KHC Employer Members Learn from Montana Commissioner

On February 7, the KHC hosted a special one-hour discussion with Marilyn Bartlett, Montana Commissioner of Insurance. Bartlett spent two years running Montana’s employee health plan, where she made better deals with hospitals and drug benefits managers and saved the plan from bankruptcy.

Bartlett shared Montana’s journey to save $15.6 million in 2018 over the estimate of what it would have paid without the change.

While her presentation and discussion with KHC employer members was not recorded, you can see her slides from the event here. In addition, detailed stories about her impressive work have been featured in Washington Post, ProPublica, Kaiser Health News, NPR, Full Measure, and more. Take a few minutes to learn more at the links below.

Round Table Reflections – Understanding Employer Needs, Goals, and Challenges for Opioid Use Disorder

Last week, the Kentuckiana Health Collaborative (KHC) convened a group of employers and experts at the LG&E/KU Cane Run Power Plant to discuss the needs, goals, and challenges facing employers as they address opioid use disorder (OUD) in their workforces. The event was conceptualized as a focus group to guide the development of the KHC’s newest project as part of the Kentucky Opioid Response Effort (KORE). With an expected release date of April 2019, the KHC is developing a toolkit for employers in implementing best practices for supporting prevention, treatment, and recovery from OUD in the workplace.

Attendants of the focus group were carefully chosen. It was important that the discussion represented multiple perspectives dependent on the size, industry, and status of OUD initiatives of employers. Experts were brought in to provide technical expertise and give additional insight.  The conversation was broken up into five domains: key metrics for evaluation, prevention, benefit design, treatment, and recovery. For each domain, our conversation was shaped by identifying goals, challenges, pertinent information for the toolkit, and any knowledge of best practices.

The focus group revealed many outstanding themes. First and foremost, there was a resounding amount of enthusiasm and recognition from employers in their role to address OUD not only in their employees, but in their communities. This was especially true when discussing prevention efforts. Another prominent point was the importance of building a culture of wellbeing and trust within the workplace. By doing so, prevention, treatment, and recovery among employees could be supported. A component of this culture would be innovation, particularly around mitigating the many barriers than often arise for employees in accessing treatment and maintaining recovery. Insurance coverage that is friendly towards virtual treatment options, Medication Assisted Treatment (MAT), defined treatment guidelines, and affordable deductibles was repeatedly addressed. Employers also recognized the importance of data and insurance benefit design in tackling this issue. Addressing OUD in the workplace will be a individualized process, as many barriers exist in implementing these changes and these barriers vary based on each employer’s demographics and capabilities. Despite this, the willingness of employers to engage in such a vibrant and transparent conversation left many of the group’s participants filled with hope and excitement for their organization’s future.

In conjunction with evidence-based research, information collected from this discussion will guide the development of the KHC’s employer toolkit. The KHC will continue to convene employers during our monthly Worksite Addiction Meetings. If you are an employer who is interested in joining this group or would like to share your perspective, please contact me at

KHC Attends National Alliance of Healthcare Purchasers’ Annual Conference, Employers Take the Wheel

The Potential and Value of Worksite Clinics

Guest Blog written by Larry S. Boress, Executive Director, National Association of Worksite Health Centers (NAWHC)

The KHC and NAWHC joined forces on September 12, 2017 to discuss the rise of worksite health centers to address the unmet health needs of employees.

Employers continue to face health care benefit costs that outstrip the inflation rate, while quality, access and satisfaction with the health system is declining.

Many employers have decided to optimize their benefit dollars by offering an onsite or near-site clinic to their covered populations. This benefit solution is not limited to large manufacturers, as employers of 200+ can obtain the savings and improvements such a facility can bring to your bottom line, productivity and retention rate.

Worksite health programs were initially developed to provide first aid and emergency care to employees working in remote or dangerous locations.  Over time, many employers decided that offering a company nurse or doctor was a good approach to treat injuries and provide occupational health services

to comply with federal and state workplace requirements. The medical personnel, usually an RN, was also available to manage absences, prepare employees for foreign travel and provide a minimal level of acute care services.

According to a recent survey by the National Business Group on Health, close to 50% of large employers, those with over 5000 worker, have onsite or near-site clinics, and by 2020, two-thirds will have such facilities. The National Association Worksite Health Centers ( has found that 30% of employers of all sizes currently offer some form of health care services at the worksite. Today, the services provided at the worksite run the entire spectrum of health care, including not just medical, but dental, vision, physical therapy, chiropratic, lab and pharmacy services are being offered.

