Advanced Primary Care As the First Stop: Expanding Preventive Care Access To Drive Better Outcomes

Join Marathon Health for a timely conversation on how advanced primary care can help employers stay ahead of costly downstream health issues. We'll explore how making primary care the first stop for employees—centered on prevention and whole-person care—can reduce avoidable ER visits, improve chronic condition management, and drive higher employee satisfaction. You'll also hear real-world examples that show how investing in accessible, proactive care leads to measurable ROI and healthier workforces.

Transcription:

Krista Beckwith (00:11)

All right. Good afternoon everyone. Thanks so much for joining us today. As part of our fireside chat or moderated discussion, we're here to really talk about a dynamic challenge we're facing as employers that trifecta of the growing cost of healthcare, the ongoing use of high-cost service settings like the emergency department and urgent care as the most accessible place to get our care needs met, and the growing prevalence of chronic conditions we're seeing in employees. For those of you I haven't had the opportunity to meet, my name is Krista Beckwith. I'm the Vice President for Population Health and Wellness with Marathon. At Marathon, we partner with employers to provide onsite, near-site, and virtual primary care. Within my role, I have an opportunity to act as an intersection point between client strategy, product, and clinical operations, providing a unique perspective for today's discussion. I'm thrilled to be joined here with two dynamic leaders who I'm honored to be sitting next to.

Krista Beckwith (01:07)

The first is Marie Yorn. She is the Director of Total Rewards with the Keystone Cooperative, and within her role leads innovation and engaging strategies to really embrace employees in taking care of their health and wellness. And then next to Marie, we have Allison Velez, our Chief People Officer at Marathon. Part of her role and leadership is keeping employees like myself healthy so that we want to come to work every day. Additionally, Allison is in a unique position because Marathon is a client of its own product, and she has been at a pivotal point over the past year launching our Marathon for Marathon program that gives employees like myself access to primary care through our health centers. We're going to start off our time today with some moderated discussion, and then we will open it up for Q&A with everyone, but please continue to enjoy your food. We up here get a bird's-eye view of everybody and what you're eating. So if you don't finish your plates, I will know and we'll be calling that out, and you'll have to ask the first question when we go to Q&A. So everybody eat up, eat your veggies. So with that, Marie, let's start with you again, talking about this dynamic challenge we have in healthcare. From the Keystone's perspective, what challenges were you facing that really made you stand up and say, we need to do something different now?

Marie Yorn (02:20)

Yeah, I think from not just Keystone's perspective, but any employer, just the rising cost in healthcare, not just for the business, but for employees alone. And then we are in very rural areas. We're primarily in Indiana, and we go all the way out to Zanesville, Ohio, and all the way up to Traverse City. We have 250 branch locations, and a lot of our employees don't have access to care. So that really alarmed me. So let alone just the rising healthcare costs, what personally got me is just knowing to hear an employee say, I don't have a primary care provider. So really focusing on that. We have some high emergency room visits that could be avoided, and then just chronic conditions that could be either avoided or managed if it's caught at an earlier stage. So that for me was like, we've really got to take action on our preventive care for our employees.

Krista Beckwith (03:23)

You come up with these key terms, access and engagement, and these are all terms that we're hearing oftentimes in the employer space and in healthcare in general. Allison, you have a very dynamic perspective in all the work that you've done with different employer groups and providing this type of benefit and coverage. I'm wondering from your perspective, what are some of the obstacles faced by employers when trying to make primary care accessible and engaging for employees?

Allison Velez (03:48)

Yeah, thanks Krista. I think there's a few things that come to mind, maybe three specific areas that I think are obstacles that we're all facing. And I think as HR and benefit leaders in the room, we're probably experiencing some aspect of these. And so the first thing is really that the current traditional healthcare model, which is a fee-for-service model, is often focused on volume and not value. And what that means is that in fee-for-service, many of our providers are not incented to really drive preventative care to identify early detection for chronic conditions. Instead, our employees, their patients, are getting 10 to 15 minute appointments, which are really designed just to address a symptom and not the whole person. So the current model, as we know, fee-for-service, has a lot of challenges, and when we talk about access and engagement, presents some obstacles to our employees, or their patients, who are trying to use the services.

