Orlando Harmon
WellNet is a healthcare company that offers self-insurance services for small and mid-sized businesses. The company aims to provide less costly health insurance plans for companies and their employees, with a focus on proactive cost management and control. WellNet offers custom plans and a hospitality-style service model that guides employees through the healthcare system with personal advocates for access to the right providers, fair pricing, and quality care. The company also provides health coaching services and data visibility to help members make informed decisions about their healthcare. Overall, WellNet's goal is to encourage good behaviour and keep members out of the hospital, while also offering savings opportunities for employers.
| Characteristics | Values |
|---|---|
| Type of Insurance | Self-insurance service for small and mid-sized employers |
| Cost | Companies pay a fixed premium. If the premium is not used, it accrues as savings. |
| Services | Health coaching, care navigation incentives, creative plan designs, and real-time management |
| Goal | To enable companies to take ownership and better manage the cost of their health benefits |
| Focus | Member-centric, with personal advocates for access to providers, fair pricing, and quality care |
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What You'll Learn
WellNet's self-insurance program for small and mid-sized businesses
WellNet is a healthcare company that offers self-insurance services to small and mid-sized businesses. The company was founded in 1994 with the goal of helping companies take ownership and better manage the cost of their health benefits. WellNet's self-insurance program allows companies to pay a fixed premium, just as they would for traditional insurance. If employees' medical claims are less than the fixed premium in a given month, the difference is saved and can be used to offset future claims. This self-funded plan provides transparency and control over costs, with real-time tracking of performance and expenditures.
WellNet's program includes software and predictive modelling services provided by Healthcare Interactive Inc., using their Point-to-Point (P2P) platform. This technology enables employers to make informed decisions with data visibility and proactive claims management. Additionally, WellNet offers health coaching services, where nurse coaches use real-time data collection to identify and support members at high risk of requiring care.
The company's approach, dubbed "Crawl, Walk, Run", recognises that each company has its own unique culture and pace for adopting changes. This flexibility allows employers to customise their plans and evolve them at a comfortable pace. WellNet also provides a healthcare concierge team to guide employees through the healthcare system, ensuring access to the right providers, fair pricing, and quality care.
WellNet's self-insurance program aims to reduce costs for both employers and employees, with savings opportunities and $0 cost care options. By partnering with provider networks, WellNet offers small and mid-sized businesses access to healthcare solutions that were previously only available to larger companies.
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WellNet's health coaching services
WellNet offers a range of services to help make healthcare more affordable for companies, employees, and their families. They provide a self-insurance program for small and mid-sized businesses, allowing companies to pay a fixed premium and accrue savings if employees' medical claims fall below that premium in a given month. WellNet also offers health coaching services as part of their self-insurance program. Using real-time data collection of prescription information, nurse coaches can identify members at high risk of requiring care and ensure they receive the necessary support. This proactive approach aims to keep members out of the hospital by encouraging good behaviour and providing access to a health advocate or concierge.
Overall, WellNet's health coaching services strive to improve access to healthcare and promote cost efficiency. By combining data-driven technologies with personalised guidance, WellNet empowers members to make informed decisions about their health while assisting employers in managing the cost of health benefits. Through proactive coaching and advocacy, WellNet aims to keep members healthy and out of the hospital, contributing to a positive healthcare experience.
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WellNet's cost-saving strategies
WellNet is a healthcare company that offers less costly health insurance plans for small and mid-sized businesses. The company provides a self-insurance service where companies pay a fixed premium, and if the employees' medical claims fall below that premium in a month, the difference is saved and returned at the end of the year. WellNet's cost-saving strategies include:
- Control and Transparency: WellNet offers control and transparency to employers, helping them make proactive decisions to manage costs. This includes providing access to vetted solutions, plan performance reviews, and real-time data management.
- Custom Plans: WellNet uses a toolkit approach ("Crawl, Walk, Run") to tailor health plans to each company's unique needs, culture, and savings goals. This flexibility allows employers to evolve their plans at a comfortable pace.
