By Katelyn Bush
It’s no secret that the United States spends trillions on healthcare— yet what is the return on investment? The search term “health costs” yields thousands of articles accusing providers and industry middlemen of inflating prices. All too often, these think pieces ignore the patients behind these expenses. “Costs are about to soar,” warns a headline from Yahoo Finance. “More surgeries driving up costs,” reads another. Costs for whom, exactly?
Our obsession with healthcare spending comes from an understandable place. Self-insured employers must consider third-party fees, networks, spread pricing, and countless other factors when designing a health plan. These expenses and confusion around where the money is going can force employers to lose sight of what really matters, and ultimately can hinder employees from receiving care, resulting in thousands of costly hospital visits and insurance claims. With so much at stake, it’s no wonder we devote innumerable resources to attacking medical costs. However, this economic approach to healthcare often ignores the end-user, the one who actually needs the care. Phillip Berry, CEO of Northwind Pharmaceuticals, writes, “It is so easy to lose track of the patient as we focus on analytics, calculations, spreadsheets, and financial statements. Meanwhile, there is a human being behind these numbers.”
Perhaps the solution lies in changing our mindset. What if we considered healthcare costs not a sunk cost, but an investment in our people? And if we invested our dollars wisely to the benefit of them, what would be the value for all in the long run? While the answer to this might be obvious, few seem to have truth in their answer. Phillip Berry with Northwind Pharmaceuticals is one who does.
Over the last decade, Northwind has pioneered an alternative approach to influence the total cost of care by building customized care plans for employers that engage employees struggling with chronic disease by removing cost and access barriers. Under their Strategic Rx StewardshipTM model, employers are able to lower costs by directly purchasing drugs and then leveraging them with measurable results in chronic disease management programs called Clinical Blueprints, supported by Northwind pharmacists and health coaches. Employers can deploy this model alongside an existing PBM or as a plan replacement to increase ROI. Direct contracting eliminates hidden fees and rebate games, allowing transparent providers to offer lower costs for employers. But pharmacy discounts are just the beginning; by breaking down the complexities surrounding healthcare and utilizing existing resources correctly, Northwind enables good stewardship by making sure healthcare is a wise investment.
For example, an employer could drive additional value from their existing on-site clinic by supplementing it with Northwind’s diabetes blueprint to engage and support diabetic members. Savings from directly purchased drugs could be invested in other disease management and prevention programs or passed back to members through the elimination of co-pays and deductibles. Healthier participants lower total healthcare costs by avoiding higher cost care brought on by poor disease management. Looking at healthcare dollars as an investment, Berry says, gives companies more resources to address employees' unique health challenges. “Health is very personal, very local, and very complex. One size does not fit all, and all of us encounter health struggles in different ways. Our approach works because it focuses on removing the key barriers of cost, access, and complexity, and we are willing to engage at the level of the individual to ensure great results.”
Granted, every company has its own idea of "great results.” Some measure success by retention rates or absenteeism. Some by better compliance and lower costs. Regardless, the bottom line remains that benefits should, well, benefit employees. At its core, a health plan is an investment in employees’ wellbeing, not an economic strategy—though reduced claims costs are an added bonus. The true reward, however, is transforming lives through personalized care. As Berry writes, “The best stewardship comes from smart money that fosters healthy employees who are thriving. Isn’t that the point?”
We are proud to feature Northwind Pharmaceuticals on The Granite List.