Allison Velez (04:56)

I think the second thing that really comes to mind is that we have a lot of point solution fatigue happening. And I don't know how many of you maybe have five or more point solutions that you've brought together as part of your benefit strategy. I see some heads nodding. We're trying to solve very discrete problems, whether it's diabetes management, or you're trying to create steerage to the most cost-effective surgery centers, or you're bringing a wellness solution. Many of us today have a laundry list of point solutions that we're trying to incorporate. We're trying to bring a holistic offering to our employees to address health. At the same time, what that does is, number one, I think we know this, it's really hard to manage, administer, communicate, and get people to engage with a myriad of point solutions. And I think that complexity really translates to our employees who then don't know how to engage.

Allison Velez (05:54)

It's overwhelming. Instead of maybe taking a step forward to really move their health in the right direction, often they're actually frustrated or overwhelmed, and that actually disengages folks. I think the last area of focus, when I think about obstacles to access and to engagement, really has to do with how fragmented our healthcare system has become. Yeah, so if we think about primary care, but then all of the other needs that our employees may have, such as wellness, perhaps mental health, maybe MSK and other solutions, other needs that they're really trying to have addressed, many times, most times, the providers in that spectrum of services that they need are not coordinated with one another. So the primary care doctor is really unaware and not in communication with the person who's delivering mental health care. So that care can become fragmented and, again, not creating the best experience for the patient. And I think these are really the three big things I'm seeing the fee-for-service model is focused on volume, not necessarily prevention; the second one is we have this point solution fatigue, and we're all trying to put our best foot forward, but in doing so, we confuse people; and then of course, the last piece of it is really just the fragmentation of the types of care that people really need.

Krista Beckwith (07:19)

Yeah, Allison, you hit on a few key points. Having come from the payer space, kind of jumping over to the primary care space, that fee-for-service model is such a struggle and that volume-based care. And really, it's getting that volume-based care to the highest level biller, being that specialist, as quickly as possible so that that revenue can be brought in. And that is such a challenge and that integration of care services and having to be our own navigator. I think about my own care or even the care of my daughter and the number of times I have to talk between people and cross your fingers that I even said the terms correctly from the medical perspective, let alone translated that correctly, how much burden that puts on us. Marie, as Keystone is starting to move forward, where do you guys see yourselves going in 2026? What innovation and what strategy are you starting to shape?

Marie Yorn (08:06)

Yeah, in 2026, I really see us moving towards Marathon Health. We kind of stumbled across Marathon Health, took a deep dive into all the services that are available at Marathon Health. And we have some overweight employees. And for me, I listen to our employees and I want them to feel like they have a voice and that they can reach out with their needs. And just knowing that they have obstacles with weight management, we'll also do the Level Up service to offer that health coaching and nutrition as well, and then even our wellness program to enhance our wellness program. We also have, it's through WellBridge Surgical, which is a bundled price surgery center. So by utilizing Marathon Health, if our employees go to Marathon Health and they need to have an outpatient procedure, we can have Marathon Health give a referral for the employee to use WellBridge Surgical. So because bundled price surgery care, it's cheaper on our plan, it's cheaper for the member, and then we give a kickback incentive to our employees for utilizing WellBridge Surgical.

Krista Beckwith (09:12)

So really, you're not doing much in 2026 is what you're telling me right now in this process.

Marie Yorn (09:17)

We're looking to make some changes. Our employees have asked for a lot, so not a lot. I shouldn't say it's not a lot, but I just really want our focus in 2026 to be the delivery for our employees. You asked, and we've been listening, so just to kind of give that to them, it matters to them, and just to keep our employees happy, I think that's helpful.

