An Employer-Directed Health Plan That Seeks To Reenergize Primary Care
- 1Raymond Zastrow (raymond.zastrow@quad-med.com) is president of QuadMed LLC in West Allis, Wisconsin.
- 2Thomas Van Gilder is medical director of quality initiatives at QuadMed in Sussex, Wisconsin.
- 3Leonard J. Quadracci is chairman of the QuadMed Advisory Board in Sussex, Wisconsin.
- ↵*Corresponding author
- Business of Health
- Cost of Health Care
- Organization and Delivery of Care
- Financing Health Care
- Primary Care
Practice QuadMed LLC.
Who and Where An employer-directed health plan, a subsidiary of Quad/Graphics, which is a large Wisconsin-based printing firm. Eleven workplace clinics in four states, employing forty-two full-time-equivalent providers, serve as preferred sites for members to receive primary care.
Core Innovations Providers are salaried and receive bonuses based on clinical quality, customer service, and collegiality. Claims and pharmacy benefit data are used to monitor patient outcomes such as medication compliance and preventive screening. Premiums are reduced for members who participate in health promotion programs.
Key Results Actuarial studies indicate that Quad/Graphics’ health care expenditures are 17–31 percent lower than those of similar employers in its region. Employees’ participation in a health promotion program for two years or more was associated with increased physical activity; reduction in tobacco use; and reduction in cholesterol levels.
Challenges It is likely that a major portion of the cost savings were produced by improved employee health, decreases in use of health care, and thorough preventive care. However, further studies are necessary to determine the relative cost-reducing role of the health plan’s aggressive contracting with external providers.
In the 1980s, the rising cost and questionable quality of health care attracted the attention of Harry V. Quadracci, founder of Quad/Graphics, the largest employee-owned printer of magazines and catalogs in the world. Trying to address both cost and quality problems, Quad/Graphics created a subsidiary, QuadMed. In 1991 Harry Quadracci launched his new, company-owned health plan—initially housed in a single clinic staffed by a doctor and a nurse—with the words, “We’ll keep you well. And if you get sick, we’ll take care of that, too.”
That prevention and wellness philosophy continues to animate QuadMed, which today operates eleven clinics employing forty-two full-time-equivalent providers—including family practitioners, internists, pediatricians, physician assistants, and nurse practitioners—as the centerpiece of …
