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February 4, 2019
Having recently participated in the World Health Care Congress in Washington, D.C., I am heartened in the future of health care in America because of the wonderful ideas discussed from around the globe. However, I was somewhat disappointed that still many employers don’t get as involved in health care as perhaps they should be.
I firmly believe the more companies that are intimately involved in health care, the more progress we shall make as a nation in creating a health-care sector that is both efficient and cost-effective.
Twenty-seven years ago out of necessity, my company — Rosen Hotels & Resorts — created our current health-care template now known as “RosenCare.” At the time, we were embarking on a new venture for which there were few examples to follow.
In 1991, we were providing a traditional third-party health-care plan and anticipating a good year because our health expenses were significantly less than our insurance premiums. How disappointed we were to receive our insurance renewal for the new year showing a rather significant increase in our premiums. How was this possible? Much to our surprise, we learned that all accounts — including ours — are placed in a group, and that our group did not fare well in the past year; so the premium would increase.
After much discussion with my colleagues, we decided to attempt something rather dramatic. We would create our own health-care program by self-insuring and offering our own primary-care medical facility. Fortunately, we were able to convert a free-standing structure that housed our corporate accounting office, which we had outgrown. We hired a physician, a medical assistant and an administrative assistant, and within a short time, we were firmly ensconced in the primary-care business. Simultaneously, we created our own insurance enterprise, Provinsure, enabling us to self-insure. The medical facility would evolve into a nationally recognized, patient-centered medical home.
Now 27 years later, when comparing our annual cost per covered life with the national average, we have saved about $340 million. Our cost is half the national average, while our benefits are far superior. We have no deductibles or co-insurance, and most medications are free. We believe that the savings result in great part from our ability to focus laserlike on wellness and prevention through our medical center.
Part of my dream and a key component to improving health-care accessibility is the 12,000 square-foot Rosen Medical Center, a Place for Healing & Wellness. It staffs five doctors, three nurse practitioners, two physician’s assistants, a dietitian, a chiropractor, physical therapists and a support team, who see 160 to 180 patients daily.
Patient care focuses on management of chronic-care conditions with keen attention to prevention and wellness. On-site services include smoking-cessation counseling, lab services, digital X-ray, ultrasound, bone-density scans, mammograms, in-patient case management, pregnancy case management, medication dispensary and many other programs to assist patients with reaching their optimal health.
We measure success by the health of our patients and in quantitative values. Even with 56 percent of our pregnancy population being high-risk, our premature delivery rate is 7 percent (compared to the Orlando average of 10.5 percent). Our medication compliance rate is over 96 percent for diabetes (compared to 50 percent diabetes compliancy rate nationwide, and over 92 percent for cardiovascular medications including hypertension. We celebrate an 85 percent hypertension-control rate. The national average is 45.9 percent.
We’ve been fortunate to have our program and medical center shopped by numerous companies and officials, where one indicated that if our self-funded program were implemented by the U.S. government, it could save an enormous amount of money. Our program also received worldwide recognition at the World Health Care Congress with three health value awards: two Diamonds in Lifetime Achievement (Health Benefits Innovation and Public Leadership); and a Silver in the Large Employers Group.
What’s needed to replicate this success? It takes the commitment of the C-suite to say it’s time to control our own destiny. We’ve learned that while the benefits administrator is an important component of the process, the broken system will not be fixed without active engagement by the chief financial officer or chief executive officer. I cannot emphasize this enough.
Why wouldn’t employers take ownership with so much at stake? Multimillion-dollar cost savings. Healthier, happier and more-productive employees. Reduced turnover rates (ours is in the low teens compared to a 60 percent to 70 percent average in the hospitality industry). Contributions to the health and future of our great country.
I believe the will of employers to do this is increasing exponentially as the labor market tightens. Now is the time to act. If an employer controls its own destiny, extraordinary things can happen.
Harris Rosen is president and chief operating officer at Rosen Hotels & Resorts.