The Granite List Live

Michael Ketslakh, CEO of National Diagnostic Services gives us a broad overview of vaccinating large companies on-site and the costs of weekly and daily testing. Sally, Leigh and Michael discuss being able to implement strategies that provide a safe environment for the individuals to be close together, but also create a model that is sensitive to the cost burden that the employer would have to be able to continue sequential testing for those employees. With OSCHA Compliance in the mind of many employers who require their staff to be on-site without a work-from-home option, the cost can make or break a company. Rapid tests, when provided onsite can cost around $20 - $30. PCR testing is between $100 and $120. By implementing a pooling method, NDS is able bring down the cost of the more accurate PCR test to the range of the less expensive rapid test. Listen to this episode to hear how it works.

About our guest:

Michael studied Epidemiology at the University of Michigan School of Public Health. In 1997 he founded National Diagnostic Services (NDS), an independent diagnostic testing company servicing Michigan communities. Our traditional services began with management and operations of Primary Care and specialty clinics in the field of Cardiology, Physical Medicine & Rehabilitation, and Neurology.

The complete transcript of this episode is here:

Announcer (00:07):

Welcome to another episode of The Granite List. Live. Navigating a sea of benefit solution is daunting at best, and new vendors emerge every week. Hosts Leigh Dill and Sally Pace bring brokers and employers a solid resource when it comes to uncovering what’s new, what’s needed, and what is happening now to allow for the best plan design possible. By staying on top of trends, brokers and employers can in turn stay on top of spend while improving employee engagement and outcomes.

Announcer (00:35):

Michael Ketslakh, CEO of National Diagnostic Services, gives us a broad overview of vaccinating large companies on-site and the costs of weekly and daily testing. Sally, Leigh and Michael discuss being able to implement strategies that provide a safe environment for the individuals to be close together, but also create a model that is sensitive to the cost burden that the employer would have to be able to continue sequential testing for those employees. With OSCHA Compliance in the mind of many employers who require their staff to be on-site without a work from home option, the cost can make or break a company. Rapid tests, when provided onsite can cost around $20 to $30. PCR testing is between $100 and $120. By implementing a pooling method, NDS is able bring down the cost of the more accurate PCR test to the range of the less expensive rapid test. Listen to this episode to hear how it works.

Sally Pace (01:48):

Welcome back to another episode of The Granite List. Live. We are thrilled to continue our conversation with Michael around now, really taking a look at how people are adapting in the current environment and Michael, your team is ever, there was boots on the ground in the middle of all this chaos, it's your group. So can you talk to us about what you're seeing in the immediate world that we find ourselves in?

Michael Ketslakh (02:17):

It's been professionally very challenging for last two years have been very rewarding professionally. Certainly it's been very chaotic to deal with it. So we work with a lot of different government entities in the beginning of, actually in the beginning of the pandemic, we were there for the city of Philadelphia to operate their radiology and cardiology departments and our step-down unit. So those step-down units in the beginning where those hospitals were overwhelmed. As overall as healthcare providers and as governments began to get a better handle on the disease and the spread of this disease and that more important than the management of the disease. For us, we've worked very closely with municipalities, counties, essential infrastructure employers, like power companies. Now we're starting to work very closely with certain districts, also essential employee workers and workforce. And the idea for us earlier on the primary focus with COVID was how are we able to put a stop to the spread of the disease?

Michael Ketslakh (03:18):

That's really the question that our government clients came to us with. And that stemmed around a problem that you guys may all remember of the fact that the results for COVID testing took approximately anywhere from six, eight days to sometimes 10 to 12 days, or really the results became completely ineffective from the perspective of ability to manage the disease. By the time those results are to ever come back, those individuals who are potentially contagious would have already spread the disease, the effective outcome of any kind of a testing strategy in a pandemic is very quick turnaround of results. Can we do it within 24 hours, quarantine those individuals and be able to really take control of that. So for that solution, we started to do was really build laboratories that were centrally located to the testing sites for either the residents, the county residents that we were servicing, or the employers.

Michael Ketslakh (04:15):

So we created kind of a hub and spoke model of being able to test individuals and then really provide a specimen analysis right there for within a 12 to 24 hour turnaround. And that became extremely effective from a perspective of being able to identify the folks and in getting them appropriate management of care that they needed. That was a big focus. We were one of the larger providers in the movie production industry right now, because those productions, in order for them to be able to operate, they have to have sequential testing models, meaning that folks that are having intimate scenes or close together need to be monitored, managed for safety on a daily basis. And those results have to be actuated within a very short period of time, short meaning eight to 12 hours. And we've been able to really manage that spoken hub model to, to be able to provide that service. So all of you guys who love sex sessions and love some of those wonderful shows and Warner media are able to watch them.