Krista Beckwith (09:40)

We're thrilled to be partnering with you, of course. And at Marathon, we provide advanced primary care. And you referenced a couple of services, our Level Up solution, which is part of our health coaching and integration of that wellness support, and how we can support wellness programming. But we talk about this term advanced primary care. And if you don't live in the world of advanced primary care, what the heck is that? So Allison, I'm going to turf this one over to you. So thinking about that term advanced primary care, how does that look different than if I were to drive down the street right now and try to get access at a local healthcare system? And then for any employer who's thinking about taking on an advanced primary care strategy, what guidance would you give them?

Allison Velez (10:21)

Yeah, thanks Krista. I think I'm going to start, before I talk about what advanced primary care is, I want to first acknowledge that as HR and benefit leaders, the work is hard right now. If any of you are in any phase of your benefits renewal, this is very tough work, and it feels like every year gets a little bit harder, and we're trying to be a little bit more creative and make our dollars stretch a little bit further. And as we think about the services, the offerings, maybe the point solutions that we're bringing to our employees, we're often talking about how are we going to invest in our health strategy. And one of the things that I have definitely seen is a lot of times what we're investing in, if it is not a solution that is increasing access, lowering risk, improving health outcomes, or changing employee behavior, which is a big part of making all of this work, we're not actually investing, we are just spending.

Allison Velez (11:25)

And so I don't know how many of you look back on the past few years and you can see where you're spending, not investing. And when we talk about advanced primary care, and I will define it as you asked and talk a little bit about what that means, this is an area where we can really invest, and we know that we can get the types of outcomes we're looking for when we think about advanced primary care. For those of you that may not be familiar with it, I think the first place to start is what is traditional primary care? And all of us probably have some experience with traditional primary care, and yet today, in most cases, that is still operating in a fee-for-service environment. And what that translates to is we can see our primary care provider, but we're still talking about a 10 minute or 15 minute appointment, and we're still only talking about one symptom or one issue.

Allison Velez (12:19)

What advanced primary care does is it really reimagines what that is and makes that care the cornerstone of the health for the individual patient. The way that we do that at Marathon Health is when we work with our clients and we're setting up an advanced primary care offering, what that is bringing to the table for an employer and for their employees are much longer appointments. We're creating access, so we're talking same-day or next-day appointments. And if you think about that for a moment, a same-day appointment with your provider or a next-day appointment with your provider is almost unheard of in most spaces within the healthcare ecosystem today. The provider has the time and the ability to really see each patient as a whole person and not as a symptom that's presenting itself in that moment. So our providers at Marathon Health, for example, in the primary care space, they know that they have flexibility, they have time, and they have the ability to really create a trusting relationship with their patients.

Allison Velez (13:26)

That over time is what leads to the change in behavior, the preventative care, and being able to identify issues early. So we think this is a really important distinction between what we normally think about with traditional primary care. And at Marathon Health, our employees reside in 47 states. So one of the things that we're able to do is through the physical health center sites, we have a network across the country. Our employees are able to access those sites and also have virtual primary care that allows anybody across those 47 states to have access to primary care when they need it. And coupling those two options has been a really powerful way to create access and engagement so that we can really start to change what's happening with our employee health and have an impact there. I think the second part of your question was what advice I would give somebody who's thinking about implementing a primary care strategy in their organization?

Allison Velez (14:30)

And here again, there's a few areas I would probably suggest. And first is to pick the right partner. When you are looking at potential partners, I would check a couple things. And the first is, do you see, feel, and know that there is evidence that there's accountability in the partner, that they will deliver on the promises and meet the expectations that you have of them as a partner, and they should always feel really as an extension of your benefits team and benefits strategy. The second part of that is really to focus in on with your partner that you are working with or partners that you're evaluating, is to talk deeply about ROI. What does it look like in terms of what can be delivered on your investment, and what expectations that you should have, and can they back that up with facts and data and studies?

