Wellvana Enterprise — Self-Funded Employers

Wellvana offers a suite of services proven to help your employers live healthier lives and lower your healthcare costs. Wellvana has paired these proven programs with a network of the very best physicians in our markets. Our clinically integrated network of providers work with your employees to ensure they have access to the right care at the right time, keeping your employees healthy and your costs low. In select markets, Wellvana has partnered with leading health systems to ensure your employees have great access to hospital care.   

Self-funded employers have a direct incentive to not only keep employees and their families healthy, but also to keep healthcare costs down. Wellvana aligns incentives across our network to ensure that the claims you pay each month are the most effective use of your healthcare dollar. Our goal is to lower your healthcare costs so you can use those funds to re-invest in your organization or in another area of need.

PROGRAM OVERVIEW

Wellvana offers proven tools to improve health and reduce medical costs, all powered by a clinically integrated network of physicians.

Wellvana’s Care Management Program works at multiple engagement points to ensure your employees have great access to world class care in a cost-effective way:

CORE PROGRAMS—

Disease Management

Our expert clinical staff connect with your employees in a variety of ways to ensure they have access to the care, resources, medication and education they need to live their healthiest life, no matter what chronic issues they are dealing with. Unlike other care management programs, our care managers have direct access to our network of world class providers to ensure patients get the coordinated care they need.

Patient Navigation & Network Access

Our team works with patients to ensure they are able to get into the right doctor at the right time. Our network of physicians are committed to ensuring Wellvana patients get priority scheduling for urgent clinical needs. The Wellvana physician network is built to keep patients out of more expensive sites of care without impacting access or outcomes.

Patient Advocacy Program

Our Care Managers round daily on patients who are admitted to one of our Network facilities to ensure patients have an advocate during their hospital stay. This program ensures that patients are given the right clinical options for their condition. In addition our team works with hospital providers to ensure patients have a coordinated plan of care that connects them with the resources they need once they are discharged. Our Care Managers are trained to walk alongside patients from the very beginning of their care to ensure they can get back to normal as soon as possible.

Utilization & Medical Review

Unlike other utilization review companies, our team works directly with our network physicians and on the ground care managers to build the right care plan for the patient. Our program has been shown to simultaneously reduce costs and improve outcomes for patients. We ensure that every dollar spent on a patient’s care has a direct positive impact on the patient’s health.

Wellvana Clinical Centers of Excellence

Wellvana’s network includes multiple specialty groups that have created nationally recognized Centers of Excellence for various conditions and diseases. Our local teams work directly with our network Centers of Excellence to ensure your employees have expedited access to these world class programs. Cancer Care, Dialysis Care, Artery and Vein Care, Lung Care, Pain Management and Heart Disease are just a couple examples of the Centers of Excellence available through the Wellvana network of providers.

 

COMPLIMENTARY BUT OPTIONAL PROGRAMS—

Onsite Clinics

Wellvana leverages its proprietary technology and provider network to provide a comprehensive on-site employee clinic. Our clinics can help patients when they are ill, provide expertise in disease management, and connect patients with a variety of specialists, all for less than the cost of a traditional on-site clinic.

Employee Wellness Program

Wellvana takes a different approach to Wellness Programs. Often, these programs are provided by a stand alone, third party vendor, with little direct connection back to happier, healthier employees and reduced costs. Our program focuses on reaching out to the right patients at the right times with tools that connect their wellness care to their clinical care.

Biometric Screenings

Wellvana offers on-site biometric testing with medical oversight from our network of clinically integrated physicians. Unlike stand alone screening companies, our local physicians review all results and work with our team members to build personalized care plans for employees who have test values outside normal ranges. If needed we can provide immediate access to a physician for employees who have a critical result.

Wellvana Stop-loss Program

Wellvana can work with your existing stop-loss carrier or one of our preferred stop-loss carriers to build a solution that aligns the interests of all parties to ensure your employees get cost effective care. Typically, physicians have little incentive to control costs. Through our model, our network of physicians is directly aligned with ensuring the cost of care is controlled without negatively impacting the experience or outcomes of your employees. Often, actuarial companies will price in immediate stop-loss savings when care is managed by a clinically integrated network like Wellvana.

