DELAND − The Volusia County School Board − which has 6,300 employees with health insurance − has awarded a $153 million, three-year contract to a new provider, Texas-based Curative.
Some − but not all − of the teachers, administrative staff, bus drivers, cafeteria workers and other employees at Volusia County’s largest employer will have to find new doctors. Curative claims to have about 1 million providers nationwide, including 427 locally who will be accepting new patients, while Halifax Health, AdventHealth, Orlando Health, Mayo Clinic, Nemours and Shands are all in network.
District officials decided to engage in an open negotiation with providers after Florida Health Care Plan, Inc., signaled a need to raise rates by about 20% after claims came in at $63 million, an amount exceeding what the district was paying in its annual premium, $59 million.
Florida Health Care and Curative were the only two health-insurance carriers to engage with the district’s insurance committee since January.
But the upstart’s offer including $0 premiums for its lowest plan, $0 copays and $0 deductibles, its provider list of as well as its preventative-care model won out. Both the committee’s recommendation and the School Board’s vote were unanimous.
Even still, John Cash, the superintendent’s chief of staff and a longtime Volusia County Schools principal, said moving away from Florida Health Care Plan was no easy decision.
“There’s an emotional part of this discussion,” Cash said. “I’ve been with Volusia County Schools for 34 years. I’ve only had Florida Health Care. I’ve only had one primary care doctor. So these changes are not something we take lightly.”
District officials signaled to employees that change was coming and some board members said they had received calls of concern.
Stephanie Workman, director of human resources, payroll and benefits, said the district will immediately start transitioning employees to Curative by assigning employees to “care navigators,” Curative employees who will be available to members to help find providers and be resources for questions.
The district will extend its open enrollment period from July 21 to August 15 with a “road show” for employees to learn about the plan in DeLand, Daytona Beach, New Smyrna Beach, Orange City, Deltona, Ormond Beach, Port Orange and DeLeon Springs.
The changeover takes effect on Oct. 1.
Curative’s path from COVID to preventative care
Curative CEO Fred Turner, 30, is a native of West Yorkshire, England, where he won the UK Young Engineer of the Year award at age 17.
He moved to the United States and by 2020, he had attempted several startups, when the pandemic shut down many businesses. Turner saw an opportunity and developed a COVID test that received emergency-use authorization from the Food and Drug Administration, allowing Curative to boost its employee count to more than 2,000.
As the pandemic eased in 2022, Curative got into the health insurance market, with an approach heavy on preventative care and a slogan, “No copays. No deductibles. No … really.”
Turner appeared at both May 13 Volusia School Board workshop and regular meetings, answering questions and presenting about Curative’s “unique” plan focused on preventative care.
According to Turner, 55% of employees in Florida with high-deductible health plans “could not afford their out-of-pocket costs if they had a major medical event or were diagnosed with a chronic illness.”
Also, 32% have outstanding medical debt for expenses not paid for by insurance.
Meanwhile, due to cost:
“So the stuff you most want people to do is what they’re most likely to put off,” Turner said.
Meanwhile, he said 10% of high-premium insurance plan members have on their own cut their medication dosage in half in the past 12 months because of cost.
“Long term, that is not the right solution to manage down long-term costs,” he said.
“Out-of-pocket cost,” he said, ” … no matter how small it is, that financial barrier puts people off seeking care.”
‘Carrot-and-stick’ approach to preventative healthcare
In the short term, those employees might save a few bucks, but by not having a primary-care physician review bloodwork and addressing an issue before it gets worse, both insurers and employees will end up paying more in the later years when ER visits and specialist visits are required.
No-cost copays play a big part in Curative’s efforts to engage members in preventative medicine, Turner said.
“You can go see your (primary-care physician) for zero dollars. You can have a baby for zero dollars. You can get cancer care for zero dollars,” he said. “And everybody gets that for the first 120 days on that plan.”
However, that $0 copay goes away unless members complete what’s known as a “baseline visit” within that 120-day window, Turner said, describing the visit a virtual, 45-minute to 60-minute Zoom call.
“As long as you show up and do that visit, you will continue having the no out-of-pocket cost for the rest of the year,” Turner said.
“If you do not show up, if you won’t give us one hour of your time to think about your own preventative health, on that 121st day, you will revert back to a $5,000 deductible, 20% coinsurance, and copays on most services,” he added. “So it’s a big financial carrot and stick to get people to engage once a year.”
Of Curative’s members, 98% make their baseline visit, he said.
Can Curative fill Florida Health Care Plan’s shoes?
Volusia County Schools figures to become Curative’s largest employer, leaving the insurance committee with lots of questions.
Workman described Curative as a newer company but one that had made a “huge footprint in the state of Texas.”
A reference that uses Curative communicated to the Volusia committee that it had seen an increase in the percentage of employees who accepted health insurance because it was something they could afford.
“That was a huge piece for me to hear because, as many of you are aware, we have some employees who say, ‘I can afford the insurance (premium). I just can’t afford anything that comes after – the copays, the insurance pieces, the out-of-pocket, the prescriptions,’” Workman said.
Jessica Scott, senior vice president at Brown & Brown Insurance, acted as an agent helping to navigate the district through the negotiation.
Support to employees will be a critical test for Curative, she said.
“Florida Health Care has done a phenomenal job here locally supporting your employees and your HR team and they’re a great partner here locally,” Scott said. “… They have a whole team that they have dedicated to Volusia schools and they have done a remarkable job answering issues. Curative has big shoes to fill there.”
But she said Curative promised to place one full-time employee locally, while its 160 care navigators will be available to employees by phone, text or email. Two Curative employees will also be on site for open enrollment, she said.
This article originally appeared on The Daytona Beach News-Journal: Volusia school employees to get new health-insurance company, Curative of Texas
Reporting by Mark Harper, Daytona Beach News-Journal / The Daytona Beach News-Journal
USA TODAY Network via Reuters Connect
