Saint Francis Healthcare announces insurance plans for small, medium businesses

Saint Francis Healthcare announced Monday morning that the organization will offer medical insurance for both small and medium businesses, with plans to start in January, 2021.

The goal of the plan, officials said in a press conference, is to cut out the middle man and keep care local with a wide-network plan.

Wide-network plans include any provider within the local market, not just Saint Francis providers. Officials said the Poplar Bluff Regional Medical Center will be included in coverage along with SouthEast Health and Missouri Delta.

Alex Ogburn, vice president of Saint Francis Medical Partners, said coverage provided by a medical institution is becoming more popular, but the majority of those doing it only provide narrow-network plans, which limit those with the insurance to that specific provider.

“While there are some cost savings to that,” he said, “it’s disruptive. We see that employees, just as much as employers, don’t really like that.”

Ogburn said Saint Francis will offer two plan options, one for businesses with less than 25 employees and one for more than 25.

Details of the plan, such as benefits and deductibles, come out of conversations between Saint Francis and the employer. Under these plans, however, businesses can cover up to 100% of the cost of insurance with deductibles as low as $0.

Ogburn said most employers cover 80% of insurance cost.

The goal is to start offering coverage in January, since that’s when most employers’ insurance renews. Ogburn said there are some who renew in October and Saint Francis will work with those who do.

Those who do renew in January are usually starting conversations in September or October for the next year, Ogburn said, and as such Saint Francis needed to release the program before those conversations start in order to be in them. He said one business interested is already in the bidding process, or first step of determining what insurance it will offer employees for 2021.

While the UnitedHealthcare dropping Saint Francis as a covered organization helped prompt this move, Ogburn said, it’s been in development for about three years.

Chief Administrative Officer and General Counsel James L. Burke said Saint Francis is still in negotiations with UnitedHealthcare about that situation.

Ogburn said the rising cost of insurance is being felt in the area and part of this step is a goal to decrease that cost again.

“The cost of health coverage continues to increase nationally, and we do see that in Southeast Missouri,” he said. “We do see companies that are seeing double digit increases on their benefits annually. And many of which will tell you, it’s unsustainable.”

The main area to decrease the cost is by cutting out the middle person, officials said. That way there’s nobody in between Saint Francis and the business to pay, and lowered prices are seen by the businesses.

“One nice thing about this is when you cut out the middle person and actually have relationships with our local employers, when we lower our prices we’re lowering their price directly,” Burke said. “No one else to skim off part of that hard work. That hard work is for our neighbors and our fellow parishioners and people in the community.”

Maryann Reese, president and chief executive officer of Saint Francis, said this move will also allow for a more preventative approach to health care. Primary care physicians will be able to see if, for example, a patient hasn’t filled their blood pressure medicine for two months and talk with the patient about why.

“This allows us to really manage the health of our population, which we’re really, really excited about,” she said. “Now that means calling the sickest 25% of our patients on this plan, and really working with them to have better health, and we don’t do that today.

“Insurance companies don’t do that. They want to deny care. So, it’s not about denying care. It’s about really partnering with our community members that have synchronous health plans, partnering with them and making sure they get wellness.”

The Saint Francis system includes over 350 providers in 25 different specialties. It includes primary care facilities in 10 cities in Southeast Missouri including Poplar Bluff, Dexter and Sikeston as well as seven urgent care facilities.