US Reporter


Pay First, Get More: Choosing Employment Health Plans in America

Pay First, Get More: Choosing Employment Health Plans in America
Photo Courtesy: WeCare tlc.

Meet the primary care provider aiming to simplify the American healthcare system for employers: WeCare tlc.

For employers, selecting the right healthcare provider can vastly improve staff retention and aid recruitment. With no reliable state-sponsored healthcare, most Americans rely on their employer for this service but it can be a bewildering maze for HR professionals to seek out the right fit. 

Lauren Kirschner, Director of Client Services at WeCare tlc believes that relationships are key to the process. “Open communication and true collaboration is at the heart of how we serve our clients,” she says. “We are here to learn their unique needs and tailor a plan that best suits their organization.”

Setting WeCare tlc apart in the saturated market is their status as a wholly independent, women-owned business that puts the health of employees and their families first. There are worrying conflicts of interest within health systems where hospitals also administer health plans, pay the claims and own care delivery services. 

“These systems manage the whole supply chain so they can ensure their profits are serviced before the individuals coming to them for help,” says Raegan Garber Le Douaron, President and CEO of WeCare tlc. “It is a mafia-like set-up where they incentivize doctors to charge employers for unnecessary services and control the care and the cost, unchecked.”

Founded nearly twenty years ago, WeCare tlc uses a different payment model to the majority of providers, in order to better integrate with the company and encourage employees to take care of their health. “Working with us is an investment because it is a pay-upfront model. This means the employees can take advantage of all manner of services without worrying about insurance costs,” Kirschner says.

“We charge a flat fee which covers all possibilities of medical treatment as well as working closely with clients to ensure employees are aware. We do ‘meet-and-greets’, have monthly engagement initiatives and do a lot of the communication work to save our clients time. The difference in staff retention is significant with employees in disbelief that they are being taken care of with no charge to them.”

Pay First, Get More: Choosing Employment Health Plans in America

Photo Courtesy: WeCare tlc.

WeCare tlc is deeply involved in the patients’ prospects, developing relationships and providing high quality and bespoke care. “The relationships we grow with the patients can be very comforting in a difficult time. We are like the air traffic controller navigating the flow of different services and options to prevent confusion or overwhelm,” says Kirschner.

“This model is such a blessing because there’s no time restriction. We’re not trying to herd cattle through the system to get reimbursed. We’re already paid for the services and the patient doesn’t have a cost. There is no pressure on providers to meet quotas or targets; the focus can be entirely on the health of the patient.”

Another unique aspect is the analytics service they provide, offering insights from the health plan and using a comprehensive data system to demonstrate return on investment to their clients. Part of the data is from insurance claims so WeCare tlc can proactively reach out to patients after ER visits and compare the costs.

“Insurance brokers are often selling the plan and we help them to understand the value of this pay upfront model. Although it is not as common to pay a one-off sum for healthcare, our clients save money in the end! We are sitting in front of the health plan so we can capture all the different service costs before anything hits the health plan,” Kirschner says.

Many care providers have wellness programs but WeCare tlc has a Registered Nurse nurse manager who is also a health coach and makes a huge difference in supporting people through chronic condition management and lifestyle changes. Beyond traditional health coach abilities, their RN can also give clinical advice.

Clients with WeCare tlc are wide-ranging, with both private and public organizations in their care. “Everyone is looking to reduce the costs of the plans and to improve the care available,” Kirschner says. “We also help with health education, to reduce the number of unnecessary ER visits. We have a calendar of events and communications to outreach to employees so employers know that’s in hand.”

She continues: “I think at the end of the day, our clients are looking to really bend the curve and cost and make sure that it’s appropriate care. In America specifically, more care is not necessarily better care. Rising premiums due to extra services are not a concern for our patients because of the ‘pay upfront’ model that protects them from cost.”

To find out more about how WeCare tlc can support your business and take care of your employees, visit their website

Published by: Martin De Juan

Share this article


This article features branded content from a third party. Opinions in this article do not reflect the opinions and beliefs of US Reporter.