Leading employers are beginning realize that by offering the services that force employees to leave work, they can reduce the cost and better manage the health of their covered populations, while improving productivity, since they’ll have reduced the number of situations and the time off the job by workers seeking medical care.

An employer-sponsored health center can serve as the hub of the worksite wellness wheel in integrating and analyzing ALL the data from vendor and employer-sponsored health related programs and activities. At the same time, the onsite clinical staff  increase the engagement of their workers in the multiple preventive and condition management programs they offer. This type of population health approach effectively identifies unnecessary services, gaps in care, opportunities for savings and quality variations to be addressed.

Employers looking at or offering such facilities should be careful not to let their clinic become just another fragmentation of the health care system. Worksite centers need to connect and share patients data with a patient’s own physician. It also offers a source of primary and acute care for those 40-60% of employees who don’t have a personal physician.

Patients see their physician 1-2 times each year, for 7-12 minutes per visit – hardly enough time to enable the provider or the patient to communicate or drill down on physical and mental health issues.

However, people are at their workplace 1000-2000 hours a year, which gives the employer a tremendous opportunity to engage, educate, monitor and motivate employees to learn about and address key health issues and conditions.

To enable employers to better understand and expand on the value of “health and wellness” centers, the National Association of Worksite Health Centers (NAWHC) was formed in 2012. The Chicago-based NAWHC (  is the nation’s only non-profit association supporting employer sponsors of onsite, near-site and mobile health, fitness, pharmacy and wellness centers. It also offers a new “Guidebook on Measuring the Performance of Worksite Health and Wellness Centers” to enable employers to understand and use credible metrics and approaches to ensure their getting true value of their investments in their clinics.

An onsite health center can serve as a vehicle to achieve many health benefit objectives, including efforts to reduce medical cost trend by avoiding utilization of unnecessary care; improve health of covered population; integrate all worksite health care, preventive and wellness programs; and reduce absenteeism, while improving productivity.

The presence of the clinic can also increase the visibility and access to other benefit programs and services, now available via a warm handoff between providers and vendors.  The consolidated data now can track patient use of service and referrals and allow vendors to collaborate on a patient’s care management. Onsite fitness centers, often underutilized, can also be integrated into the health center’s physical therapy and cardio programs. Finally, the integration enables easy collection and measurement of the center’s performance and impact on the population’s health and employer’s benefit costs.

Tomorrow’s onsite center will serve as the integrator and hub of an employer’s health data and activities. In doing so, employers, with the cooperation or local providers the and support of their vendor partners, will finally be able take control of their health care spend, while assuring their workforce easy access to quality providers, at little of no costs. This will enable employers to achieve population health management and reduce cost, while improving health, productivity and their firm’s bottom line.

Larry Boress is Executive Director of the National Association of Worksite Health Centers and can be reached at

The Rise and Evolution of Onsite and Near-site Clinics

A few decades ago, I remember sitting in a meeting with our company doctor planning new hire orientation, feeling miserable, and wishing I could just have him see if my cold needed to run its course or required a prescription. Instead, I took a half day off of work for a doctor appointment, but I longed for easy and hassle free access to a healthcare provider at or near work. Today, more and more companies are adopting onsite or near-site clinics, also known as worksite health centers, as a way to meet the healthcare needs of their employees.

Onsite clinics were at one time only for the largest of corporations, but companies with as few as 500 employees are now adopting a worksite health center model. According to Springbuk, the current market penetration of worksite health centers is 16 percent and is expected to surpass 30 percent by 2020. This means that up to 10 percent of the adult population under the age of 65 will receive their healthcare through a worksite health center.

There are three primary reasons employers are adopting worksite health centers: 1) improved access to care that enhances productivity and job satisfaction, 2) improved population health management, and 3) better management of healthcare costs. The role of worksite health centers is evolving from the occupational medicine clinic – like the one my company doctor ran – to primary care clinics. We are now seeing an evolution that focuses more on employee well-being by integrating population health, wellness, and evidenced-based medicine into a more holistic approach to employee health.

