One to One Health adds clinics at Purdue, Middle Tennessee

March 26--Faced with ever-rising health care premiums for its employee health insurance, Hamilton County government leaders decided three years ago to try a different approach to primary care for its 4,500 workers and their dependents.

As part of its Cigna health insurance plan, the county added a physician-led clinic on site along with its in-house pharmacy and wellness center at its McDaniel Building in Highland Park.

"The goal was to have a medical home to provide our employees access to care that is convenient and affordable so that we can take a more holistic approach to health care," said Alecia Poe, human resources administrator for Hamilton County government.

The county selected a new physician-led business known as One to One Health Physician Network to help improve the convenience of care and lower the more than $30 million-a-year cost of employee health care for the self-financed county government.

The new business was created by Dr. Keith Helton, who has practiced internal medicine and pediatrics in Chattanooga for more than two decades while serving in leadership roles for both Erlanger Health System and the Galen Medical Group. Helton helped establish a clinic at Baylor School nearly a decade ago, which he still oversees, and was so confident in the on-site health and wellness program that he offered to be paid by Hamilton County, at least in part, on the savings he expected the county to reap by giving better access and monitoring of primary medical care and improving referral to other physicians and specialists in its network.

The Galen Medical Group operates a clinic for One to One to serve Hamilton County employees with a physician, physician assistant and nursing practitioner in the McDaniel Building, which is open weekdays from 8 a.m. to 6 p.m. The firm also helps promote wellness, nutrition, health coaching and coordination.

In its first year, the county estimates One to One helped cut the county's primary health care costs by nearly 10 percent from what they would otherwise have been, according to estimates by Russ Blakely & Associates, the health care adviser for the county.

"Being located on site, the medical clinic is more convenient and is a less expensive option for the employee to seek primary care," said Brent Wick, employee benefits advisor for Russ Blakely/ "For the county, the costs tend to be less as a fixed fee, rather than on a cost-of-service payment plan."

The county is still tabulating the results from the past year for preparation of its fiscal 2017-2018 budget. But Poe said the clinic has helped lower health care costs from what they otherwise would have been in each of the past three years by treating ailments and diseases earlier and providing more coordinated care.

The county estimates the number of persons in its plan rated to potentially have moderate to high risk of health problems has dropped from more than 90 percent three years ago to about 62 percent today.

Helton said One to One focuses on education, prevention, and behavioral change and care providers focus on cost-effective treatments and referrals to the best physicians to treat individual health problems.

"I try to apply the principles of taking care of an individual to taking care of a group of individuals and doing the most good for the most people," Helton said. "It really feels good to me to help employers and their workers and I feel like physicians are well suited to do that. A lot more employers today are really grabbing on to the idea of on-site clinics and population health."

Expanding to Purdue, Middle Tennessee

The company's success with Hamilton County government helped One to One land another county on-site clinic contract with Sumner County, Tenn., which began in January covering about 8,000 people with several clinics in county facilities.

"Our families are excited about our new partnership with One to One Health, especially the extended hours," said Del Phillips, director of schools in Sumner County. "This allows us to add value to our employees and offer them access to a world-class team of physicians and facilities."

In July, One to One will add its biggest contract so far at Purdue University, where One to One was awarded a three-year contract to manage the Center of Healthy Living at Purdue's West Lafayette campus. At Purdue, One to One will provide an on-site clinic and care for up to 30,000 employees and their dependents.

Helton's firm was selected for the $2.75 million contract at Purdue from among a number of competing on-site clinic providers. One to One is expected to help cut Purdue's health care expenses by $255,000 below the current vendor's budgeted expenses.

Audrey Mosely, director of operations and business development at One to One, said the company is gearing up to start the Purdue contract on July 1 and will add up to 20 staff members to handle and staff the clinic and the program administration.

On-site clinics, Helton says, allow employees to get more convenient and quicker treatment of health problems and such services can be delivered with far less time off work and in a more cost-effective setting.

"By focusing on health quality rather than service quantity, we deliver improved health along with bottom line savings," Helton said.

Nearly half of all Americans don't have a primary care doctor, but Helton said studies show "the most effective way of prolonging life at the highest quality and at the lowest cost is to have a primary care physician."

Mosley said another key advantage is the improved communications offered about health care for both employers and employees who participate with the company's clinics and providers.

"We also create web sites for our clients with customized patient portals and information for HR departments to send to their employees about ways to improve their health," Mosley said.

One of One is not an insurance provider. Instead, the company is an additional benefit to employees who want to access care quicker at on-site clinics or participate in savings incentives for participating in wellness programs or using in-network physicians. Helton insists that One to One is different from other clinics in that it customizes its health and wellness programs.

Although the new contracts this year are rapidly expanding Helton's business, he insists he doesn't have any set growth targets for the future and is cautious about getting over extended or not fulfilling his pledges.

"I just don't think about what growth we will have in the future," Helton said. "My goal right now is to make sure we c0ntinue to provide the very best care we can in Hamilton and Sumner counties and to get ready to provide great care for the folks at Purdue," Helton said. "If we take care of people and do what we say we are going to do, then I'm a firm believer it will work out just fine."

Contact Dave Flessner at [email protected] or at 423-757-6340.

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