Sally Pace (05:17):

Okay, you really just got my attention. It has nothing to do with healthcare as a country, we have been thrown into such a topsy-turvy position. And you think about even in the movie industry, the production that you just described, the way that people interact with their colleagues, whether they're on the big screen or in a manufacturing plant, your team has had to pivot a lot over the course of the past year. Can you talk a little bit about where we find ourselves right now impacts not just the medical plan side, but the work comp side and what you're seeing in that space?

Michael Ketslakh (05:59):

For employers one of the realities of being able to exist as a capitalist country, as a country is we have to work. And a lot of the population does not have the flexibility of working from their home. They have to be onsite. They have to be at a manufacturing facility and those manufacturing facilities have to be open because they are also part of our essential infrastructure as it pertains to the overall economy in the United States. So from that perspective, we've been able to take a look and implement strategies that provide the safe environment for the individuals to be close together, but also create a model that is sensitive to the cost burden that the employer would have to be able to continue a sequential testing for those employees. And what I mean specifically by that is we've, in certain cases, we've implemented strategies of using rapid tests in a sequential basis.

Michael Ketslakh (06:52):

They aren't the most accurate tests on earth, but what they do is if in a proper sequential sequence, they do provide a certain level of protection. Right now, most recently our laboratories have developed something called a pooled model where we're able to actually use the sensitivity of the high complexity laboratory tasks. So that, that type of test where you're getting a collection from your national and goes out to a laboratory. So now we're able to maintain that sensitivity of that test, but now we're able to combine five or six samples into one, thus reducing the cost up to 80% of the costs of that sample to the employer. So again, that's a strategy that is being implemented right now on a sequential testing model. A special testing is when the folks getting tested on a weekly basis, but also then reducing that cost and really bring that cost down to the same level as a rapid test, but still maintaining that sensitivity that everybody wants to make sure that their workplace remains safe

Sally Pace (08:01):

When you put dollars and cents to that. If I'm an employer and I'm hearing you talk about cost savings, what does that mean?

Michael Ketslakh (08:06):

So a traditional rapid test when provided onsite, the cost is usually someplace around $20. $20 to $22. When PCR tests that high complexity tests is provided onsite, that traditional cost is, right around $100 to $120 by implementing the pool strategy model that I just described, we can bring down the cost of the PCR test down to that same $20 to $25 range that is there for the rapid testing. So it's quite substantial. Currently without current mandate, that's coming out from the federal government, mandatory testing for the non-vaccinated population and utilizing OSHA as the governing body to enforce that mandate.

Michael Ketslakh (08:49):

It's important for the employers to have the proper tools in order to able to comply with a mandated requirements. Before us, we have the benefit of having our own software development team. We're able to develop software tools for the employers to track individuals who are being tested, their results, track them over time. So in a scenario of an audit situation, they'll be able to retain those records and they'll be able to manage with their own safety, their employer population.

Sally Pace (09:26):

So how would an employer engaged your services to help with this mandate?

Michael Ketslakh (09:27):

People can come or write to our website @ndswellness.com, they're welcome to call our telephone number, my personal telephone number at (248) 739-9717 and call our office number at (248) 476-6980.

Sally Pace (09:46):

And in more detail, what are you offering? Is it your current clients that you're helping test their employees for the mandate that have over a hundred employees? Because you do serve larger groups, or are you going to help with one-off testing? Will you send a mobile clinic weekly to test the unvaccinated? How has the whole logistics of that going to take place?

Michael Ketslakh (10:08):

Unfortunately, because of our infrastructure, we service employers with a minimum employee base of 400 employees. And we have folks with employers at 400 employees and all the way up to 40, 50,000 and serve certainly municipalities has just described that close to 700,000 in those counties, the determination of the clinic or the staff that's needed on-site as depending on the particular project. So it is, again, it goes, it is not a cookie-cutter solution.

Michael Ketslakh (10:40):

We try to customize a solution depending on the needs of that particular client and the space that they have available. So in certain cases like in movie industry where the filming changes locations all the time, a mobile clinic is very applicable in a larger manufacturing plant. They may already have space available, a mobile clinic, maybe an unnecessary additional cost burden. And we can utilize the current space that they have to be able to lower the employer's costs on the service side.

