How JHF turned access to care into a better bottom line

“We had to challenge assumptions that we didn’t even know existed about how difficult it is to get an appointment, then to get to the doctor, and the experience that they were having in a traditional doctor’s clinic,” said Rich Gau, CEO at John Henry Foster.
He is, of course, referring to the time before the company introduced a Rezilient benefit as part of its healthcare plan. “How do we, as an employer, make access to that care easy? We’ve consciously made this culture of access to care with [Rezilient] by trying to make access to care easy.”
John Henry Foster (JHF) is a small, privately held industrial distributor of hydraulic and pneumatic equipment based in St. Louis, MO. Since the 1980s, it has had an employee stock ownership plan (ESOP) and is currently 100% employee owned. “We try to educate our employees: you are an owner in the company, what you do matters,” Rich continues. “You’re not just a number, you’re not just getting a paycheck. We’re very transparent with all our costs. Every month we publish our sales numbers, our profit numbers, and our income statement. We also share what health insurance costs the company every year.”
Like many businesses, health insurance is JHF’s biggest expense next to payroll. Previously, while fully-insured, the company was seeing a 10% or more increase in the cost of premiums every year.
JHF at a glance:
- Established in 1944
- Based in St. Louis, MO
- Distributor of industrial equipment with territories covering parts of Missouri, Illinois and Kentucky
- 200+ eligible employees
- Rezilient customer since August, 2023
“It wasn’t sustainable,” says Rich. “We had to do something to keep costs under control, but we had no information to make decisions [on a fully-insured plan]. We could have passed more costs on to our employees: instead of the company paying 80% of the premium, we could have only paid 70%. We didn’t want to do that, but if we didn’t get this under control we might not have had a choice.”
Instead, the company chose to transition to a captive arrangement and add an HSA to its health plan, then ultimately a Rezilient benefit.
“The biggest cost in health insurance is sick people,” Rich continues. “So how do we encourage our people to be healthy? Our benefits adviser suggested we run a biometric screening program.” While the initial two screening programs JHF ran saw moderately successful participation — more so when the incentive of an HSA deposit was introduced — it wasn’t until the third program run by Rezilient that Rich saw a tangible impact.
“Previously, the majority of our people didn’t even open the envelope when they got the blood work back,” Rich says. “It was a way to get money in their HSA account. With the Rezilient program, we not only got to a 90% participation rate, people actually took it to their doctor in the CloudClinic or a virtual appointment. We’ve had great success.”
“The key to that success for us with Rezilient is the access to care,” Rich continues. “Our employees have found that this is easy, both the virtual and the clinic appointments. I can tell you multiple stories where our employees have talked about how they like and trust their Rezilient doctor. We’re not only arming them with the information of what’s going on with their health, they have access to doctors who can help them understand it and help them do something about it.”
The biometric program has proven to be an effective way to give JHF employees the tools to be proactive about their health, and it’s helped to establish Rezilient as their home for their care. Over the course of the first 12 months JHF has offered a Rezilient benefit, the engagement rate has been a steady 3% per week, with a total engagement rate above 75%.
Not only that, it’s had tangible effects on the health of JHF’s people. “I’ve heard personal stories where we have caught early detection of potentially serious diseases,” Rich says. “I know of three gentlemen whose screenings showed elevated PSA numbers. Because their Rezilient doctor could go through the results with them, they caught prostate cancer early enough to have non-invasive treatment.”
“And had we not been doing this?” he continues. “What would that have led to? It’s not just the health insurance cost, but just the quality of life. Had we not caught this, what would have that meant to that employee and his family five years from now? I feel good that we can potentially prevent someone from developing serious cancer, or having a heart attack and then needing a bypass.”
Aside from catastrophic situations, less serious illness still has an impact on the company and its people. “If they’re unwell and stressed about their health, they now have a reliable place that they trust to go to for advice and treatment. It’s going to positively affect not only their work life, but their entire life.” Rich says.
Rich also learned that the biggest cost driver on JHF’s health plan is pharmaceuticals. “Having access to Rezilient means we can help get people off medication and into healthier lifestyle habits,” Rich says. “And we like that that’s a core part of how Rezilient operates: not only to provide an accessible primary care service that catches when someone’s blood pressure is high and monitor it easily, for example, but also create a plan to do something about it beyond medication. We want to help people get healthier and stay that way.”
“The goals of our two companies are aligned in what we’re trying to accomplish,” Rich continues. “I’m excited to continue to work with the Rezilient team and see how this evolves. How do we continue to keep our people healthy and keep our retention high? Rezilient is a valuable benefit that we can advertise to say, ‘here’s another reason to come to John Henry Foster, and certainly to stay at John Henry Foster.’”
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