SEATTLE – Employers trying to get a handle on healthcare costs often find their hands tied by one simple fact of life: You can’t predict the unpredictable.
While medical emergencies can’t be anticipated, they can be managed better. Carena, a Seattle-based provider of healthcare management services for employers, aims to do just that by offering two types of service, one providing house calls to sick employees (called Urgent Care) and the other focused on injuries that occur at the workplace (called Workplace Care).
“It’s an innovative approach to a problem that is nagging every company on the planet,” said Mike Viles, Carena’s vice president of technology. “How do you control healthcare costs among your employees … and help them make better decisions about their own care?”
The company, founded in the late 1990s as OnSiteDocs, now has contracts with more than a dozen organizations, including Microsoft, Costco Wholesale, Starwood Hotels and the Commonwealth of Kentucky, offering healthcare and education to more than 120,000 employees. Carena maintains a round-the-clock call center and contracts with two physicians’ groups, one based in Washington’s Puget Sound and the other in Louisville, Ky.
Viles points out that Carena isn’t replacing the primary care physician. The company’s programs are designed for quick intervention, a reduction of emergency care costs, and coordination with the company’s health plan to assure a continuity of care. A visit by a Carena physician is roughly 33 percent cheaper than a visit to the emergency room, though more expensive than a visit to one’s primary care physician.
“We really offer the doctors an opportunity to practice medicine their way they envisioned when they went through medical school,” said Viles.
Carena’s contract with Microsoft was based in part on a 2004 study by the Centers for Disease Control and Prevention that indicated only 13 percent of all visits to the Emergency Department are considered necessary, and yet visits to the ER had increased 25 percent from 1993 to 2003. With that in mind, Carena developed the Urgent Care program, launched in 2006, which provides employers with an around-the-clock physician service that can make house calls. The dispatched doctor, armed with information about the employer’s health plan, can treat whatever needs to be treated, perhaps refer the patient to a hospital for more urgent care, and lay out a program for future healthcare needs.
According to Viles, where an ER visit in Seattle might cost $850, Carena charges $570. In addition, a study conducted by Carena on Microsoft’s behalf indicated that 80 percent of those employees who used Carena’s service would have gone to the ER if the service weren’t available.
Carena’s work with Microsoft, Viles said, prompted Humana, Inc. to contract with the company for employees of the Commonwealth of Kentucky. The program, begun earlier this year, covers some 40,000 state employees in and around Louisville, and Viles said Carena hopes to expand to other parts of the state – not to mention other parts of the country.
“We are looking at national expansion,” he said.
The program with Costco, begun in 2003 and now covering 16 of the company’s warehouses and other facilities, offers on-site medical care for employees who are injured on the job. Carena physicians are dispatched to the worksite once an incident has been reported. They perform immediate medical care on site, refer the patient to a hospital if needed, and help with worker’s comp workflow. Viles estimated that 6 percent of all Carena visits result in hospitalization, while another 12 percent decline further medical treatment after being seen by a Carena physician.