By ANNE D’INNOCENZIO
October 3, 2019 - AP News
NEW YORK (AP) — Walmart is rolling out a health care pilot program for its employees that will come up with a curated list of high quality providers but offer fewer choices than under the current plan.
Through the program, Walmart will help employees connect with local doctors in areas like primary care, cardiology and obstetrics. It is working with Nashville-based data analytics company Embold Health, which will cull through vast amounts of data from public and private insurance plans to come up with recommended providers based on effectiveness and cost-efficiency. Walmart will in turn use that data to curate a list for employees.
“It’s a thoughtful approach to a goal of better health and better health care,” said Adam Stavisky, senior vice president US benefits, Walmart during a media call on Wednesday.
The program will cover U.S. Walmart and Sam’s Club workers in Orlando and Tampa Florida, the Dallas-Fort Worth, Texas area and Northwest Arkansas starting Jan. 1. A human personal health care assistant will also be available for workers in North and South Carolina as a go-to resource on billing questions, making an appointment and understanding a diagnosis.
The goal is for the services to eventually be available to the 1 million Walmart and Sam’s Club workers and family members on the company’s health insurance program. The retailer also plans to share its practices with other companies.
The downside of the program is that employees will be faced with fewer doctor choices. Walmart says that workers can use doctors who are not on the company’s curated list but it will cost more.
Walmart executives say it’s hoping to remove a meaningful chunk of unnecessary health care cost for the company and its employees. Overall, employers that provide health coverage have long been frustrated by costs that rise faster than inflation and wages. Benefits experts say other approaches to keep costs down, like raising the deductibles, haven’t worked so companies are focusing more on how people use the health care system.
That can mean offering coverage that steers patients away from expensive hospitals for routine imaging exams or pushes them toward doctors that are considered higher quality. Walmart had already seen positive results through its so-called Centers of Excellence Program, which began six years ago and involves flying employees with serious conditions to out-of-state hospitals with highly-ranked doctors in a bid to cut health care costs. It found that half of its workers participating in the program who were initially diagnosed as needing a spine surgery ultimately did not. And once they were given a different treatment plan, they recovered quickly and avoided a surgery they didn’t need.
“Employers ultimately want people to get the right care in the right setting,” said Paul Fronstin, an economist with the Employee Benefit Research Institute. “Their concern is waste, paying for things people don’t need and paying for care that is potentially harmful. They want people to be healthy, they want them to be productive and at work.”
As part of the pilot program, Walmart is expanding its telehealth program where workers get diagnosed with a live doctor via video. Currently, Walmart offers basic telehealth to nearly everyone on its medical plans for minor medical issues like a sore throat. However, as of Jan. 1, workers in Colorado, Minnesota and Wisconsin can opt to access a personal online doctor and a team to manage chronic conditions like diabetes as well as preventative care.
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Associated Press Health Writer Tom Murphy in Indianapolis contributed to this report.