SelectHealth provides administrative service and healthcare coverage to 515,000 members.

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There are many insurance companies, but SelectHealth is “more than a normal insurance company,” CEO Sid Paulson says. Based in Salt Lake City, the non profit firm is part of Intermountain Healthcare, a non profit system of hospitals, clinics and doctors.

SelectHealth started operations in December 1983 and today provides administrative service and healthcare coverage to 515,000 members, Paulson says. He notes that the company distinguishes itself from competitors by taking cost-effective initiatives.

Making a Difference
For instance, by studying clinical data and claims information, SelectHealth partners with Intermountain and providers in the primary care setting to create programs to help manage disease and give the most effective care. Extensive programs have been created for congestive heart disease, diabetes, asthma and preventive services such as immunizations and cancer screenings.

With this information, physicians can understand best practices and the cost differences in the ways “they practice for different types of disease,” Paulson explains. “We know we can make a difference in how care is delivered,” he says.

In addition to its role as “the eyes and ears” of the marketplace for Intermountain, Paulson explains SelectHealth’s  low costs also drive other insurance companies to charge less. “They have to keep their prices in line with ours [in order to compete],” Paulson explains.

Helping People
Paulson has 32 years’ experience in the insurance industry, and joined SelectHealth in 1993. “The last 15 years have been particularly fulfilling,” he says.

“In insurance, you can’t always cover everything,” Paulson admits. “However, if you belong to a delivery system, you can help people.”

Celebrating its 25th anniversary this year, SelectHealth is continually looking for ways to be engaged in the community. The company partners with health organizations throughout its service area to raise awareness for health issues and support community events.

The company also benefits from a pervasive spirit of volunteerism among employees as they participate in many community efforts, including volunteering at a Title One elementary school nearby. Annually, SelectHealth says it holds a free Family Fitness Festival to promote healthy behaviors, nutrition and safety in the surrounding community.

In addition, when Paulson started at SelectHealth, the company had a case where the son of a member had hepatitis and needed a liver transplant. Although the client’s policy did not cover the transplant, SelectHealth worked through Intermountain Healthcare to organize fundraising efforts for the transplant. “That young man received a liver within a few months, and became a healthy [person],” he says.

SelectHealth also makes charitable contributions, Paulson says. When the company had a surplus of revenue last year, it gave $5 million to 14 community care clinics specializing in serving the uninsured and underinsured.

Working Together
Paulson says he enjoys working alongside his associates at SelectHealth. “[We have] a wonderful group of executives that are really dedicated [to] their job,” he says.

“They’ve all been at it a long time,” Paulson says. The executives carry an average tenure of 29 years. He adds that SelectHealth works with Intermountain’s physicians to help people realize the value of generic medications. “Our generic usage five years ago was [at] 42 percent,” he calls.

Through their efforts, which have included giving patients generics without co-pays, the company has increased that number to 70 percent. “Every percent exceeds a million dollars of savings,” he says, noting that this allows the company to charge less to its policyholders.

 “We feel a spirit of cooperation as the combined group of insurance, hospitals and clinicians work together to improve health and reduce medical expenses,” Paulson says.

Keeping Well
While some caregivers wish to charge more for their services, Paulson says SelectHealth will continue focusing on reducing the costs of care. “If you can do procedures today and keep [people] out of the hospitals, you can save money,” Paulson explains. “We want to promote that.”

To keep people out of the hospitals, SelectHealth educates and reminds members on screenings and services to help them stay well, Paulson says. Just last year, SelectHealth made some 440,000 contacts to members to give reminders on things like diabetes, asthma, immunizations, screenings, cholesterol management and others.

The company’s case managers also follow up with members after their surgeries to make sure that they stay on their medications. The company also gives reports to their members’ doctors, as well. “We gave over 25,000 reports [last year] to physicians relative to their patients,” Paulson notes. “We’re very proactive in providing and acting on data that can affect medical expenses.”

Other Activities
The company also participates in wellness activities that include wellness fairs and giving out free flu shots, Paulson says. “We know that if we do that, we’ll keep people out of the emergency room in the winter,” he says. “That, in the long run, saves money.”

Last year, SelectHealth gave away more than 23,000 immunizations, Paulson says. “Our goal this year is to do 10 percent more than that,” Paulson continues. “Our feeling is, we’re all about helping people try to keep well.”