Employers are an integral part of the community and require a healthy and productive workforce to be successful.
As a healthcare system and employer to over 40,000 associates, Montefiore Health System can relate to the challenges employers face in providing quality and affordable healthcare to their employees. Internally at Montefiore, we implement employee health programs so that our employees can come to work each day healthy, happy and ready to be productive. We offer this first-hand experience and these programs by partnering with employers to identify high-cost employees and determine impactful interventions that will reduce the cost of care while improving employee health.
Employee health issues we address include:
- Anxiety and stress management
- Complex chronic conditions
- Excessive emergency room usage
- Obesity and nutrition challenges
- Quick access to medical/behavioral health providers
- Substance use
- Worksite injuries
Care Management Solutions
Most employers struggle with identifying and providing care management to employees with the costliest chronic medical conditions such as end-stage renal disease (ESRD), diabetes, kidney disease and cancer, conditions which tend to not be actively managed by insurers. Montefiore Care Management Solutions have a successful track record of engaging with employees.
Orthopedic Bundled Payments
Montefiore is one of eight Joint Commission-certified orthopedic programs in New York State—and the only one in the Hudson Valley—and performs the second highest number of joint replacements in the downstate region. Unlike insurance carriers and third-party administrators, providers and surgeons are integrated within Care Management services when purchasing bundles directly from Montefiore Health System.
The Montefiore Orthopedic Bundled Payment solution includes all services associated with an orthopedic procedure for a predetermined time, typically 90 days' post-surgery. This enables employees to get back to good health and return to the workplace more quickly.
Behavioral Health Solutions
Overlooking the behavioral health issues of employees can lead to higher overall healthcare costs and reduced productivity including challenges with being able to access timely in-network mental health providers. The below illustrates the cyclical impact of leaving employee behavioral health unaddressed in an organization.
Untreated Depression Leads to Lost Productivity and Disability
The Montefiore Health System provides a network of over 1,500 behavioral health providers locally, including psychiatrists with whom employers can contract directly. Montefiore provides a single-point-of-access line for scheduling all emergent, urgent and routine appointments as well as independent medical evaluations and engagement monitoring in behavioral treatment for short- and long-term disability cases.
Gaps in Care
The Montefiore Gaps in Care solution focuses on identifying the employees who may not have received all of their preventive care services during a specified time period. The Montefiore program delivers results by being able to leverage its extensive provider network and technology integration both for community-based and other providers to rapidly identify and close gaps in care. The program focuses on preventive services such as diabetes screenings, cancer screenings and vaccinations.
Data Review and Analysis
- Clinical and nonclinical data analysis
- Claims-based extracts
- Electronic Health Record (EHR) data
- The application of clinical logic to identify gaps in care
- Push identified gaps to providers and employees
- Standard National Committee for Quality Assurance (NCQA) HEDIS® value codes
Employee and Provider Engagement
- Performance monitoring
- Preventive care promotion
- Scheduling of overdue wellness visits
- Tracking gap closures
Monitoring and Tracking
- Coordination with employee, payer, care manager, primary care physician (PCP) and specialist
- Employee education, engagement and preventive health self-management
- Team-based outreach
Musculoskeletal Care Bundles for Workers’ Compensation
Employers typically do not have relationships with local musculoskeletal providers. Facilities such as Burke Rehabilitation Hospital, part of the Montefiore system and a leader in medical rehabilitation for more than 100 years, are effective cost and care managers. By partnering with Montefiore, employers can direct employees to a provider group to access a care bundle for treating worksite injuries at preferred rates for services including physician evaluations, treatments, therapies and injections.
COVID-19 Return-to-Work Package
The 2019 coronavirus crisis has impacted all aspects of work and personal life. Montefiore was one of the first health systems in the New York region to face the COVID-19 crisis, as the Bronx and surrounding areas saw the most infections per capita in the city. It is critical for business continuity in the current era to ensure that each individual in an organization is well-educated in COVID-19 safety protocols. Montefiore is battle-tested in providing COVID-19 services to thousands of patients while at the same time ensuring its own employee’s safety in the workplace.
Montefiore now offers this expertise so that employees can safely return to work. We can help businesses demonstrate to the state and customers that they are ready to reopen. As part of the Montefiore COVID-19 Return-to-Work package, we provide guidance in a variety of key areas including:
- Behavioral health and wellness
- COVID-19 nurse line
- Environmental health and safety site review
- Rehabilitation medicine
- Reopening document review
- Staff training
- Toolkit guidance
Benefits Consultant Partnership
Benefits consultants are encouraged to recommend the Montefiore Employer Partnership Solutions to their clients. By engaging with the team at Montefiore, benefits consultants will be offering a unique and beneficial opportunity to their clients in order to develop a direct partnership with the major healthcare system in the region. We will partner together to review the employer’s healthcare data and make appropriate solution recommendations.