David W. Bowers, MD
President and Chief Medical Officer at Innovative Healthcare Teams, LLC
Employers are taking a more active role in creating a culture of health and wellness in the workplace. As a former Medical Director of a preferred provider organization (PPO), whose clients were predominantly self-insured employers, I’ve consulted with employer clients to design and implement strategies to create a workplace population health strategy. The foundation of the strategy rests upon building a supportive culture of health and wellness and an employer benefit design plan that promotes and supports this culture.
It may initially seem to be a Herculean task to “change the culture” so it is important to start with simple yet effective steps to build a sustainable culture of health. So, for example, employers often begin with the everyday touchpoints in people’s lives at work. What type of food is served in the employee cafeteria? Is it loaded with high fat, simple carbohydrate foods? Are there choices for fresh fruits and vegetables or low calorie meals in the cafeteria? Are the vending machines loaded with unhealthy snacks and high sugar drinks? When it’s break time, what choices do the employees have to improve their health? Are there walking paths, an exercise room or a daily exercise class on site? Does the employer financially support memberships in health and exercise clubs? How about smoking cessation, yoga and smoking cessation classes? Have the employees been given pedometers and organize friendly competitions to see which department walks the most at work? Is the facility and its grounds non-smoking / tobacco free?
Many employers, particularly those who are self-insured, have revised their employee health plans to incentivize healthy behaviors, preventative services and establishing effective relationships with primary care providers.
Improved measures of health at the workplace are not only good for employees but also benefit the employer! Furthermore, improved health of the employed population filters to the bottom line of the company, which permits more raises and stable employee premium contributions to their insurance premiums.
In 2005, as Medical Director, I created and implemented an innovative program with several client employers. The results in each and every case demonstrated improved health metrics and lower costs for the employer, which were sustained over several years. Although this type of program is rather commonplace in today’s market, it was quite new at the time. The basic premise rested upon the health plan cost data, which consistently demonstrated that the majority of healthcare costs in any employed population were concentrated within a small segment of the covered lives, typically less than 5% of the beneficiaries. Furthermore, there were consistently two clinical cost categories that were responsible for the majority of the high cost claims—Advanced Cardiovascular Disease and Advanced Stage Cancer!
When I drilled down into those two high cost and catastrophic clinical categories, it was apparent that there was a huge opportunity to diagnose the underlying conditions or risk factors much earlier in their asymptomatic phase, and, in some cases completely prevent or significantly reduce the risk of a catastrophic outcome!
Skeptical? Consider these examples. High blood pressure, especially combined with high cholesterol and smoking, is the underlying cause of the majority of strokes and heart attacks. Nearly all high blood pressure is asymptomatic but if detected early in its course and controlled, the risk of stroke and heart attack can be greatly reduced. Additionally, when we implemented this screening program with our employer clients, we found that 30% of the employees were either diabetic or pre-diabetic! Similarly, 2/3 were either overweight or obese. Many of these employees had not visited their doctor’s office within the past year. On the cancer front, the 2nd largest cancer killer in the USA is colon cancer, which is largely a preventable condition! Did you know that it typically takes several years from the development of a pre-cancerous colon polyp to become cancerous? Timely colonoscopy is a cure for these conditions. Yet, typically, only 20% of all employees and their spouses take advantage of their health benefit to undergo regular colonoscopies. Of course, the largest cancer killer in the USA remains lung cancer, the cause of which is largely attributed to smoking, which represents yet another huge cultural opportunity that employers have a stake in leading!
Employers are in a great position to devise health benefit plans that encourage timely preventive screenings that are ultimately life-saving events. Just think if every employer could achieve 100% compliance with immunizations, blood pressure, blood sugar, weight loss management, and cancer screenings such as mammograms and colonoscopies, what the benefit would be! Not simply in financial terms but in the benefits of their employees and their loves ones.
Innovative Healthcare Teams can bring this expertise to your workplace.