph Inc. and author of “The Company That Solved Health Care.” It will be made available to Lorain County employers at the beginning of 2013.
A huge component of the program will be how health care is administered to participants. The full range of Mercy services will be available as well as those in the University Hospital system, as the Cleveland health giant has partnered with Mercy to round out the comprehensiveness of the plan.
Yergen said the focus will be on wellness programs, disease maintenance and preventive medicine.
This partnership between Mercy and UH is not new. In November, Mercy and University Hospitals Seidman Cancer Center announced a partnership that provides Lorain County residents with close-to-home access to some of the most advanced cancer treatments and clinical trials available.
As employers subscribe to the SelectCare program, Mercy will set up wellness clinics throughout the county to serve as first points of contact in the medical spectrum. Patients who have a pre-established relationship with a primary care doctor will be encouraged to continue, but for those who do not — Yergen said an estimated 30 percent to 40 percent of Lorain County residents do not have a health home, as a relationship with a primary care doctor is often referred to — the wellness clinic will offer a place to receive treatment.
Ed Oley, president and CEO of Mercy, said SelectCare is a direct result of conversations with business leaders in the community.
“While high-quality health care is crucial to our community, it is not enough,” he said. “Improving the health care status for those in our community is absolutely essential to our business model.”
Employers will see benefits from going the self-insured route because SelectCare emphasizes preventive care and patient compliance, he said. As workforce health improves, both employers and employees become eligible for further plan incentives and discounts.
Yerger said costs can be managed several years out and the cost of re-insurance becomes more manageable and predictable as workplace wellness initiatives are implemented. Employers with 50 or more employees may be eligible for a multiyear cost-savings guarantee — the only guarantee of its kind in the state.
Torinus championed the plan, calling it a business-minded solution.
“The medical side of health care in America can be brilliant, often sensational with modern miracles happening every day,” he said. “The economic side constitutes economic chaos. It is busted and has to be rebuilt.”
Torinus said it will be the leading-edge employers that put new health care models in place piece-by-piece.
“Revolutions in the private system are bending the costs curve and that has little to do with the new health care mandate,” he said.
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