Greetings! 

The field just continues to grow, and as we reported earlier, now all state employees in Montana (an entire state) will have access to on-site clinic services.  A year ago we would not have predicted this (at least not this soon).

The Tennessee process continues with amended material released as recently as the 23rd of May.  We love it when states and public institutions enter in the field as customers because the process has to have some exposure to public scrutiny, and this means that the material for the RFI, RFPs, and the background for analysis is out in the public domain.

This kind of ransparency can be fun.  Take a look at the Tennessee procurement document, and you will see the process they have laid out and the Q&A that they have gone through with vendors.  They also have a spreadsheet that details their concept of risk and how they think a vendor should share in that process.  The whole program is rather focused on wellness and prevention, but it has a significant on-site preventive service as part of the process, and the bonus standards are really interesting in that they are oriented toward the management of disease states and the measurement of population health status.

Speaking of transparency, when will hospitals figure out that more is better than less?  Anyway, the big hospital story of the past week is the World Record for the largest hospital bill ever recorded....at something over $9M.  Can anyone say "stop-loss?"  The bill actually was generated last year, but it hit the news again this year as the New York Times reported on debt collection personnel embedded in the EDs of large hospitals.

So, while employers are talking about embedded care management and ways to keep beneficiaries out of the ED, the hospitals are embedding their collection agents in the Emergency Department to catch the employees that don't get it.   

Congratulations to Ernie Clevenger and CareHere.  We reported earlier that the whole state of Montana (at least all the state employees) was up for grabs as administration officials grappled with proposals from several vendors, including what some might have viewed a "shoe-in" (MiCare of Montana).  MiCare officials aren't happy about this, so we'll have to wait for the other shoe to drop (sorry for all these references to footwear, but the subject just begs the use of these phrases) after MiCare formally registers their objections.

However, in the meantime, CareHere officials, who won the contract (also beating out another Montana favorite, Cooperative Health Center), is surely busy getting the first clinic ready to open - projected to serve 11,000 employees and dependents, which does not yet have an opening date.  There will be a potentially rough road to fruition with Republicans in the legislature opposed to opening the clinics without legislative approval.  The Governor, who supported the plan, is, of course, a Democrat.  Where else but in the U.S. could a political issue get in the way of saving huge amounts of money and improving health status (projected savings are more than $100 million over five years after all clinics are running)?   

This time, congratulations go to Purdue and to CHS and their team recently unanimously endorsed as the new on-site vendor for students, employees, and contractors on the Purdue campus.

This must be the month where vendors prove that their services are really national since Indiana is one state where vendors abound (CHS home offices are in Reston, VA).  Most universities are large employers; Purdue University in Indiana has approximately 10,000 employees and 12,000 dependents. The center will serve an entire range of ages from newborn-to peds-to adult.

The contract is for a three-year period, and if you liked the specifics on the state contracts referenced in the previous article, take a look at this link for all the CHS/Purdue details. 

We are all aware of RepuCare, NoviaCare Clinics, and OurHealth, with corporate offices in Indiana (all three in Indianapolis - getting a little crowded there?).  Enter Activate HealthCare, a more recent start-up (also headquartered in Indianapolis) which started with a clinic for Monroe County government workers in 2010.  These providers are, at least right now, relatively small vendors, but they compete with the bigger, more established players and the hospital systems and are obviously coming out on top.

We are not sure how many of the markets are now being shared between local or regional providers and the national groups, but this does seem to demonstrate that there is a demand process that seeks a local solution and a segment that is focused on national presence.  Many recent contracts suggest that each of these categories of vendors are going to be competing head-to-head in coming years. 

Take a look at the conferences scheduled for the summer and fall.  Global and the World Congress are represented with their offerings that specifically address the "on-site" community.  However, there is an important conference at Harvard that is a fall offering which also merits mention.  If you take a look at that conference, you will see that it has included Ray Fabius, M.D. (a recognized pioneer in the on-site industry).  The conference is more oriented to wellness and prevention, but anything with Ray involved will eventually get around to addressing on-site programming.

If you want to do one of the industry-specific conferences, they are recruiting attendees now, and a call or a contact with either could get you a significant discount.  I would suggest that participating in conferences is like any negotiation process - you won't get the best price unless you ask for it. 

Sincerely,