Michael Ketslakh (11:10):

I think from the current regulatory environment is very murky right now. We have a very general described federal mandate. The specificity of that will come out very shortly. We have very comprehensive legal team. That's looking at it and doing analysis, large component that is going to be, I think one of the keys to the success of the mandate is the cost of it. So in a public setting, so the nonprofits, whether they're counties, school districts, those are funded by federal cares dollars right now for these different program.

Michael Ketslakh (11:47):

And I think shortly we will see what kind of funding there's going to be available for employers self-insured employers. And there is discussion right now of some of that funding coming in from the federal government. So at that point in time, we will be ready to help employers find that funding, to take a look at and see if that cost could be offset for them through the current programs.

Sally Pace (12:10):

How long is this, this mandate going to, I mean, are we looking at 2030 people getting tested weekly for something like this? Is this, is there any idea that you have?

Michael Ketslakh (12:23):

I'll give you perspective from a standpoint of panic right now, statistics on this particular disease is from individuals who are vaccinated. There's approximately 136 deaths per every 1 million individuals who are infected, who are vaccinated. So if you look at those statistics, the statistics against individuals who are unvaccinated is about tenfold that, so it's about 1,360 people that wind up dying per million in an unvaccinated population.

Michael Ketslakh (12:52):

And again, that's significant because it is really reduced to where that was six months ago. Six months ago, those numbers, the unvaccinated folks were close to 50, 80 times more higher at risk for having a high complication because of the technology monoclonal antibodies that you may have heard of. And all of the knowledge that the health providers now have to manage the complications of the disease, the outcomes have really improved. So where is it going to go? Will COVID go away? COVID will never go away because it will change and it'll be with us, but from a perspective of the crisis, how it has impacted all of our lives. I think that that's going to really dispay by end of 2022. I'm optimistic. I'm hoping.

Sally Pace (13:42):

We both, we fingers crossed we're in your corner, but thinking about this mandate and looking at costs, you know, obviously it's a risk to a self-insurance employer to have multiple employees as high-cost claimants. Those, you know, the complications that can happen with COVID can be very costly on the health plan side. Employers will be aggressive in wanting the vaccinated to join their workforce so that they don't have to pay for testing and the potential penalty that would come for not testing them. So are we going to see a curve kind of like enrolling in school, you have to show your shot record. Is that going to be a new thing going forward?

Michael Ketslakh (14:20):

So that I think is very difficult at this stage of the game to mandate vaccination for Americans. For a lot of reasons, there are complications from vaccination and the outcomes of frequent vaccinations it's called serum disease. They are there they're significant, potentially we have not seen them in the populations yet, but as the frequency of rate of vaccinations or boosters and your re vaccinations, that certainly creates an increased risk to the individual. So from a perspective of when do you mandate? When do you mandate? This is a very new vaccine is very effective and we encourage folks to get vaccinated.

Michael Ketslakh (15:10):

So it's a long answer to a short question, but I think it's going to be some time until we know some of the facts of the vaccines, and we have a better understanding of this disease. I mean, it's been a very short period of time. I mean, this is only been two years, even two years, year and a half. So I think that it'll take some time before somebody like this could be vaccinated, an example that you gave where it could be mandated across the board. There's a lot of different variables that come into that decision.

Sally Pace (15:40):

Well, Michael, thank you very much. Thank you for your leadership in the industry. Thank you for the way that you and your team are rising to the challenge and the mantle you have taken on as our country has gone through a lot of twists and turns in particular, those, like you said, the frontline defenders that are, that have to show up for work, whether it's in a municipal capacity or in some service level that they have to show up and do their jobs, no matter what's going on in the world around us, we are really honored to be able to share your story with our audience. And I look forward to many, many more continued success stories as you get on this path. So thank you very much.

Michael Ketslakh (16:23):

Thanks guys. Thank you very much. And we hope that we still continue to have opportunity to make a difference. It definitely makes you feel good that's for sure.

Sally Pace (16:30):

Absolutely. Well, that's a wrap

Announcer (16:34):

National diagnostic services. Onsite programs are designed as a supplement to team members, existing healthcare providers, our programs focus on educating participants about their health status, educating them on behavior, change options, and engaging them to additional care when needed. Our scope has expanded to onsite programs for municipalities and self-insured corporations with a goal of removing barriers of participating by delivering a concierge level program at the place where people spend the majority of their time, their work, the demand for this service expanded NDS has reach to a national footprint. Currently servicing employers in 33 states, learn more @ndswellness.com. Thank you for listening to this episode of The Granite List. Live access our entire library by visiting your favorite podcast venue or subscribing our site, thegranitelist.live