The doctor is in

When Christy Potter developed a sinus infection a couple of weeks ago, she faced a decision: Get it looked after—which could mean waiting for an appointment, camping out at the doctor’s office for hours while missing work—or simply hoping that the condition would improve on its own.

As it turned out, Potter faced no such dilemma: The doctor came to her.

Since February, her employer, the Asheville-based W.P. Hickman Co., has paid a physician to make monthly visits to the plant. The company’s Housecall program gives its nearly 50 employees a measure of preventive care, seeking to address life’s little ailments and head off potentially larger health issues. Employees—most of whom already have health insurance through the company—pay nothing for the service, and it costs the custom metal fabricator very little.

Company CEO Scott Hickman says it was last fall when he “first started to whine” about the need to improve his company’s health-care strategy. “I was aware that we had a lot of health issues—with both employees and their families—that meant people being out of the office. Our full-time employees all have health insurance, but a lot of that is geared to the ‘what happens after something bad happens’ kind of care and not the preventative sort of care that’s actually keeping people healthy.”

Hickman says he wondered if the company could have a doctor come in on a monthly basis and “make old-fashioned ‘house calls’ and talk with employees about anything they wanted to talk about in confidence.”

Hickman had another concern as well: the roughly 10 seasonal employees he hires to shear, weld, machine and pack metal during the busy summer months, most of whom have no regular access to health care except through the county Health Department and local hospital emergency rooms.

“I’m thinking how can I expect to have employees coming in that have no health care [to] work on machines and equipment where—well, happily, we’ve got a very good safety record, but what if?”

Adding seasonal employees to the company’s Blue Cross/Blue Shield plan was out of the question. Health-care costs had already jumped 40 percent that year, says Hickman, and they now account for nearly half of the business’s total labor cost.

His musings eventually led him to Bill Murdock of The Eblen Charities. Murdock knew of a nonprofit primary-care provider, Three Streams Family Health Center in West Asheville, that was looking to connect with local businesses. It seemed a perfect fit. (Business-services organization Western Carolina Industries co-sponsors the program.)

A physician travels to the Hickman factory each month and conducts clinics on various wellness topics, such as high blood pressure, cholesterol checks, quitting tobacco use, weight control and healthy eating. During those visits, the doctor is also available to confidentially address individual workers’ health concerns.

Hickman explains: “An employee with a little bump on their arm might say: ‘You know, I can’t make the time to see a doctor. I can’t be bothered to go in, make that appointment and finally get in and have them say, “You’re fine.”’ They don’t make that effort until it becomes a much larger bump. This, on the other hand, is a way to offer preventative care in a very easy, accessible way.” To date, says Hickman, 20 percent of his employees have participated.

A separate program called Employee Health Connection enables the company’s seasonal employees and their dependents to receive primary care at the Three Streams clinic for a $10 copay per visit. Hickman subsidizes the program, paying $35 per visit. Health Connection does not cover drug or hospitalization costs, but it does give these employees access to a physician that they wouldn’t have otherwise.

Besides enjoying the satisfaction of feeling that he’s doing right by his employees, Hickman says the arrangement is much cheaper than the company’s health-insurance policy, which costs about $5,000 per person per year. If an uninsured worker’s needs far exceed what Health Connection can provide, notes Hickman, they can turn to The Eblen Charities for additional financial help.

A guinea pig

The growing burden of providing health insurance is a universal concern for employers across the country.

Last year, employer health-insurance premiums increased by 7.7 percent nationwide, according to the Kaiser Family Foundation, which provides information about major health-policy issues. Small employers saw their premiums jump by an average of nearly 9 percent, and firms with less than 24 workers averaged a 10.5 percent increase. Since 2000, health-insurance premiums have increased by 87 percent; during the same period, wages have grown by just 20 percent, the foundation reports. In 2006, employers paid an average of $4,200 to cover the insurance premiums for single workers; for a family of four, the average expenditure was $11,500, Kaiser reports.

And as costs rise and more employers stop providing health coverage for their workers, the ranks of the insured are thinning. According to a recent study by Mission Hospitals, 20 percent of Buncombe County’s roughly 220,000 residents now lack health insurance.

“We realized that there’s not going to be a solution coming out of Washington anytime soon,” says Hickman. “So we believe that the best solutions are homegrown. We’re using my company as the guinea pig.

“I think this could work for other companies,” he adds. “And that’s our hope, that they will embrace this.”