Allen Prettyman, right, takes Barbara Harrison's blood pressure during an exam at McDowell Hall.

UD's nurse-run center a model in containing health care costs

February 23, 2012

NEWARK -- Karen Roberts had a lingering illness she could not shake. With her packed daily schedule, the University of Delaware employee also had a dilemma.

"I just thought, 'Oh my gosh, I have to go to work, but I have to go to the doctor,' " said Roberts, a communication specialist for the College of Engineering. "I probably should have gone sooner, but I didn't want to take the time."

As she soon learned, university employees can now get primary medical care without leaving campus. At 8:30 on a recent morning, she walked into the Nurse Managed Health Center -- no appointment needed -- and moments later left with a prescription for bronchitis medication.

For the past year and a half, the Nurse Managed Health Center has operated inconspicuously in a tiny space in a back corridor of McDowell Hall. It's a quick walk from some of the busiest areas of campus -- the Trabant Student Center and The Green -- and those who have discovered it rave about its convenience.

However, UD leaders conceived the center as much more than a perk for employees. They hope it will also save the university money.

As they have for most organizations, health care costs for UD employees have risen in the recent years. In 2011, annual spending on health cared increased to $46.2 million, up nearly $13 million from five years ago, according to the university's budget office.

On-site nurse-managed care could help contain those costs in several ways.

For one, nurse practitioners run the facility, not doctors. These skilled nurses with advanced training can diagnose, treat and write prescriptions as primary care providers. For many routine illnesses and minor injuries, practitioners can provide the same care at a cost 15 percent less than a doctor.

"You don't need a physician doing all this care, when nurse practitioners are very well-trained," said Kathleen Matt, dean of the College of Health Sciences, which runs the facility. "It saves you dollars, it saves the physician time and you can bring that physician in for cases that require a certain expertise."

UD provides its 4,000 employees with the same insurance benefits state employees receive. UD is self-insured, meaning it pays the actual cost of its employees' medical bills. Every dollar employees save on their care also saves the university's bottom line.

The school also hopes the center could cut down on work time lost to illness. With a convenient, on-campus location, employees can get care and return to work more quickly.

The center provides required screenings for employees working around hazardous chemicals, such as researchers in science labs. UD used to pay an outside contractor to perform that service.

Although only a few hundred such facilities exist across the country, nurse-managed care has become more common on college campuses. In addition to the more affordable care of nurse practitioners, the center tries to engage UD employees visiting the center in health assessments. They can act as a gateway to employee wellness programs and offer tips for preventing future illness, hopefully saving on health care expenses in the future.

"If you come in with a sore throat, I'm going to ask, 'Do you smoke, are you overweight?' " said Alan Prettyman, the director of the center.

Even though UD employees essentially receive care from a UD-owned facility, federal law forbids the center from disclosing medical information to the patient's employer.

"It's not any different in that way from any other medical facility," Prettyman said.

Aside from employee wellness, the center has an important academic mission. Graduate nursing students all do a required rotation through the center, and undergraduates interested in community health can apply to work at the center. The experience of working in the center has given Allison Campbell a heightened respect for nurse managed care.

"People should really take advantage of it," she said. "Not many people know about it."

That could soon change, though. The center now has a mere 500 square feet, with a waiting room, an office and two small examination rooms. But by the end of 2013, it is expected to move into a new 4,000-square-foot facility on the Science and Technology Campus, the site of the former Chrysler plant. With more convenient parking and a more noticeable location, Prettyman anticipates more UD employees will start using the center, as well as members of the general community.

"They accept Medicare and Medicaid, and we're looking to pilot initiatives to serve people who are uninsured," Matt said. "It's really an opportunity to offer care at a much lower cost that is still comprehensive."

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The News Journal