Washington, D.C. — Private health plans at many of the nation's largest corporations are proving to be lean, mean and accountable—using the same principles of coordinated-care found in the Affordable Care Act, according to “Fortune 500 Employers' Influence on Health Policy,” a general session at this year's HCap Conference in Washington in December.

That's big news in a nation struggling to find a universal healthcare formula, which is why the audience of providers, managed care executives and healthcare lenders were hanging onto panelists' every word, especially those of Tim Dickman, President of QuadMed.

As the “insourced” health plan at Quad Graphics, the nation's second largest printer, QuadMed was started in 1990 with a simple mission: to be an “affordable, high-quality healthcare provider” for the internal audience of Quad Graphics employees. It was a radical enough idea at the time that only got more innovative as time went on.

Twenty one years later, the QuadMed mission has stayed true to form, with one exception. Today, QuadMed exports its brand of corporate healthcare to companies all over the Midwest, and has put the company on the map as a viable alternative to conventional healthcare options. This has translated to the installation of in-house clinics at companies like Milwaukee-based Briggs & Stratton. Operated by QuadMed, the clinics offer a full range of primary care, dental, vision, occupational medicine and select specialty care such as cardiology, dermatology, obstetrics/gynecology, and orthopedic surgery.

“Because large companies are often bearing the risks of increased healthcare costs, they don't just take off-the-shelf products from insurers,” said panelist Steve Wojcik, VP, Public Policy, National Business Group on Health. “They change the provider-network structure. They change the benefits. And they say (to insurers), work with these other vendors.”

It's these economies of scale that are the driving force behind QuadMed's success. But what sets QuadMed apart from other corporate-provider programs is that QuadMed learned early on, well before there was an Affordable Care Act, that wellness and preventative medicine make for healthier employees, which in turn drives cost out of the system.

“Large companies really get the fact that you have to have a wholistic, integrated program. The days of sort of bolting on programs, like a chronic condition program, are much less effective,” said Dickman. “I think that's one of [QuadMed's] secret sauces. We've tried, through technology, to be an integrator and connect the dots.”

For large corporate plans like QuadMed's, wellness is not just an add-on that dresses up a traditional insurance plan but never gets used. Rather, wellness is at the core of the program, and preventative medicine is a part of everyday life for employees under the QuadMed plan.

“One of the things that makes a (corporate) wellness program successful is the one-on-one, in-person touch to the participant,” said Wojcik. “Financial incentives go to a certain level, but after that, how much you're paying them is what's going to get them to quit or lose weight or whatever. It's trying to figure out what motivates the person. That's the key to success.”

In addition to requisite health assessments, QuadMed's approach is to encourage associates to auto-enroll in its wellness program. In turn, the associate begins to see immediate material returns in the form of a benefit card that earns the user points for reaching benchmarks and rewards them with of premium reductions over time. Dickman warned, however, that the requirements for such benefits under the QuadMed plan are stringent. For example, patients who are deemed overweight use Body Mass Index as a target for wellness and have to lose 10% of their total body weight in order to receive the maximum amount of reward points.

“I think where this goes is putting people in charge and giving them better tools tied to reference-based pricing,” Dickman said. “If I, as a patient, could go online and learn where I could get that kind of care in my area, it really leads to the disintermediation of the insurance companies. That's the strategy we're embarking on, and other big companies are trying to drive to that sort of model.”