Health clinics offering St. Louis unions better primary care

Insulators Local 1 newest union to provide service

By CARL GREEN
Correspondent

St. Peters, MO – Imagine having a doctor’s office where you can get in right away, spend an hour or so with your doctor if you need to, and get handed your medicine – not just a prescription – as you walk out the door. And all of it covered by your union’s medical fund.

That’s as opposed to waiting days or weeks to see a doctor, getting rushed in and out and still facing another long wait at the drug store – the way most of us get health care.

This “primary care” concept has been making headway across the country and is finally arriving in St. Louis for unions that sign up with Activate Healthcare, a program run by the Everside Health company in which unions can make primary care – that is, seeing a familiar family doctor for most issues and referrals – more easily available to their members and their dependents.

“This is a great program for our members,” said Insulators Local 1 Business Manager Gary Payeur. “It provides our members with more benefits, incredible service and no out-of-pocket costs. It’s fantastic.” He said an added benefit is substantial costs savings for the union’s health fund. “As more trades sign up, it’s like having our own building trades clinic,” he added.

Local 1 is the second union to sign up for their members. Cement Masons Local 527 was the first several months ago, with several others considering the new service.

“The reason we exist is that right now, the health care system in many ways is broken,” said Ryan Moore senior vice president of sales for Activate, in an interview with the Labor Tribune. “You used to be able to spend a lot of quality time with your primary care doctor. You’d tell him your issues, you’d spend about an hour of time, and trust was built.

“But health care now is all about volume,” Moore said. “Number one, it takes 27 or 28 days just to get in to see the doctor on average in this country. Then they spend an average of 9 or 10 minutes with you, and most of that time they are charting. Those providers have to see about 25 or 30 patients a day on average because it’s all about volume.”

PHYSICIAN FATIGUE
But that’s tough on both the medical staff and the patients. The doctors get burned out and fatigued, and patients don’t always get the care they need, Moore says.

“What’s good about urgent care is that you can get in. What’s bad is that it’s expensive, and you probably will never see that doctor again in your life – they’re there to treat what’s wrong with you right now,” he said.

That system has not only been tough on doctors and their patients, but on unions, too.

“What’s hurting the union health and welfare funds is the insidious creep of chronic conditions,” Moore said. “It’s those people who haven’t had a physical in a few years or maybe not since high school football. They don’t have a relationship with a doctor.”

Programs such as Activate try to improve working conditions for medical staff, he said. “Let’s take the provider from a situation of seeing 30 patients a day and working 15 hours a day to working normal hours and seeing 8 to 10 patients a day,” he said. “I would rather see that provider. They are happier, and that’s why they went to medical school — to give good care and take care of people.”

FIVE CLINICS UP AND RUNNING
It’s also better for patients, he added. “I call, I get in to see the doctor the same day, I can spend an hour with the doctor in person,” he said. “That is what we’re bringing to the unions.”

The company has established five clinics in the region — in south St. Louis County, Florissant, Creve Coeur, Chesterfield and the newest one in St. Peters, where Insulators Local 1 representatives visited recently to get to know the program better. Next, the company plans to open up shops in Festus, Washington and Collinsville and eventually have 12 to 16 clinics in this region.

“These clinics are dedicated to the union working families,” Moore said. “We contract directly with the unions. The health and welfare funds and the families of those funds – those are our customers. We’re not an insurance company, and not a health system, so we serve the customer. When they need to come in, we get them in.”

MEMBERS ARE ENTHUSIASTIC
Insulators Health & Welfare Trustee Tom Leahy was among those meeting company representatives and personnel at the event in St. Peters clinic, at a building on Mexico Road that looks like a traditional doctor’s office. After giving the program a hard look, he was enthusiastic about how it will work out for the membership.

“I think it’s going to be great,” he said. “We just started on June 1, so we’re still in the process of trying to get members. We’ve been going to the apprenticeship school and talking to the young guys about using the clinics and not having co-pays and deductibles, so it’s very nice.

“They can get prescription drugs here and generics,” he noted. “They can just get them here – come in and see the doctor and do everything. The fund pays for it, and we pay for it –– and hopefully, in the future it will save us money.”