- Healthcare Concierge Team: WellNet provides employees with a healthcare concierge team for guidance. This team helps employees navigate care options and make cost-effective decisions, potentially saving companies up to 10% through incentives and creative plan designs.
- Proactive Claims Management: WellNet helps lower plan costs and positively impact stop-loss expenses by proactively managing claims. This includes implementing the right stop-loss strategies, pharmacy strategies, and $0 cost care options.
- Health Coaching Services: Self-insured members have access to health coaching services. Nurse coaches use real-time data to identify high-risk members and ensure they receive the necessary care, with the goal of keeping them out of the hospital.
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WellNet's custom plans
WellNet offers custom plans for companies seeking to provide affordable healthcare insurance for their employees. WellNet's custom plans are designed to fix, repair, and upgrade a company's health plan. This is done through a process called "Crawl, Walk, Run", which acknowledges that each company has its own unique culture and pace.
The custom plans are based on a 20+ point toolkit, which includes a hospitality-style service model that focuses on the member first. This means guiding employees through the healthcare system with personal advocates to ensure access to the right providers, fair pricing, and quality care. WellNet's custom plans also include a healthcare concierge team for employees, which can save companies money through care navigation incentives and creative plan designs.
WellNet's self-insurance program is designed for small and mid-sized businesses. Under this program, companies pay a fixed premium to WellNet, and if the employees' medical claims fall below that premium in a given month, the difference is saved and can be used at the end of the year. This self-funded plan provides transparency, allowing employers to know exactly how much they are paying for each aspect of the service.
WellNet's self-insured members also have access to health coaching services. Through the use of P2P with real-time data collection of prescription information, nurse coaches can identify members at high risk of requiring care and ensure they receive the necessary support. WellNet also shares this data with providers so they can actively manage the care of high-risk members.
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WellNet's partnerships
WellNet has launched a self-insurance program for small and mid-sized businesses, partnering with two of Eastern Pennsylvania's largest provider networks. Under the WellNet program, companies pay a fixed premium, and if the employees' medical claims fall below that premium in a given month, the difference is accrued as savings. If the claims go above the premium, the stop-loss insurance included in the plan covers the difference.
WellNet's self-insurance program is based on software and predictive modelling services provided by Healthcare Interactive Inc. based in Glenwood, Maryland. Using the company's Point to Point (P2P) platform, employers can track, in real time, the performance and expenditures of their individual plans. Self-insured members also have access to health coaching services provided by WellNet.
WellNet is actively seeking new partnerships with PPOs with the intention of expanding to another 10 markets nationwide.
WellNet Integrated Care Program is a suite of GP-led programs providing targeted and coordinated chronic disease management delivered through a Patient Centred Medical Home model. This approach shifts the focus of health care delivery from the clinician to the patient through a redesign of infrastructure, health care team roles, and modes of delivering care.
The WellNet Integrated Care Program is supported by public and private funders, including Primary Health Networks (PHNs) and private health insurers (PHIs). Sonic Clinical Services (SCS), the primary care division of Sonic Healthcare, has partnered with PHNs and PHIs to resource primary care in a way that complements the Medicare fee-for-service structure. In New South Wales, SCS has partnered with Sydney North PHN and four PHIs to fund the BeWell program through five general practices. In Victoria, SCS has partnered with the Australian Health Service Alliance, a service company representing small to medium-sized PHIs, to deliver the program through six general practices.
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Frequently asked questions
Wellnet is a healthcare company that offers less costly health insurance plans for small and mid-sized businesses. They aim to provide companies with ownership and management of their health benefits.
Wellnet offers a hospitality-style service model that is people-centric. They guide employees through the healthcare system with personal advocates for access to the right providers, fair pricing, and quality care. They also provide health coaching services and real-time data collection of prescription information to ensure high-risk members are receiving the care they need.
Companies pay a fixed premium to WellNet, similar to conventional insurance. If the employees' medical claims are less than the premium in a given month, the difference is saved and can be used at the end of the year. If the claims exceed the premium, stop-loss insurance covers the difference.
