We recently sat down with Philip Fredrick, Vice President at Vera, to discuss labor groups, the challenges they face due to COVID-19, and how they can benefit from the Vera advanced primary care model. Enjoy the interview!
Vera Whole Health: What are the challenges labor groups face right now?
Philip Fredrick: Many of the groups we’ve been speaking with during the COVID-19 outbreak are in the building and construction industry. Those groups actually took a four-day pause when most of these stay-at-home orders went into place because it was a little bit uncertain what was going to happen in the marketplace. Building sites shut down, construction industry companies shut down, and they were unsure how to correctly follow state guidance. But very quickly, governors realized that construction was critical infrastructure for their industries and they then released orders saying that those workers should be back on the job site. And so in some ways that's really good news for these workers because they're able to maintain their income.
A lot is being demanded of the workers still on the job. They are having to put social distancing in place as much as possible. And that's really challenging on a construction site. As you can imagine, a lot of times these men and women are handing tools back and forth to each other. People in the construction and building trades are being asked right now to go to work every day and work long hours. They’re very likely being exposed to high-risk situations.
These groups also usually have an office that runs the business side, where the union members can go and check in, they can pay their union dues, they can sometimes get dispatched if they're an electrician or a plumber. Those offices are shut down. So their day-to-day resources are not there because the office-based members are not essential and have to work from home. And so it's like if you and I are corporate employees and we were being told we had to be out in the field working, but our corporate office is completely shut down. So we don't really know where to go for resources.
VWH: What is the unique value that Vera can bring that helps solve those challenges?
PF: The Vera model is really helpful for labor groups right now. We provide an opportunity for people to get access to care that they couldn’t have received before. Whether that be TeleHealth via video chat or over the phone to our providers, or actually coming into our care centers. Because some people still need to see providers in-person. So we're still able to keep all of our care centers open to provide that access to care that people need right now.
In many cases, we provide testing to determine whether or not they've been exposed to COVID-19. I think that's a real need for these folks that are out there on these job sites. Whether it's today or as we move forward into this new environment, I think there's going to be a real need for determining if someone has been exposed and if so, let's get them off the job site so that they're not exposing more people. And then beyond just the COVID-19 situation, how do we provide better access, better quality of care to our members in an environment that we, the employer, and/or the union trust fund can customize to best fit the needs of membership.
VWH: Why are you confident labor groups would benefit from working with Vera?
PF: One is that we've had success so far in the public sector with municipal groups, as well as with other labor and multiemployer groups. For example, city and county employees share a lot of similarities to groups in the building trades. Their demographics look very similar. They're typically working in similar environments. The building trades, oftentimes, are working on infrastructure projects that serve municipal government. And so I think the successes that we've had in those organizations, in the public sector, translate over to what we see in the building trades.
Another reason is that labor trust funds are typically responsible for the health of a member and their family over a much longer period than traditional employers, even into retirement. Even if members of a trade switch employers, they will likely remain in the same health and welfare fund. Vera’s care teams have experience working with members from birth well beyond retirement.
VWH: How does the Vera advanced primary care model help labor groups achieve their “value-based” goals?
PF: When you shift to thinking about managing the health of the entire population over time, it clearly requires a different approach than what is available in healthcare today. Our model can deliver 80% plus of care within our care center environment because our teams are not incentivized to treat symptoms and then write a referral or write a prescription. They are trained and incentivized to spend time, listen, and build a care plan that is personalized to each member. This allows us to drive better cost outcomes.
When they do need to step outside the four walls of the care center, we are able to look at higher-quality, lower-cost providers. We also coordinate that experience. This involves helping members make appointments with specialists, communicating with those providers, getting their files to those providers, and getting them back into the care center for follow-up care. It really simplifies things for the member to make it a wraparound solution, that then drives total cost production for the plan.
And, ultimately, we put guarantees around performance so the trust or fund can make sure that the cost reductions actually occur.
VWH: Does what a labor group thinks it needs ever differ from their actual needs?
PF: Labor groups often think that all they need is access to care. They want to have same day access to urgent care. So, I have a cold and I want to get in to see a doctor. And that feels like the right answer immediately.
But when it really comes down to it, that's not the most important issue for the trust. It doesn’t help improve the quality of care, manage population health, or control costs. It’s really just putting a bandaid on the broader problem.
Advanced primary care minimizes obstacles to health by emphasizing time-rich appointments, empathetic listening, and behavior change. The results are better outcomes, improved population health and satisfaction, and fewer claims. While we do set up our care centers to provide that same day access if someone needs it, our advanced primary care model is built around a population health solution. We analyze the population’s claims up front to understand the risk of the population. We conduct targeted outreach to members to get them into the care center before they’re sick. We integrate health coaching and really manage the population as a whole. This isn’t just an urgent care solution.
VWH: What should labor groups be looking to accomplish in 2020?
PF: This is something that we've been talking a lot about the past couple weeks. It's going to really provide an opportunity for them to reevaluate what access they’re providing to their members to get the quality of care that they need. Labor groups are going to have to determine how to create that access to care and to the quality of care that their members really need in this environment. And to do it in a way that you as a plan, what they call like a trust, can control. You can control the investment, you can control the message, and ultimately you can then better control the outcomes that you're getting out of it.