Allison Velez (15:23)

The second thing is access. So I talked about that a little bit, whether through virtual primary care or in-person primary care, what is the match with the needs of your employee population? And then certainly engagement is critical. How do you actually get your employees to engage with the care, which is step one in order to reap all of the tremendous benefits? And here, a great partner would be working with you on creative ways to create engagement. And that could be, for example, maybe there's no copay for a visit. And so when your employees are trying to decide where to get their care, this becomes one of the most cost-effective and efficient ways to get the care that they need. And it might be through incentives or other creative communication strategies that you drive your employees to be able to use the services, but a great partner, I think, will help identify those creative solutions that work for your situation and your company. Last thing I'll say about this is when we think about advanced primary care at Marathon Health, it is not a bolt-on to our strategy or our program. It is not a point solution. It is the heartbeat that then is connecting the entire ecosystem of healthcare that we're bringing forward to our employees, which is important to make sure that all those other things in the ecosystem are working well as well. So that would be a little bit long-winded, but advanced primary care and maybe some things to think about if folks are thinking about that solution.

Krista Beckwith (16:59)

Awesome. That's such helpful advice. And I think I keep hearing that term partnership, and it truly is, whoever you pick as your partner, it's a long-term partnership. We as humans evolve, we dynamically change. And that partner walks alongside you throughout that. And thinking just as an employee at Marathon, my own experience with our health centers, I have a husband who doesn't like to use healthcare at all, and I'm sure many of you have a partner who doesn't like to use healthcare at all, until I force him to. He'd rather clean the garage than actually go out and get his healthcare visit. But he struggles with anxiety and had a moment where he was having a lot of stress at work and needed access to care quickly. And being able to get in with Marathon Health in a virtual appointment where he could sit down with a provider for 20 minutes, 30 minutes, and actually talk through what was going on to get that best level of support really changed his ability to show up at his job every day. He had called his primary care provider. Guess how long it would've taken him to get in for that need?

Krista Beckwith (18:01)

Three and a half months. And we live in a pretty urban area in Denver, Colorado, so it's not as if I'm dealing with that rural access. And that was just for a general appointment with a provider who probably would've seen him for two minutes and would've spent the rest of the time with a medical assistant. It truly does play out. Marie, coming back to you. Let's fast forward three years from now. Everybody has finished their lunch because whoever doesn't finish, I'm going to call on you, so you better keep eating. Where do you hope that Keystone is in three years? What do you see as success, and how do you know that you'll have achieved it?

Marie Yorn (18:36)

My first success would be everyone having access to care. I think that's most important on my list. As Allison had mentioned earlier, the virtual care, so that to me, when you do a heat map, if not all of your employees are within a certain mile radius of an onsite or a near-site clinic, you can send a kit to them so they can do their routine physical from their home. So there honestly is no excuse for an employee to have care. And it's my understanding, too, and you may add to this, when they do the virtual care, they're meeting with the same physician as they would, and they're getting the same quality of care. So that to me is very important. So them experiencing having the same experience that they would at an onsite clinic is important to me, just for all of our employees across the board.

Marie Yorn (19:33)

I do want to see measurable reductions in avoidable ER visits. We have a lot of emergency room visits that we can avoid. And then also preventative screenings. It's very alarming to me the last year and a half when I review, when we sit down to review our plan, 54% of our employees have not been for a preventive exam or an annual screening. So that to me is very, very alarming. I'm a numbers-driven person, so I want to see that number increase next year. I want to see a lot more participation. And part of doing that, we'll be partnering with Marathon Health, as well as building our wellness program, just enhancing the wellness program to one. We currently have two wellness programs right now. We have some DOT CDL drivers for our company that are in a well driver program, and their wellness is based on their DOT certification, a one to two year certification.

Marie Yorn (20:37)

And then non-drivers go through your traditional wellness program where you're completing a health risk assessment, you're having biometrics done for your blood work. If you don't meet certain criteria, then there's health coaching involved. What our VP of HR, Angela, and I found out this year is that CDL drivers, they're not getting the blood work done. So we have one group of employees who are having all the blood work done, and then one group who's not. So we are missing a huge population of our employees who could have nothing diagnosed because they're not going for a preventive biometric screening. So that is where I really want to move next year as well, just having that one wellness program, and then just the employee satisfaction related to their benefits and their wellbeing. I want them to really appreciate everything that Keystone is offering to them. And then you mentioned also for the Marathon Health, you can do it at no cost. So there really will be no reason. We have an incentive-based program where if employees don't complete their wellness program initiatives this year, they're paying 50 extra dollars per pay next year. So there really is no, there's no reason for them to not have care because the access will be there for them.