With the increasing adoption of onsite and near-site clinics, employers considering an investment in a worksite health center now have access to case studies and information about how well these clinics have supported companies’ long-term healthcare goals. On September 12, 2017, the Kentuckiana Health Collaborative and the National Alliance of Worksite Health Centers will host a half-day event to discuss the latest information on worksite health centers. Confirmed speakers for the event include:

  • Diana Han, MD- Global Medical Director, GE Appliances, a Haier company featuring their onsite clinic vendor, Premise Health
  • Larry Boress- Executive Director, National Association of Worksite Health Centers
  • Gregg Potts, MD- Senior Medical Director, Papa John’s International
  • Dexter Shurney, MD- Chief Medical Director/Executive Director Global Health/Wellness, Cummins Inc.

If you are considering a worksite health center or would like to learn more, be sure to join us for The Rise of Worksite Health Centers to Address the Unmet Health Needs of Employees. This event requires registration and is free to current KHC and NAWHC members. This forum will be held at the Jewish Hospital Rudd Heart & Lung Conference Center in Louisville, KY.


Employer Health Forum September 2017

The Kentuckiana Health Collaborative will host its second annual healthcare conference to help shape the future of health and healthcare value. Hear from national healthcare thought leaders on the latest measurement and payment reform updates, how each sector can drive more value, how patient outcomes can be optimized through medication adherence, and how communities can come together to catalyze these changes. Join a force of great minds that will inspire and challenge you on March 16, 2016, in Louisville, KY. This conference is more than a chance to network with key healthcare professionals; it’s also an opportunity to play a part in affecting real change in healthcare value.

Next KHC Employer Round Table to Address Employee Depression and Related Resources

Unbeknownst to many employers, the shocking ONE IN 10 Americans living with depression goes beyond the personal realm to significantly impact the bottom line of companies from every sector, ultimately costing employers BILLIONS OF DOLLARS ($102B) each year.

Managing Specialty Drugs a Top Priority for Kentuckiana and National Employers

A few years ago, my mom had neared the end of treatment options for a serious and life-threatening condition. When the FDA approved a drug we had been watching closely, our family was thrilled that her medical team acted quickly. At the same time, the status of my mom’s employer-sponsored supplemental health insurance was in jeopardy, with a company bankruptcy lurking. The intersection of employer viability and healthcare coverage had just become very personal.

We all want access to these breakthrough biologic and specialty drugs that are changing the course of complex, rare, and previously untreatable conditions. With more of these drugs in the research pipeline, accounting for about half of all FDA approvals, employers need a strategy for managing specialty drugs.

Larry Boress

At the KHC’s first employer round table of the year, Kentuckiana employers gathered to discuss what they can do to most eff ectively manage specialty drugs and healthcare benefits. Larry Boress and Cheryl Larson of the Midwest Business Group on Health (MBGH) lead the National Employer Initiative on Specialty Drugs project and facilitated the interactive discussion, held at Ford’s Louisville Assembly Plant.

One of the biggest challenges for employers is managing the higher costs of specialty drugs. Kentuckiana employers were asked to bring their company’s data on recommended key metrics for specialty drug utilization and spend. Polling during the meeting showed that the largest portion of local employers pay 21-40% of their drug spend on just 1-2% of their population. Inflammatory illness, oncology, Multiple Sclerosis, and Hepatitis C were identified as the top conditions for specialty drug utilization.


Cheryl Larson

Costs could reach $400 billion, or 9.1% of national health spending, by 2020 according to a report by United Health Group. According to the MBGH’s research with employers across the nation, the most effective strategies for managing costs and improving outcomes for persons on specialty drugs are:

  • Requiring use of a specialty pharmacy
  • Requiring prior authorization for pharmacy claims approval
  • Providing patient support and case management

Amanda Elder

“The specialty drug employer round table generated dialogue that was extremely valuable. The environment is ever changing and staying abreast of the potential impact is key to managing the costs, while ensuring our employees and their families maintain a healthy, productive lifestyle,” said Amanda Elder, Wellness Coordinator, LG&E KU.

According to the MBGH’s annual national employer benchmarking survey, the top three national healthcare benefit priorities in 2017 are 1) managing specialty drugs, 2) creating a culture of health, and 3) improving benefits communication. These priorities also made the top five local priorities, along with outcomes-based contracting and benefits cost management. Employers are becoming bolder in their efforts to manage healthcare. The Healthcare Transformation Alliance is a group to be watched in this space and can be heard at the KHC’s 3rd Annual Conference on March 15.

There is no doubt that specialty drug management will continue to grow as a top priority for employers.