(WARRENSBURG, Mo.) – The university signed an agreement Friday with St. Luke’s Hospital of Kansas City, Western Missouri Medical Center and Blue Cross Blue Shield of Kansas City designed to keep costs down by keeping people healthy.
UCM President Chuck Ambrose said one of the biggest changes in health care is that it’s moving to a more outcome-based model.
“One of the only ways for us to control the rising cost is to help provide the highest quality of care at the lowest cost with a culture that tries to keep us well rather than knowing when we get sick,” Ambrose said.
He said the partnership consists of three parts: the health insurance provider, Blue Cross Blue Shield; the health care providers, WMMC and St. Luke’s; and the faculty and staff at UCM.
“Over the last two years, Western Missouri Medical Center and St. Luke’s has been working to provide, under the patient-centered medical home model, a network model that is a patient outcome basis model by which we can have the best care at the lowest cost,” he said.
Chelsea Mudd, the marketing manager at WMMC, said the hospital has taken steps toward the innovative communication care model.
“The agreement is another step toward partnering with employers,” she said.
Ambrose said Blue Cross Blue Shield has provided a benefit structure that helps reduce the cost of the institution’s health care that contributes to keeping tuition low and keeping people employed.
“This is only the first year of the model, so we’re bringing these elements together,” he said.
The goal of the agreement is to stabilize overall health care costs and create a medical home serving UCM faculty, staff, students and their dependents, according to a news release.
Ambrose said the premium cost of a family plan has been expensive, so the new plan will accommodate for individuals and their dependents.
“Our individual employees probably pay two-thirds less than most people pay for individual plans in most work places, so incrementally, it’s a bigger percentage increase, but it’s different than paying $600 a month for families where you just can’t even insure them,” he said.
Ambrose said the new agreement impacts people, but costs should come down if faculty and staff stay within their customized plan.
“If you stay within your customized EPO or PPO plan and utilize primary care as your primary point of provider, your actual copay and coshare of cost will come down,” he said. “If we can mitigate the big increases, the overall cost of our health care under this new plan is less for the university and that never happens.”
There is a possibility that some health care providers won’t be included in the network depending on what tier in which they are included.
“Customized networks do sometimes narrow the choices, but it narrows the choices where almost 90 percent of our use is already going, and then Blue Cross has been willing, if someone is outside of the network, to work as aggressively as possible to get them in the network,” Ambrose said.
He said this agreement is a step in meeting the objectives of higher care at lower costs. He also said it’s a way for the university to save money that is needed to keep from reducing faculty and staff positions.
“If you’re not getting any more money from the state, and you can’t charge students more for tuition increases, and your mandate costs are increasing at the way they are, the alternative the university has is to have less people,” Ambrose said
He said the university’s goal is to have a primary care service for faculty and staff that is convenient and accessible on campus.