Grand Rounds Blog

Group benefits buyers for school districts are facing many challenges today — from ensuring their employees stay healthy and productive at work, to continuing to provide impactful health benefits in the face of shrinking budgets. At Grand Rounds, our experience servicing many of these groups across the U.S. has provided us with a unique perspective on how to solve these problems, from trimming the annual health care cost trend to promoting better health outcomes.

The Budget Problem

When it comes to operating budgets, public school districts across the country have had to tighten their belts — and faculty and administrators are feeling the pinch. In the 2014 school year, at least 31 states received less state funding per student than in the 2008 school year, before the recession. Furthermore, in at least 15 states, the cuts exceeded 10 percent.1

In the 2014 school year, at least 31 states received less state funding per student than in the 2008 school year, before the recession.

Not surprisingly, these shrinking budgets have a huge impact on health care budgets, a burden that falls directly on the shoulders of the various school districts. Health care costs for the public education workforce continue to increase2, and as a result, most school districts are not able to implement new health benefits programs unless they generate almost immediate cost savings. While benefits leaders are focused on ways to cut costs with their health care spend, they also want to continue providing high quality and comprehensive benefits packages to their faculty and administration. Achieving both has been a challenge; however, schools may not be aware that a solution exists – one that can both save money and guide their employees towards quality care.

The Quality Problem

It’s not solely the growing cost of health care that presents a problem. More than 50% of school districts are located in rural areas and remote towns, where access to academic medical centers and high-quality health care isn’t as readily available as it is in metro areas like San Francisco, Boston, and New York.

More than 50% of school districts are located in rural areas and remote towns, where access to academic medical centers and high quality care isn't as readily available.

An analysis of more than 96% of the physicians in the U.S. (on many predictive measures of physician performance including training quality, treatment patterns, patient volumes, procedure volumes and medical outcomes) revealed that regions with better access to top physicians tend to have the best outcomes.3 Similarly, studies have found that 77% of rural counties are experiencing shortages in primary care professionals and that these residents are more likely to report fair to poor health.4 Many school employees in non-metro areas have no insight into which physicians they should see, and if and when travel is necessary.

The Absenteeism Problem

While school districts navigate budget constraints and access to high-quality care, they are also trying to keep their employees healthy and teachers in the classroom. On any given school day, absenteeism for American teachers is approximately 5.3%, which is 76% higher than the national average for private sector employees.5 Looking at data from 40 large school districts across the country, in 2013 teachers missed nearly 11 days out of an 186-day school year, and 16% of those teachers missed 18 or more days – or roughly 10% of the school year.6 How many days could be salvaged by keeping teachers healthy? The difference between seeing a high-quality physician versus a low-quality physician can result in a 2x faster return to work, not to mention healthier, happier teachers and ultimately, better education for students.

The U.S. spends about $4 billion annually to cover substitute teachers and related administrative costs.

Teacher absences disrupt their students as well as the standard flow of operations, often putting a burden on other teachers. If a substitute teacher is not able to fill in, students may be divided into other teachers’ classrooms, or teachers are forced to drop preparation periods to cover other classes. Beyond the logistics and workflow disruption, hiring substitute teachers is extremely expensive. One of the districts examined spent about $424 million on substitute teachers in the 2012-13 school year.6 Overall, the U.S. spends about $4 billion annually to cover substitute teachers (and related administrative costs) — funds that could be better used on salaries, supplies for students, staff benefits, and more.

The Solution

There is a bright side: even school districts with budget constraints and remote workforces can implement programs that can help their staff and their families receive access to better health care options. Grand Rounds guides employees toward the most appropriate services for their specific health care needs, helping them get to the right physician and receive the proper treatment when they most need it. Grand Rounds provides employees with access to the most qualified physicians for in-person care, remote second opinions from world-class experts, and other key services at critical moments of need.

Many education groups are seeing results with Grand Rounds, including Allegheny County Schools Health Insurance Consortium (ACSHIC) and Self Insured Schools of California (SISC). These groups and over 50 other organizations are providing a comprehensive health benefit, helping their employees and dependents achieve better health outcomes while also reducing health care costs.

With Grand Rounds, a teacher in Arnold, Nebraska, has the same opportunity to access the most qualified physicians as a teacher in Boston. Whether a teacher is dealing with a tricky diagnosis, looking for an alternate treatment plan, or simply in need of more personalized care, Grand Rounds guides them through the process and empowers them to make well-informed health care decisions.

The Real Winners

It’s the patient stories that really highlight the value Grand Rounds can provide. Carmen, a teacher from rural Texas, has a rare neurological disorder that was not properly diagnosed by her local doctors. When Grand Rounds intervened, Carmen’s disease was progressing rapidly and her health and independence were in a downward spiral. Within ten days, Grand Rounds was able to connect Carmen with top experts and an accurate diagnosis and treatment.

The remarkable thing is that no matter where you live, Grand Rounds is going to find the right doctor for you. I look forward to being the person I used to be. - Carmen teacher


Getting teachers the care they need, when they need it, is essential to their health, their productivity, and the quality of education for their students. Budget cuts may reduce the variety of school supplies and the amount of athletic equipment (among many other things), but it should never hinder the one thing students rely on most: a healthy and available teacher.


  1. Leachman, Albares, Masterson & Wallace. “Most States have Cut School Funding, and Some Continue Cutting,” Center on Budget and Policy Priorities; January, 2016.
  2. Public School Expenditures, National Center for Education Statistics, May, 2015
  3. Grand Rounds data on file.
  4. Geographic Disparity United States, America’s Health Rankings, United Health Foundation
  5. Raegen Miller, Teacher Absence as a Leading Indicator of Student Achievement Center for American Progress. November, 2012
  6. Allie Bidwell, Report: Teacher Absenteeism Can Hurt Student Achievement, US News. June, 2014


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