From Staff and Wire Reports
Walmart will test a variety of new health-care programs for some of its workers next year, aiming to provide easier access and better care while reducing its own expenses.
The retailer will use a data-analytics company to connect workers with select local doctors in North Texas, Northwest Arkansas and Central Florida; expand its tele-health program in other areas; and offer health-care “concierges” to act as a single point of contact for staff in the Carolinas, the company said last week.
“If you get people the right care, you end up seeing downstream savings in the long run,” said Lisa Woods, Walmart’s senior director of U.S. benefit strategy and design. “If we get this right, we can raise the tide for all health care.”
Arkansas-based Walmart is the nation’s largest private employer, and the fifth-largest in Longview.
In the most talked-about pilot, the company will help employees connect with local doctors in areas like primary care, cardiology and obstetrics. It is working with Nashville-based data analytics company Embold Health, which will cull through data from public and private insurance plans to come up with recommended providers based on effectiveness and cost efficiency. Walmart will in turn use that data to curate a list for employees.
The company declined to disclose the percentage of its doctors in the pilot geographic areas who have the new quality distinction or how much workers could save by using their services.
About 60,000 employees and dependents in the three initial areas could be affected.
The effort to steer workers to certain doctors mirrors a similar approach Walmart uses with hospital care through its Centers of Excellence program. Since 2012, it has directed the 1 million employees and dependents on its health plan to better-performing hospitals for high-cost services, such as heart and transplant surgery.
While using these hospitals — including Mayo Clinic and Cleveland Clinic — may cost more than a local alternative, Walmart officials have said the strategy saves money by averting complications and unnecessary care. Several other large employers have followed a similar strategy.
Next year, Walmart will add kidney transplants to the list of procedures it covers through the Centers of Excellence program. That program began in 2013 and is part of a larger trend of big employers trying to gain more control over health-care costs, as evidenced by the alliance between Amazon.com Inc., Berkshire Hathaway Inc. and JPMorgan Chase & Co. Thirty percent of all health-care spending is wasted, according to the National Academy of Medicine.
Earlier this year, Walmart became the first large employer to direct its employees to diagnostic imaging facilities that it found provide more accurate care.
Employer health experts said Walmart’s initiative with physicians is a groundbreaking step — but fraught with risks such as alienating doctors and upsetting employees who don’t want to change doctors.
“It’s a bold move to use the data they have and share it with employees for their benefit,” said Steve Wojcik, vice president of public policy at the National Business Group on Health, a trade group of large employers. “It’s part of Walmart’s pattern to disrupt and transform health care for the better.”
Embold, the data-analytics company, selects the doctors who “consistently deliver the best outcomes,” Walmart said. If employees prefer other doctors, they will pay more.
The steps, which take effect in January, also are the latest example of how Walmart is sweetening the benefits offered to its 1.5 million U.S. employees, after weathering years of criticism that it shortchanged them. The moves include everything from expanding parental leave to relaxing its dress code.
The goal is for the services to eventually be available to the 1 million Walmart and Sam’s Club workers and family members on the company’s health insurance program. The retailer also plans to share its practices with other companies.
The changes come amid a broader health-care push by Walmart, a strategy that includes opening low-cost medical clinics for shoppers, offering subsidized degrees in health-related fields and rolling out a bundle of health-care offerings for members of its Sam’s Club warehouse chain.
In recent years, employers’ health-care costs have remained steady as a share of total compensation expenses. They’ve done that, partly, by shifting costs to employees. The cost of family health coverage in the U.S. now tops $20,000, an annual survey of employers found, a record high that has pushed more American workers into plans that cover less or cost more. The steady rise of costs has led to deep frustration with U.S. health care, as some employers drop coverage while some workers choose not to enroll.
Walmart’s decision to add $35 co-pays for primary care visits should encourage employees to seek care earlier rather than wait until it becomes an urgent issue, a company spokesman said. Under the current plan, the cost of routine doctor visits can vary, and are charged against employees’ health-reimbursement accounts or their deductible.