How Midwest Operating Engineers Increased Preventive Care Visits and Improved Chronic Condition Outcomes

The Challenge

Midwest Operating Engineers Welfare Fund (MOE), a Taft-Hartley fund located in Chicago, IL, faced a familiar challenge for large organizations: union members were struggling to find high-quality primary care in their communities. MOE recognized that this challenge, left unaddressed, would have long-term consequences on the health of their members and their families. They decided to take best-in-class healthcare for union members and dependents – a population of approximately 55,000 lives – into their own hands by partnering with national primary care company Premise Health to deliver convenient, accessible, high-quality care directly to their members.

For MOE, their members’ health and wellness comes first. Their member population is comprised of active workers, their families, and retirees, spread out across the quad cities area, Chicago, and northwest Indiana. Many members work active jobs outside in the elements, operating heavy equipment for long hours. That type of work has the potential to create short and long-term injuries if members don’t have regular access to primary care.

In Chicagoland, community appointment times for primary care have long been an issue. Then the passage of the Affordable Care Act in 2010 created a flood of newly insured people in the healthcare market, without a corresponding increase in primary care providers and appointments. Union workers and their families were waiting for weeks just to see a primary care doctor – if they were able to get an appointment at all. The organization knew that something had to be done. To ensure that their members had access to the breadth and depth of quality care that they needed, MOE decided it was time to provide that care on their own.

Greater access leads to greater results.

Since 2015, Premise Health and MOE have focused on improving access to primary care by opening seven nearsite wellness centers together. As a result, overall member engagement has increased by 12%, center visits are up 20%, and satisfaction is at an all-time high with a net promoter score of 94.

Their vision to build better health was simple:

  • A comfortable space designed for union members
  • Convenient same day and next day appointments, both in-person and virtual
  • Free preventive services and affordable primary care
  • A welcoming clinical staff focused on health improvement and a differentiated experience
  • Create synergy between the services offered and the benefits provided by the health plan, making it easier for members to access and fully utilize their benefits

To bring this vision to life, MOE partnered with Premise Health to provide personalized care to members through a network of nearsite wellness centers.

The Solution

Premise and MOE kicked off their partnership in 2015 by establishing a pilot nearsite wellness center in Countryside, IL, the home of MOE’s main district hall. This first center served members in northern Iowa, Illinois, and southern Wisconsin, increasing primary care access for a large segment of the MOE population.

After evaluating the positive feedback from the initial site, MOE decided to expand the services offered and build a second nearsite wellness center in Merrillville, IN in 2019.

Together, these two wellness centers provided healthcare coverage and primary care access points for 41% of the total member population, an estimated 23,000 lives.

The next year, 2020, brought the COVID-19 pandemic and new healthcare challenges. MOE and Premise worked together to adapt the centers to meet members’ needs. They implemented additional services, including organizing COVID-19 vaccine clinics and, at the Countryside location, added physical therapy and much needed behavioral health services.

Through this long-term collaboration with Premise, MOE was able to deliver on its original vision to create a model of care that provided unmatched access to primary care. They also expanded their vision to provide comprehensive behavioral health and physical therapy, growing needs for their population. All of these benefits were provided at no cost to union members. As health outcomes continue to improve over time, the Fund expects to continue to save on its total cost of care.

As a result of the partnership’s success, MOE and Premise are continuing to build on MOE’s vision by expanding the reach of their nearsite wellness center network even further. In 2023, Premise partnered with MOE, Midwest Coalition of Labor (MCL), and their participating Funds to open an additional five Illinois nearsite wellness centers located in Grayslake, Northbrook, Elgin, Joliet, and Utica.

These sites will provide primary care with provider dispensing and behavioral health services for roughly 150,000 members and their families across Chicagoland. These shared nearsite wellness centers extend access to care for MOE members by an incremental 30%, establishing access to a Premise Health wellness center within 20 miles for 58% of MOE’s membership.

The Outcome

As a direct result of investments in primary care access, MOE has increased preventive care visits and improved chronic condition outcomes for union members, their families, and retirees. They also achieved high patient satisfaction rates, with a net promoter score of 94. Beginning in 2020, many organizations experienced rising costs associated with delays in care for their populations. These delays initially arose during the pandemic but then continued in 2022 as many families put off paying for medical care in the face of inflation. In contrast, the steps that MOE took to engage their population and ensure care remained accessible and affordable has led to higher engagement.

From early 2020 to early 2022, MOE and Premise:

  • Increased overall engagement by 12%
  • Increased overall visits by 20%
  • Increased preventive visits for unique members by 16%
  • Generated positive ROI for the Fund, of more than 1:1 year-over-year1

This strong engagement has led to better long-term outcomes for members, especially those facing chronic conditions.

Together, Premise and MOE achieved diabetes and hypertension management percentages well above national benchmarks.2

Active members utilizing the Premise wellness centers also experienced a 7% decrease in emergency room admissions compared to the 28% increase for non-users, while inpatient admissions increased 1.3% for users compared to 20% for non-users. Additionally, preventive screening compliance rose, up to 20%, leading to earlier detection and prevention of serious health conditions including various cancers.

Today, MOE continues to be committed to delivering high-quality, accessible, value-driven care for their members which has resulted in healthier, happier members, families, and retirees. What’s more? It’s also a sustainable cost trend for the Fund.

“Out of all the programs and initiatives I have been a part of during my time with MOE, the decision to provide dedicated high quality convenient health care access has by far been the most impactful to the hard-working members and families of Local 150.”

Tom Bernstein, Administrative Manager
Midwest Operating Engineers Fringe Benefit Funds

1Premise Health internal analysis of attributed vs. unattributed members from Q2 2020 to Q1 2022.
2HEDIS – The Healthcare Effectiveness Data and Information Set is a tool used by over 90% of U.S. health plans to measure performance of care and service. The National Committee for Quality Assurance (NCQA) ensures that the HEDIS metrics are kept up to date by collecting survey results directly from health plans and Preferred Provider Organizations (PPOs).

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