Working to contain the rising cost of health care, LIUNA health and welfare funds have implemented a variety of innovative programs that enhance patient service and save money. Descriptions and comments are below. We invite you to share examples from your fund’s work by contacting the LHSFNA’s Health Promotion Division.
Member Assistance Programs provide Laborers and their families with resources to help assess and address a variety of personal problems including substance abuse, stress and mental health, divorce, interpersonal relations at work or a death in the family.
“Often, a number of problems are mixed up together. Counseling helps the client sort out the causes and make a sound decision about how best to utilize benefits under the overall health care plan.” Sue Harkness, Metro Detroit Health Care Fund.
“The MAP gives the small fund administrator someone she can consult with when problems arise.” Dora Crenshaw, Railroad Maintenance and Industrial Health & Welfare Fund.
“No way is there a downside to a MAP program.” Tom Masiello, Massachusetts Laborers’ Health and Welfare Fund.
Medical Access 101 taps local resources to fill gaps that sometimes arise in a member’s health care coverage due to new member status, temporary unemployment or retirement before Medicare eligibility. It also assists members with chronic conditions that are not fully covered by their health plan.
“We have established relationships with the health care providers in our area, and they earn substantial revenues from our purchase of their services. With Medical Access 101, we’re able to tap these vendors to get something back for our uninsured members.” Cynthia Smith, Central Laborers’ Welfare Fund.
Health Assessments allow the fund’s health care provider to identify Laborers or family members who do not come in for annual check-ups yet have chronic conditions that require disease management.
“People generally won’t go to the doctor unless they feel it’s absolutely necessary. Yet, we know if they wait until they feel sick, it’s already too late. To motivate our participants to talk about their conditions, even if they aren’t at the doctor, we devised an incentive program.” Dennis Sarnowski, Laborers’ District Council of Western Pennsylvania Welfare Fund.
Medical Therapy Management addresses conditions that require specialized, patient-administered drugs by ensuring their unique refrigeration or other shipping requirements, providing equipment for self-administration and facilitating medical services and counseling for patient support.
“LaboreRx, in collaboration with its pharmacy benefits manager Express Scripts, handles specialty medications for patients with chronic, complex conditions and provides focused support services, depending on each patient’s needs.” Mary Jane MacArthur, Laborers’ Health and Safety Fund of North America.