Changes to UI Choice give UI employees incentive to seek care at nationally recognized UIHC programs

	UI employees who carry the UI Choice health insurance plan will have smaller copayments for office visits at UI Health Care facilities in 2010. Photo by Kirk Murray.

Changes to the UI Choice health insurance plan for calendar year 2010 will provide a financial incentive for University of Iowa faculty and staff to use University of Iowa Health Care (UIHC) providers and facilities for care—modifications critical to the vitality of UIHC and its 9,200 employees.

Copayments for office visits at UIHC facilities (Level 1 providers in the UI Choice plan) will drop from $10 to $5, while copayments for office visits to non-UIHC facilities (Level 2) will increase from $15 to $20.

Hospital room and board deductibles and coinsurance rates for UIHC hospital service ($400 and 10 percent, respectively) will not change. Room and board deductibles at Level 2 and 3 providers will increase in 2010 ($600 and $800, respectively), and coinsurance for Level 2 will be raised to 20 percent.

UI Choice participants—94 percent of whom live within 30 miles of UI Hospitals and Clinics—will benefit from seeking care at one of the nation’s top-rated providers while also providing UIHC greater capability to help preserve UI jobs.

Tom Moore, University spokesperson and UI Health Care media relations coordinator; Sheldon Kurtz, Percy Bordwell Professor in the College of Law and cochair of the Funded Retirement and Insurance Committee (FRIC); and Richard Saunders, director of benefits and payroll in UI Human Resources, recently fielded questions about the reasons for change, what UIHC is doing to prepare for a likely increase in patient traffic, and UIHC’s economic impact on the state and the University.

fyi: What prompted the changes in the UI Choice plan?

Saunders: Changes to our health plans occur frequently. These could be the result of federal or state regulations, reactions to costs, or refinements to the benefits offered or payment terms. The changes to UI Choice this year are a result of the University trying to encourage our employees and their families to utilize our health care facilities and providers, while still maintaining employee choice of providers.

When UI Choice was designed, the plan had three levels of providers: simply UI health care providers, non-UI health care providers in Iowa, and any other provider outside of Iowa. There were only small differences between the University providers versus other Iowa providers—in some cases, no differences.

Our health care complex is staffed by University faculty and staff—as a matter of fact, the majority of University employees now work in the health care complex. The health care complex is an integral part of The University of Iowa. We need to support that enterprise just like we support other parts of the University. So for 2010 we created a larger incentive to utilize our own services than those of other providers.

Moore: UI Health Care would like for all members of the UI family to discover/experience what a fine resource their own academic medical center truly is, with many nationally recognized programs and services. In addition, we are committed to helping hold down the costs of health care by continually striving to create greater efficiencies across all of our services. Delivering more cost-effective health care provides more resources that we can invest in our strategic missions of research and education.

Ultimately, all members of the UI family benefit if we retain more money in the UI system, which also helps preserve jobs. As a self-funded plan, it is advantageous every time a UI family member is treated at UI Hospitals and Clinics, rather than elsewhere, because the payment stays within the University as an organization.

fyi: How will UI employees benefit as a result of the changes in the health insurance options offered by University of Iowa Health Care?

Moore: UI Health Care is making concerted efforts to increase its focus on enhancing access and service for members of the UI family. Advantages for UI employees include the ability to experience comprehensive care, whether at our primary location or at one of our growing number of community clinics. Other advantages include coordinated health care delivered in more locations, enhanced convenience for patients, and an even greater commitment to providing high quality care.

fyi: What preparations are under way to help facilitate these changes?

Moore: The UI Health Care team is enhancing access to our network of clinics so that anyone in the UI family can easily schedule an appointment in any of our clinics. Efforts are under way to ensure enough open appointments are available to meet the increased demand. We are also striving to reduce waiting times and to increase the number of patients we see every day. In addition, the UI Health Plans Office, at 319-353-7531 or 800-356-8442, is available to help UI employees and their families schedule appointments and coordinate care.

Kurtz: In working with FRIC on this new copay schedule, representatives from UIHC also committed to working with FRIC in developing a questionnaire, satisfactory to FRIC, to determine employees’ level of satisfaction with the care they receive at UIHC. It is anticipated that armed with information from this questionnaire as well as with improvements in scheduling and wait times that the overall health care experience at UIHC will improve.

fyi: It sounds like this can be described as a “win-win” situation, right?

Moore: This enhancement is indeed a “win-win” situation for all of our employees. Our goal is to increase access to our comprehensive, world-class care. Everyone in the UI family can receive that world-class care in locations close and convenient to their homes in a manner that is coordinated, efficient, and cost-effective. Plus, reducing expenses helps all of us so that resources are available for other uses, such as additions to the curriculum, facility upgrades, and other similar needs.

Saunders: We are not mandating care be received at the University, but only offering an incentive for obtaining care here. Everyone still has a choice of where their care can be obtained. We feel we have a first-class facility with first-class providers and as an employer we do intend to support our enterprise. By making these changes we feel that this will result in a win-win for all of us.

fyi: What other incentives for employees come from the UI Choice plan?

Moore: One of the best “incentives” is staying healthy.  UI Health Care is very focused upon primary care, prevention of problems, screening programs, routine immunizations, wellness, and other programs and services geared at optimizing health.

Kurtz: Agreed, the obvious incentive, which is rarely questioned, is the incredible quality of the specialty care one receives at UIHC. That will always be the principal reason employees get their care there. The question is whether UIHC can convince enough patients to also get their primary care at UIHC.

Moore: We are developing a coordinated scheduling function and a common billing platform across the system to include the UI-CMS and UI QuickCare locations. The billing system includes both the hospital and clinic services, as well as physician charges. This means that you get one bill for services at UI Health Care, rather than separate bills for the hospital and each doctor.

Our patients also benefit from having access to their own electronic medical record. When our new service, called My Chart, becomes available in 2010, patients will be able to schedule an appointment, review their records, get answers to their questions, request a prescription refill, and even see their test results in a secure online environment. These advances will enhance our ability to provide unified, comprehensive world-class care.

Additionally, the University also will provide special discounts to all UI staff and faculty at the new Wellness and Recreation Center, along with comprehensive wellness services.

fyi: What economic impact does UI Health Care have upon our community and the state?

Moore: As is the case with the entire University, UI Health Care is a major economic engine for Iowa. Total operating revenues for UI Hospitals and Clinics in 2008 exceeded $866.7 million. According to a study conducted by Tripp Umbach in 2006, those earnings have an eightfold multiplier effect—that provides a boost to Iowa’s economy of more than $6 billion.

by Christopher Clair