High Performing Hospital Contract

Wellvana has partnered with local hospital systems in the markets we serve to combine the best network of doctors with the best hospital systems. Now for the first time, employers have access to both groups under one solution.

 

Self-Funded Plan without Support of a Clinically Integrated Network

Typical self-funded plans pay claims as they come in, relying on various programs to ensure care and costs are appropriate.

Self-Funded Plan with the Support of Wellvana

Wellvana aligns incentives across our network to ensure that the claims you pay each month are the most effective use of your healthcare dollar.

 

SERVICE
TYPICAL 3RD PARTY PROGRAM
WELLVANA PROGRAM
CORE PROGRAMS
 
 
Disease Management
Managed as a stand-alone service
Integrated into the other Wellvana programs to ensure continuity of care
Patient Navigation & Network Access
Not a typical service offered by third parties
VIP access to all physicians within the Wellvana network
Patient Advocacy
Not a typical service offered by third parties
Ensures your employees have an advocate before, during and after trips to the hospital
Utlization and Medical Review
Typically built for hospitals and Insurance companies
Built as a patient and provider centric service that focuses on doing the right thing for the patient
OPTIONAL PROGRAMS
 
 
Biometric Screenings
Provided as a stand-alone service
Integrated into the other Wellvana programs to ensure continuity of care
On-site Clinics
Stand-alone onsite clinic without the backing of an Integrated physician network
On-site and virtual access options to fit any budget
Employee Wellness
Success varies greatly in this space
Integrated into the other Wellvana programs to ensure continuity of care
Wellvana Stop-Loss Program:
Stop-loss carriers rarely factor in the benefits of working with a clinically integrated network of providers like Wellvana
Wellvana has relationships with carriers that incorporate our proven cost reduction strategies into stop-loss rates
High Performing Hospital Contract
Traditional hospital rates are expensive and do not include the care coordination efforts that are part of the Wellvana Patient Advocacy Program
Wellvana has strong hospital rates with the leading hospital systems in the markets we serve. We can pass these rates on to you as immediate plan savings

IllUSTRATION

Self-Funded firms of all sizes can easily save on medical claims costs by using an clinically integrated network like Wellvana.

DOCUMENT

WITHOUT A NETWORK LIKE WELLVANA

Claims costs could easily rise by over 10% each year

Wellvana focuses on not only driving claims costs down, but also in ensuring employees are healthier and more productive.

Firms can immediately benefit financially through reduced claims costs.These savings can be reinvested in another area of need.

FREQUENTLY ASKED QUESTIONS – 

LEVEL FUNDED PLANS

What size employer can participate?

Wellvana and its partners can provide the programs above for self-insured employers of any size in our current markets.

How does the employer obtain a quote?

We can provide a customized proposal for your self-funded plan. There is a simple guided questionnaire that we walk through together to ensure we are providing the right level of resources to ensure your employees get the maximum benefit.

How do we integrate these programs into our current plan?

In most cases, we strongly encourage in-person enrollment, so that all employees understand how to get the most value out of the innovative tools and resources provided by the Wellvana Network.  In addition, we have found that building a plan design that drives patients into the Wellvana Network is the best way to ensure the plan’s success.

Does everyone in the company have to use the Wellvana programs?

Our programs are voluntary for all employees, however case studies have shown that proactive education through in-person enrollment, effective plan design  and the use of employee incentives are by far the best way to ensure collective success for the employer and plan participants.

How do I incorporate the Wellvana Provider Network into our current self-funded plan

Wellvana can be a third option to the traditional in-network / out-of-network plan designs.  Through plan design, we can incentivize patients to choose Wellvana providers. Patients usually see lower out of pocket costs when accessing our providers and the employer can save money by knowing that the Wellvana providers are incentivized to lower costs while keeping employees healthier and happier.

Can my employees use the Wellvana Care Management Resources without utilizing the Wellvana Provider Network for care?

Yes. The Wellvana Network provides great access to world-class physicians in the markets we serve, however patients still have the choice to go outside the Wellvana Network for care. Combining the Wellvana Care Management Programs with the Wellvana Provider Network is by far the best way to ensure the patient gets the most comprehensive access to coordinated care.

Our expert team is standing by to build a customized plan to meet the needs of your self-funded health plan, please fill out the form below or email us at employers@wellvana.com