Krista Beckwith (22:01)

That's quite a large drink of water to think about success-wise. You'll not be

Marie Yorn (22:06)

Doing much in the next three years. Right. Well, having the supportive leadership, our senior leadership, we have an amazing broker through NFP, they're amazing. They are genuinely an extension of our team. So we sit down with them and we look at all of our benefits. It's not like what all add-ons can we add for you to offer to your employees? They look at Keystone, they're one of us, and that's how we map out our benefits. And it's nice. And I feel that, too, with Marathon, like sitting down and looking at our wellness program, how can we make this one program very robust and work for every individual?

Krista Beckwith (22:49)

So you referenced a couple of key ingredients that access, the ability to get care in the way that that employee wants it, whether that's onsite or virtual in the comfort of their own home, increasing preventative screenings. Think about early cancer detection, early treatment options, early diagnosis of chronic conditions. Yeah, those high claims. The high claims, too. Yep. High claims could be avoidable. Reducing that emergency department utilization and urgent care, which we know has a billboard on every mile of a highway, tells you how quickly you can get in the emergency department. Allison, from your perspective, sniff test, is this type of thing achievable? Is that even something that is a visionary into action that Keystone could really see happen?

Allison Velez (23:31)

It absolutely is. In fact, I'd love to share a couple of insights that we know from our own research, and I can talk about my personal experience at Marathon Health as well as a client of Marathon. I'll start by talking about just broadly. I think most of us may want to know, we've talked a little bit about ROI. How do you get the improvements that Marie is looking for? And when we have studied really what the ROI is across millions of claims, think about 3 million claims that we've studied most recently, what we see is that the ROI starts to happen very fast, and in year one, employers are starting to see an investment and a payoff for their investment right away. That grows over time. So the more consistency you have with advanced primary care, the higher the engagement, the bigger the payoff. And in fact, by year five, many of our clients are seeing, and we see again this through the claims data, you can see up to almost a four times return on your investment. So for every dollar that has been invested in this program, we're seeing those types of really meaningful returns.

Allison Velez (24:44)

My experience says it's really hard to get that kind of a return on other point solutions

Allison Velez (24:50)

and other benefit strategies that we've deployed. Well, you might be wondering, where does that come from? How are you getting that type of a return? And I think this really ties into Marie, your objectives that you shared. And there's a number of places where you really start to see the cost savings come through. And this is again, through that advanced primary care model that we've been talking about. We see a really clear reduction in ER and urgent care visits. ER on the claim study that we recently did, we see a 17% decrease in the utilization of ER. That's meaningful when we go look at what our claims are, where our costs are coming from, getting that type of an improvement goes right to the bottom line. On urgent care, we see just over a 30% reduction in the utilization. And one of the things I find pretty staggering is a 41% reduction in inpatient hospital admissions, which means that those advanced primary care providers are catching things early.

Allison Velez (25:56)

So we're preventing issues from becoming big, and then really reducing the utilization of ER, urgent care, and then the worst-case scenario is hospital admissions. So when we think about ROI, where is that coming from? What's driving it? It's all coming through the trusted relationship and partnership between an advanced primary care provider and their patient. We're capturing them. We understand their issues at Marathon Health and are able to really drive to preventative care and catching issues early. So that's a really critical part of where that value comes from. I think to make this a little more tangible, let's think about it, per employee. What we see is an annual savings of $1,100 per employee that is engaged with the primary care model. For those with any type of chronic condition, that savings jumps up to about $1,400 per year per employee that is engaging in the model.

