wu direct © a 2015 wu employee health initiative

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WUDIRECT © A 2 015 WU EMPLO YEE H EALTH INITIATIVE

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Page 1: WU DIRECT © A 2015 WU EMPLOYEE HEALTH INITIATIVE

WUDIR

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Page 2: WU DIRECT © A 2015 WU EMPLOYEE HEALTH INITIATIVE

WHAT IS WUDIRECT©

A new program designed to provide WU insureds (employees and dependents) priority access for initial appointments with Washington University Physicians 14 days non-cancer 7 days cancer or suspected cancer

diagnosis

Page 3: WU DIRECT © A 2015 WU EMPLOYEE HEALTH INITIATIVE

WUDIRECT©

Endorsed by: Washington University HR WU/WUSM Central

Administration WUSM Clinical Department

Heads

Page 4: WU DIRECT © A 2015 WU EMPLOYEE HEALTH INITIATIVE

WUDIRECT©

Importance to WUSM: Approximately 48% WU insureds seek

care from non-WUSM providers Loss revenue $18m - $22m annually Ability to provide enhanced care and

lower cost to WU If successful, sets stage for WUSM

exclusive network product offering in 2016

Page 5: WU DIRECT © A 2015 WU EMPLOYEE HEALTH INITIATIVE

WUDIRECT©

Importance to WU Insureds: Enhanced care Lower out-of-pocket co-pays

and deductibles

Page 6: WU DIRECT © A 2015 WU EMPLOYEE HEALTH INITIATIVE

WUDIRECT©   HMO/POS Plans PPO Plans   WUDirect Other WUDirect Other

Non-preventive PCP Visit

$15 $25 10% 20%

Non-preventive Specialist Visit

$25 $40 10% 20%

Preventive Exams/Diagnostics

$0 $0 0% 0%

Chiropractic/Spinal Manipulation*

N/A $40 N/A 20%

Outpatient Mental Health

$25 $40 10% 20%

ABA Therapy for Autism (UHC)

$25 $40 10% 20%

Autism Services (Anthem BCBS)

    10% 20%

PT/OT/Speech Therapy $25 $40 10% 20%Urgent Care Facility Services

N/A $35 N/A 20%

Non-Preventive Diagnostics- Lab/X-Ray services- Major Radiologic

Tests

 N/AN/A

 10%20%

 N/AN/A

 20%20%

Page 7: WU DIRECT © A 2015 WU EMPLOYEE HEALTH INITIATIVE

WUDIRECT©

Perceptions That Must Be Addressed For A Successful Program: Timely access to care Patient confidentiality

Page 8: WU DIRECT © A 2015 WU EMPLOYEE HEALTH INITIATIVE

HOW WILL IT WORK?• WU insured calls department to schedule an

appointment• If appointment is not able to be scheduled in

a timely manner, patient calls 314-747-6500• Access specialist calls Scheduling Supervisor

for assistance getting a timely appointment• If appointment is not able to be scheduled,

Access specialist notifies FPP Clinical Operations

Page 9: WU DIRECT © A 2015 WU EMPLOYEE HEALTH INITIATIVE

HOW WILL IT WORK?• FPP Clinical Operations calls

Department Business Manager/Executive Director for assistance

• If a timely appointment is not able to be scheduled, FPP Clinical Operations notifies FPP CEO

• FPP CEO calls Department Chair for assistance

Page 10: WU DIRECT © A 2015 WU EMPLOYEE HEALTH INITIATIVE

WUDIRECT©

Page 11: WU DIRECT © A 2015 WU EMPLOYEE HEALTH INITIATIVE

WUDIRECT©

We Need Your Assistance Identifying obstacles to program

success Designing a methodology to

achieve targeted appointment wait times

Educating your staff regarding WUDirect©

Timely feedback about how it’s working