Small Business Partnership

Small Business Partnership “Providing affordable primary health care to small employers” The Relationship  The SC Primary Health Care Association (PCA) met with the SC Small Business Chamber Commerce (SBC) while participating on a Department of Insurance Coalition to address strategies to provide insurance coverage for employees of small businesses. South Carolina Data The majority (75%+) of the employers in South Carolina are small businesses  Small businesses are defined as employers with 500 or less employees  Survey of small employers showed 60% of small businesses with 100 or less employees did not provide any type health benefit to their employees  South Carolina Data  The average cost of health insurance for an individual is $3,700/year according to SC Fair Share. The Partnership The PCA and SBC formed an alliance to address the provision of health care services as opposed to health care coverage. The PCA and SBC held informational meetings across the state of SC, inviting small businesses and health center directors. The First Pilot The first pilot was started in September, 2005 between Mid-Carolina (small employer) and two community health centers in the area (Eau Claire and Richland).  Mid-Carolina provided information on their employees (age, income category, dependents)  The First Pilot The two centers provided visit cost information based on the data MidCarolina provided and developed two options: fee-for-service and capitation  Results:  chose the fee-for-service option. Employees are appropriately assessed based on income - sliding fee scale.  Mid-Carolina is billed for the difference after the employees $10 co-pay  Mid-Carolina The First Pilot Mid-Carolina has extended this benefit to dependents of their employees  A MOU was signed between Mid-Carolina and each health center (Eau Claire & Richland) stating the terms and billing procedures (handout)  Each employee was given a fact sheet explaining the benefit (handout)  The First Pilot  Each employee was given a membership card which clearly states the card is NOT an insurance card. (handout) The Department of Insurance The DOI is constantly updated and consulted. (Excerpt from February 8, 2006 editorial) The Greenville News A small coalition of organizations has offered several realistic solutions to this crisis. The S.C. Small Business Chamber of Commerce, S.C. Appleseed Justice Center, S.C. Fair Share and the S.C. Association of Non-Profit Organizations have taken steps to move the health-care issue onto the state's agenda.  These organizations believe that a combination of public/private hybrid solutions is needed to address both the cost of health care and health insurance.  Here is a summary of just two proposals.  The Small Business Chamber and the S.C. Primary Health Care Association have launched what appears to be a first-in-the-nation pilot program to make health care more affordable for small businesses without insurance. Affordability results from these community health centers being both nonprofits and qualified to draw down federal money to subsidize services to {uninsured} patients with incomes up to 200 percent of poverty. Last September, Columbia-based Mid-Carolina Steel and Recycling entered into a private sector agreement with two community health centers. The workers and family members had a $10 copayment and the employer paid the rest of the cost on a fee-for-service basis.  This pilot program has been a tremendous success for the employees, the health centers and the employer who now can afford to offer important health care to all his workers.   Efforts are under way to help other small businesses in the same way and to secure $5 million in state funding to enable community health centers to serve 12,000 to 15,000 more similarly uninsured across the state. Front of Card SC Health Care Services Partnership This is not an insurance card. Employer Name: _________________________________________ Employer Code: __________________________________________ Employee Name: ________________________________________ First Last Service Type:  Employee Only  Employee/Family Please check with the health site to determine which services are available at that site. Back of Card Because your employer has partnered with a member health care provider organization of the South Carolina Primary Health Care Association, you can present this card at any site of the Eau Claire Cooperative or Richland Community Health Care Association to receive primary and preventive health care services. Pilot Results Total employees 38 (9 managers with insurance coverage; 27 employees with no insurance coverage)  Total # visits between 9/28/05 and 3/28/06 = 21 (10 individuals)  Of the 21 visits: 13 dependents, 8 employees  Total cost to-date: $1,907.52  Expansion of the Pilot Long Drugs (DME Department): 35 employees  SC Manufacturers Extension Program partnership  businesses participate in a catastrophic insurance program  The health centers will provide primary and preventive care  400