Allison Velez (27:00)

So we know when employees engage, when they take care of themselves and get their annual exams, they're seeing a primary care doctor who has trust and relationship with them, that we can really start to see that savings happen on an individual basis as well. At Marathon Health, one of the things we just went through, we actually go through client reviews, just like our external clients do. So every quarter we're looking at our data and our metrics and our results. And in our most recent review, we actually found that 71% of our high-risk or at-risk employees who have chronic conditions, for those who were engaging with our own services, we saw a reduction in their chronic health condition issue. So we're seeing improvements in the numbers for those who are engaging. And again, that's our highest risk, most critical population within the organization. So we have firsthand experience, see the benefits, we hear the stories all the time about health that is being changed, lives being changed through getting this type of holistic care.

Krista Beckwith (28:09)

That's amazing. And again, to work for a company as an employee, because I have that opportunity to be the employee in the company where this is delivered, it is such a benefit that I haven't always had in my career, and a reason that I do stay at Marathon and have that access. With just a couple minutes left before we move to open Q&A, I wanted to ping with you both a little bit about the human behind it. Again, I think about my own experience. I think each of us in the audience can think about our own experience or that of a loved one when they went through a health need or they had an opportunity that they needed healthcare and having that time, that time and that access to an actual provider who was going to call them back on the phone. I think if I had gotten a doctor to call me back on the phone before Marathon, I probably would've hung up on them thinking it was a spam call, being like, why are you calling me? I've never had that happen. Now I expect that as part of my care, and I have my provider's first name, and I know who they are. I'm wondering if you can both just quickly talk about a moment or a scenario that really for you made you want to stand up and champion this type of work and the way that we care for each other as humans. Marie, let's go ahead and start with you.

Marie Yorn (29:18)

I'll go first. I think what really drives me is the story that I learned about after I joined Keystone, and it was why they decided to start the Well driver program and the wellness program. So as you know, we have DOT drivers, and we had an employee that was in an accident, and it was a tragic accident, and it was because of a medical condition that could have been prevented. So that's the reason for driving to the Well driver program. So our drivers can have access to care, they would have access to a nurse advocate at any point in time. They're driving for us all the time, so they don't have access to care. So that really stuck with me, and I thought, what can we do and how can we give more for our employees? Give them more access to care? And like I said earlier, that's where we noticed that we are missing a mark with our employees with that preventive care. And with Marathon, too, if they go to a Marathon health clinic and then having their blood work done right there at the clinic before they leave. So to me, I know because I'm doing the benefits, and I understand them, so it'll be messaging to our employees, this is really amazing. Just go, you'll get all the things done. And it's a one-shop stop. It's a one-stop shop. So that's really got me advocating for our employees, and I really hope that they genuinely feel that we are advocating for them and that they trust us.

Krista Beckwith (30:53)

It's a very powerful moment, and I'm sorry to hear about the incident that happened, but very powerful for you all moving forward. Allison,

Allison Velez (31:03)

I'm really fortunate because of what we do, I get to hear these stories all the time.

Allison Velez (31:08)

And I've had people in my team really profoundly impacted by getting this type of care and really improving their health conditions. But there is one story, and it's a recent story I just heard that I'll share with the group that has really impacted me. And we have a teammate who shared this with us just in the past couple months. But when she joined Marathon Health as an employee, she was not seeing a primary care doctor, did not do annual exams, did not have any routines around preventative screenings. It just simply is sort of not been important to her and really not on her radar. And in fact, her family history was very healthy. There were no conditions she was worried about. And in this case, this particular person, in her family history, there was no history of breast cancer. She didn't have a screening like a mammogram, really even on her radar.

Allison Velez (32:12)

And this is not an uncommon story at all. She eventually, because of working at Marathon Health, was persuaded through our incentives, our communications, I talked about those strategies to get people engaged, to start seeing a primary care provider. And over time that provider built trust with her and a relationship with her and really got to know her and encouraged her to go ahead and go through and get her, not just her annual exam, but get her preventative screenings. As it turned out, in this case, this teammate went for a mammogram and breast cancer was detected. It was an early detection, and that's the good news. And because it was an early detection, she was able to get the care and the treatment that she needed right away. And her prognosis and her path to recovery is really strong. It's amazing to talk to her and to hear her story. And she has shared it with a number of people. She really credits that relationship with her provider with not just helping her with her health, but in this case potentially saving her life.

