Independent healthcare provider WeCare tlc explains the ‘mafia’ system of the American healthcare industry.
Often, the simplest solution is the best one. Yet, industries can get tangled in bureaucracy and greed that puts profit before people. This is one of the issues with the healthcare system in America; an issue that an experienced and dynamic primary care provider is aiming to solve. By simplifying the process, relying on data, and prioritizing population health over their bottom line, WeCare tlc is partnering with employers to offer high-quality care.
For nearly twenty years, WeCare tlc has worked closely with clients to tailor healthcare plans for employees and their families. As an independent, women-owned business based in Altamonte Springs, Florida, they are making waves in an industry that typically relies on big corporations to fill this need. These corporations running the American healthcare system are saturated with conflicts of interest and profit-orientated dealings.
Raegan Garber Le Douaron, President and CEO of WeCare tlc, says “Hospitals are actually incentivized to keep people unhealthy because healthy people typically don’t need their services. As a privately held organization, we are focused on increasing population health and supporting employees through ancillary programs to improve their well-being. Health systems are technically not-for-profit but in reality, they are primarily concerned with market share.”
She continues: “In every community in the country, competing health systems will purchase primary care doctors and have contract clauses that require a certain percentage of patients to be referred to their service providers or facilities, whether the service is needed or not,” she continues. “Doctors are financially incentivized to fulfill these obligations and penalized for not doing so. What I always tell people who are not in the health care or health benefits space is that healthcare is our only legalized form of mafia in America.”
Raegan goes on to explain the self-serving feedback loop at the heart of the industry. “Health systems (hospitals) have always butted heads with health plans, but now health systems have moved into paying claims, which is typically what the health plans do. These huge health systems now administer health plans, pay the claims, and own care delivery services so they have control over the whole supply chain. The health plans are getting into the healthcare delivery space to control their destiny. None of it benefits the patient or the employer paying the costs for the health plan”
This is where the independent nature of WeCare tlc can shine. Without shadowy motivations of sales targets and a conflicted supply chain, this provider is focused on reducing healthcare costs for employers by getting people healthy so they only use the health plan as needed. “We know our clients’ employee assistance programs so we can support them in individually tailored ways. We treat the person as a whole, rather than a bunch of symptoms or conditions,” Raegan shares.
WeCare tlc has an independent clinical team that is not personally incentivized to increase services—and their background in healthcare and medicine means they understand the mechanisms that make healthcare cost more. “We are an ally to employers, helping them navigate this industry and services on offer,” says Raegan.
As a healthcare provider, they are often mistaken for health insurance, but that is not their remit. They work with employers to discover the pain points in their health plan, devise a strategy depending on the size and location of the company, and provide a medical resource. Part of the WeCare strategy is to integrate with other programs that the employer has to maximize their utilization. “We like to change company culture into a culture of wellness,” Raegan emphasizes.
“It’s important for employees to be aware of the benefits and take advantage of the programs. We give the employer everything they need to communicate to their teams and review annually what’s working best. Access to care is a huge issue in America, especially in rural areas. 40% of the population have health insurance but for all intents and purposes, they are uninsured because if you cannot access the care, it is of no use.”
WeCare TLC is bringing unbiased care to less populated areas and running robust data systems to show tangible results for its clients, upheld by CEO Raegan Garber Le Douaron, a firm believer in the philosophy of prevention: “Better care that is also more affordable comes from being proactive with treatment and awareness in the early stages of feeling unwell,” she says. “Other providers are now waking up to the prevalence of anxiety and depression but we were aware even before the pandemic and have a strong focus on supporting the mental health of employees and their families.”
To find out more about how We Care tlc is revolutionizing healthcare in the workplace, check out their website.
Published by: Martin De Juan
