Employer Advantage Enhanced Primary Care for Healthcare Providers



Employer Advantage’s turnkey solution gives healthcare providers the tools and processes to develop Enhanced Primary Care Programs — basically, a high quality care delivery network that engages primary care physicians to act as coordinating providers for the provider’s own employees. Not only does this ensure provider employees remain in network, dramatically reducing domestic leakage, it enhances value-based care and population health initiatives, improves quality measures, and keeps employees healthy and away from unnecessary treatment. Primary care physicians are empowered with cost data, giving them exceptional clarity into referral patterns and the impact their decisions have on patient outcomes.

Employees are directed to the most efficient specialists and facilities for downstream care, and physician coordinators provide coordination, guidance and support for each covered life. This eliminates the confusion that can prevent patients from accessing the best care choices based on their condition, medical history, and budget; this saves money for both the patient and the employer and produces the best possible medical outcome.

The model also enables healthcare providers to leverage their services and expertise to deliver comprehensive wellness and disease management programming to their employees, establishing preventative programming that can dramatically reduce long-term healthcare costs and improve employee satisfaction. This in turn reinforces the concept of the provider as a caring and dedicated employer that prioritizes the wellbeing and happiness of its own employees, not just its external customers. Achieving these goals requires the healthcare provider to think like a business first and a hospital second, whereby there is a strong focus on efficiency, cost-reduction, and a commitment to improving financial performance over the long term.

Perhaps the most critical element in making the program a success is the identification of primary care providers who are ready, willing, and able to be held accountable for cohorts of covered individuals, and who are prepared to accept the responsibility of prioritizing care quality and efficient referral practices — that keep patients away from unnecessary hospitalization. Crucially, Employer Advantage manages all engaged provider activity and provides performance and accountability oversight and reporting for maximum transparency. They also provide targeted focus groups that give primary care physicians the opportunity to contribute their expertise and feedback in support of developing a contextualized model; these focus groups are acknowledged for having achieved recognition by the NCQA as a Patient Centered Medical Home — they are also challenged to demonstrate a level of proficiency as a NCQA PCMH model practice to meet Triple Aim results.