Members can go to any of the five  Activate locations once they’re in the system, Leahy added.

“We’re just starting to get reports on how many people are coming, and they’ll tell us what kind of diagnoses people are having,” he said. “We’ve had some good feedback. We give our union physical ––CT scans of lungs for asbestos, breathing tests, covered 100 percent. It’s good every year to see where it’s at, and if you’re getting something else in your lungs.”

While dependents are included in the program, retirees 65 and over are not in the program because they are covered under Medicare, he noted.

BETTER FOR UNIONS
Moore said he can’t overstate the effect the program can have on union locals.

“What they see is their population gets healthier,” he said. “What happens, when you take care of chronic conditions, is that your claims go down. It’s one of these rare things in health care where they are actually getting a return on their investment and their members are healthier and happier.”

The clinic model has been growing across the country but is still relatively new to St. Louis, he said. The company now works with 38 union health funds.

Moore noted that the program supplements but does not replace the medical coverage negotiated in union contracts.

“If you love your doctor, you can still go see that doctor. Your specialist network is still in place,” he said. “But you come here for your primary care, and you can have as much primary care as you like, and if you need to see a specialist or see a doctor, we share notes. When a member comes here, there’s no co-pay, there’s no deductible, there are no barriers to coming here.”

ENTHUSIASTIC DOCTOR
Each of the Activate clinics has a designated doctor. In St. Peters, that’s Dr. Paul Angleton, a youthful physician who demonstrated his enthusiasm for the primary care model at the event.

“This is fantastic,” he said. “It’s such a wonderful perk for people to get through the union or employer. It’s a chance for me to practice medicine the way that I wanted to – having time to actually get to know my patients and being able to call my patients back with results is fantastic, cause then I get to talk to them again. That thing they forgot to tell me about, they remember now, instead of just phone tagging.

“It’s great –– actually having times scheduled with the patients to be able to ask about things, and when something comes up, not saying, ‘I don’t have enough time for that.’ Just having time to actually go through that is fantastic,” he said.

Because it’s still new, the system of clinics currently has plenty of capacity for more patients. If the clinics ever get too busy for one doctor, they are set up for a second one, Angleton said.

“We’re definitely in the rapid growth phase,” he said. “This model of care has been incredibly successful all over the country. It’s just relatively new to the St. Louis area. We ramp up as quickly as we need to. If trajectories are showing we’re going to be at capacity, we’re going to add capacity. The model we run doesn’t work if you overload it.”

FROM A MERGER
Everside, he said, is the result of a merger of companies that were previously developing the concept and learning how it can work for the unions, the union members and the medical staff.

“When these union members are coming in, they don’t have co-pays, so when they come in to see me, they’re not worried about telling me about things,” he said. “In the outside world, you go to the doctor for a physical, and you don’t want to tell him you have a mole, because when they see the mole, now they add an office visit on top of the physical, and you have a co-pay that you didn’t know you were going to have. There are just no surprises like that here. It’s all included.

“We had a guy who came in with a skin infection and left with his antibiotic – not the prescription, but the actual pills. We provide that and we do the blood work and those kinds of things here. It’s kind of that one-stop shop that primary care is really all about. We take care of all of it –– the primary care kind of stuff as well as the more urgent care kinds of things.

“We get you in the same day or the next day, and we’ll get you taken care of. We’ll get your testing done, figure out what you’ve got, get you treated and away you go.”

DOCTOR WITH A LEATHERMAN
Angleton said he enjoys his union-member patients, who sometimes notice the ever-present Leatherman tool on Angleton’s belt – more of a workingman’s tool than a doctor’s.

“Why would I not carry a multi-tool?” he said. “I don’t call the maintenance guy for everything; I just fix it. I think the guys appreciate that.”

And he still dresses like a hard-working doctor on the job, in scrubs.

Anyone interested in finding out more about Everside Health’s Activate program may can call 314-820-0733 or go online to eversidehealth.com. The St. Peters office is at 5700 Mexico Road, Suite 16. Its phone number is 636-224-8445.