Krista Beckwith (33:21)

Yeah, many, many patient stories that we hear about breast cancer, colon cancer, these cancers that are on the rise and on the rising younger populations, and how often either we put it aside because let's admit, a colonoscopy is not that fun. Who wants to actually have to go through that? But that really could be lifesaving. And having that partner in a primary care provider who's going to listen and who's also going to help persuade you to take those steps, it truly can be lifesaving.

Marie Yorn (33:49)

Absolutely. We had an employee, just to piggyback off that, we had an employee, I don't know what stage their colon cancer was in, but they were supposed to go for knee surgery, and the doctor wouldn't perform their surgery on them until he had his preventive care done, and he went for a colonoscopy. And he has, I believe, I want to say stage three colon cancer.

Krista Beckwith (34:12)

It's lifesaving

Marie Yorn (34:14)

for sure. Right? Yeah. Preventive care is a hot topic of mine, very high on my priority list.

Krista Beckwith (34:21)

So with about 10 minutes remaining, I wanted to open it up to this larger group. What questions, what comments? I'm looking at all your plates. You all did a wonderful job. Many of you are onto the dessert. Dessert, some dessert. I can't see this table. So technically they did. Okay. They did. All right, all right, all right. We're doing well here. What questions come up? What thoughts or comments come up as you're hearing this discussion? Yes.

Audience Member 1 (34:57)

What are the performance metrics that you're looking forward to sharing in, say, first year? What do you want to see as this is successful? And then what would that look like year two, year three?

Marie Yorn (35:10)

So I believe with us focusing on preventive care, making that a high priority in 2026, we are probably going to be faced with some claims, probably cancer claims and other claims that we, so you

Krista Beckwith (35:25)

have more screening

Marie Yorn (35:27)

As we have more screenings, access, more access to care. Probably won't see ROI our first year, but I do hope, I think it just takes that one employee also to go and have that experience. So I really hope to have year one, year two, a really good experience for our employee population. And year three, I would hope to have some ROI, but just really that access to care and employee testimonials.

Audience Member 1 (35:58)

Just in addition, just curiously, the way that your population has worked historically, what was, when you've tried to roll out something in the past, right? This is new, this is a great idea, you should use it. These are the benefits. And you have the early adopters, and they share the information, and then you've got people that are maybe not as ready to jump on. What have you done in the past that you think has really resonated with those second tier adopters? And what do you think you're going to have to do in this particular situation to get folks excited about your new clinic?

Marie Yorn (36:41)

Communication. I think communication is going to be key in this and the why behind it. Just having an unhealthy population, not having access to care. And I think really driving the message to our employees, as you ask, and which we genuinely have had employees ask us if we would have any near-site clinic for them. But just really getting them to understand that we genuinely do care and we are listening to them and giving back to them. I think that

Audience Member 1 (37:15)

Is there any kind of communication that's worked best?

Marie Yorn (37:19)

We do a lot. As in the previous session, not everyone reads their email. Not everyone has an email through their employer. We do several ways of communication. Our marketing team will send out texting communications to our employees. We use Workday, so we have an announcement in Workday that we put out for all of our employees. We have a weekly newsletter, and then monthly I host an open for business call for our employees. I typically do it in the evening, and I chose the evening just in the event that a spouse would want to listen in on the benefit, then they can chime in or join the call and ask any questions. And it's not just on medical, dental, vision, it's across all boards. We're going to be having one on financial wellness coming up. So it's another way for them to say that, for me to say that we are communicating.

Audience Member 1 (38:14)

Also follow Marie on social media. She drives to every location, and it's pretty amazing.

