Statesboro-based TransformHealthRX recently was named one of the 50 fastest growing women-owned/led companies in North America by The Women Presidents' Organization, in partnership with American Express OPEN. And the local company is changing the way city and county governments provide health care services for their employees.
Founded in Bulloch County in 2006 by registered nurse Allison Judge, TransformHealthRX provides clinical case management services through established centers for employees and their dependents that are part of a self-insured health insurance plan.
The city of Statesboro recently held a ribbon cutting ceremony for its new employee Health and Wellness Center founded and operated by TransformHealthRX.
"The first meeting that I had with the company was almost two years ago," said Jeff Grant, human resources director for the city of Statesboro. "We have a self-insured health plan which means we have a pool of money dedicated to pay for primary care for our employees, before re-insurance kicks in. Containing primary care and chronic care costs are very important."
Grant said employee/dependent use of the center for primary care such as regular office visits, physicals, pharmaceuticals, and labs is designed to capture about 50 percent of the primary costs of health care for those enrolled in the city's plan, which equates to 25 percent of total claims.
"In other words, TransformHealthRX will oversee the employee's health care through the center, managing what services they may need outside of the center, such as x-rays, mammograms, or care from a specialist," he said. "Instead of employees managing their own care, TransformHealthRX does it, which cuts down on unnecessary visits, as well as lower costs contractually with specialty providers and pharmacists. Employees can visit the center without paying anything, and generic drugs and lab work are only $5."
The program begins with a complete risk assessment for each employee. With good program communications, the program typically achieves 90+ percent participation rates. Each risk assessment is evaluated by one of the company's provider teams, and a wellness plan is developed based on each employee's individual needs. The clinic providers schedule consultations with employees to discuss starting a pro-active plan to reduce their controllable risk factors.
"Our employees do not have to take a half of a day off to get medical care," Grant said. "They can go for free to the center without having to take any time off, and get seen, and leave with the prescription that they need. I cannot tell you the difference in moral and productivity that we have seen in just two months. It is tremendous."
Judge said her idea for the company came from her experience as a clinical case manager for Iraq/Afghanistan war veterans at Fort Stewart in Hinesville.
"In 2003, the Army had over 1,500 soldiers requiring treatment upon their return from the Middle East, and they needed a process to fast track these soldiers back to health," she said. "Several of us were hired to do that, to case manage their care. The Army realized over $20 million in savings in a very short period of time, because the nurses were local, and were familiar with all of the medical providers in the region. I felt that I could translate that same type of service to a different population - worksite health care and correctional health care."
Judge said it is typical to have 15 percent of an employee population being responsible for over 80 percent of an employer's health care costs.
"We have learned 'boots-on-the-ground,' face to face health care delivery is the best way to connect with those patients and get results," Judge said. "The Team One Program uses the worksite clinic to engage, encourage, educate and reward participating patients for progress in managing their conditions such as diabetes, high cholesterol and hypertension."
Judge said that people want to be compliant with their diagnosis, in other words, they want to do what is necessary to treat whatever condition they may have, however, there are barriers for many in the workforce that keep them from being compliant.
"If you have someone making $10 an hour, they may have to decide between paying rent or filling a prescription," she said. "Typically, they are going to pay rent which means their health care suffers, and they end up at the hospital. If they owe a bill to their primary care physician, then they just won't go, yielding the same result. If we remove those barriers, the cost of medication, and the cost of a doctor's visit, then they become compliant, and their overall medical costs are greatly reduced as in-patient admissions are drastically reduced."
The city of Cordele has had TransformHealthRX in place since least September.
"We have a self-funded plan for our employees which was paying about $1.5 million in claims every year, and the wellness programs that we had in place really weren't working," said David Wade, human resources director for the city. "After the initial startup we are seeing $12,000 to $15,000 a month in savings."
Wade said it has been a "good news project" for the city as it has been the single most effective program implemented in recent memory resulting in improved employee relations, as well as tremendous cost savings to the city, and ultimately the taxpayers.
"Our employees can go to the doctor, come out with whatever medications they may need, and be back to the worksite in one hour," he said. "If we did away with this today, I would be out of a job, because this has been so well received. Just the savings in our pharmacy and lab costs would knock your socks off."
TransformHealthRX operates 26 health and wellness centers throughout Georgia, South Carolina, North Carolina and Tennessee.