Marie Yorn (38:20)

And meeting employees, I have to say, meeting employees where they are is, that has been, I joined Keystone about a year and a half ago, and we have 250 branch locations, 2,200 employees. And I think getting out there in the field, having that FaceTime does wonders. You walk into a branch, and the admin or manager says, Marie RNs here from HR. Someone were like, go HR. I'm not that type of HR. If you have any benefit questions, if you need help. One location I went to, it was our Traverse City location in Michigan. Just sitting with the employee, not knowing, they didn't know how to create their login for their medical insurance. So literally sitting with them, clicking with them, answering any question they have. Sometimes you'll walk in and employees say that they don't have any questions, right? Then I guarantee you, within five minutes, I have a line of employees. You know what? I do have a question. So meeting employees where they are. And we also have a lot of employee-facing training, an applicator training day, where there's 300 of our employees, and I set up a tent. There I go. And then I'm able to have FaceTime with them. They know that I'm there, and I have my computer with me, and they know I'm happy to help them. And if not, they know that I will return their phone call or answer their email if they have any questions.

Krista Beckwith (39:46)

I like the Energizer Bunny that just keeps going and going and going. I love it. I love that process. It keeps me going.

Allison Velez (39:52)

I might piggyback just a little bit, and having gotten to know you a little bit, Marie, I think you have this just really personal high-touch approach, which I know is high impact. I think the other things that I would add in terms of success, one winnings, it's worked really well for us, is actually bringing the primary care offering right into our incentive program. So we incent our teammates to obviously get an annual exam. We want everybody to know their numbers, but part of that is there's a little bit more if you do that at a Marathon Health center or virtually with a Care Anywhere provider as well. So we can complete an annual exam process virtually. We just use local labs to make sure all the blood work is happening. But designing that right into the other programs like wellness incentives and open enrollment communications is really where we've seen a lot of effectiveness just to weave it into almost everything that we do.

Krista Beckwith (40:53)

That trust, that engagement, that dynamic why, which can look different for different people in terms of why they come to the table, is huge. We have time for one last quick question from the audience. We have a mic runner, and he did eat lunch, so he needs to move.

Audience Member 2 (41:17)

So there's no question that direct primary care or advanced primary care moves the needle in terms of cost and quality. What resources do you bring when things don't work on a conservative care, and now you're throwing in the morass of MSK or cancer? And then what happens because that's when your costs really go up.

Krista Beckwith (41:40)

Yeah.

Allison Velez (41:40)

Do you want to talk about that from a population health point of view?

Krista Beckwith (41:44)

So one of the key components about advanced primary care when we find things and those costs become more significant is anchoring that patient with a primary care medical home. I used to work on the payer side, I've worked in federal, I've worked in private, I've worked in Medicaid, Medicare, you name it. And one of the key things that we always looked to primary care to deliver on, which it struggled in that fee-for-service, was the anchoring of a patient in a primary care relationship. So they have that medical home or that landing spot where the patient is always brought back to. They may be experiencing higher levels of care, MSK or other things that maybe we hook into primary care, but they're always landing back in that primary care home. The moment a patient doesn't have a landing spot to come back to is the moment that you open yourselves up to vulnerability of that patient getting lost in the system or that patient either not getting into the system period, which is also a risk because no care is as risky as high-cost care.

Krista Beckwith (42:43)

Or they end up in a home with a very expensive specialist who they start to see as their primary care provider, whether that's their cardiologist or their endocrinologist, and they're going to them for everything versus being able to stay anchored in that primary care setting. The more that we make care work around the patient versus trying to make the patient figure out how to navigate their own care, it's the place that we will become more successful overall in managing the cost curve in general.

Audience Member 2 (43:12)

Do you have resources for direct specialty care?

Krista Beckwith (43:20)

We do. That is part of, we do navigation services as part of navigating specialty care when a patient does need to leave the primary care setting. At Marathon, we've also built solutions around MSK and some of those high-cost care needs where it stays integrated into the Marathon Healthcare Home. And as referenced in previous sessions, we are also in the center of excellence space, starting to define how best do we partner with those vendors as part of a primary care relationship. Again, keeping that patient anchored in the primary care home is the most successful strategy that you'll have in general. And with that, I'm probably going to get flagged here in a minute. So I wanted to thank you both for your time here today and all of the great advice. And Marie, you don't have a lot going on, so you're going to have lots of extra time coming off this session into 2026, but I believe you ladies will be around for at least a few minutes after the session if there's questions that come up. And thank you all for your time today.