Business of Well-being

Increasing Wellness Engagement and Saving Billions in Healthcare Costs: A Cleveland Clinic Case Study

Healthcare costs are spiking at record rates; for employees and employers alike, especially given the post-pandemic economic context, this is slowly leading to a huge financial crisis. Many employees are running into steep debt trying to save their lives and treat chronic diseases, while some have decided to avoid medical care to prevent further debt. To make matters worse, experts say healthcare costs are not slowing down any time soon. 

It there behooves employers to devise means to cut healthcare costs while still ensuring that their employees stay healthy and well. Consequently, there seems to be a greater shift toward employee wellness in some quarters; however, the question is are your employees engaging in these initiatives, and are they getting healthier for it, or are you reeling out tens of hundreds of wellness programs that are not shifting the healthcare metrics of your workers significantly?

In a recent episode of the Edelheit Experience, Jonathan Edelheit, Chairman of Global Healthcare Resources, speaks with Dr. Michael Roizen, Emeritus Chief Wellness Officer at the Cleveland Clinic talks about tackling rising employer healthcare spending by increasing employee wellness engagement and participation. Using the case of Cleveland Clinic as an example, Dr. Roizen explains how improved participation in the right wellness solutions translates to better health profiles and less healthcare spending. 

Dr. Roizen talks about the “Healthy Choice” program, a voluntary employee wellness program initiated in 2008 at the clinic with goals centered on reducing healthcare costs and building the healthiest and most productive workforce.  

“We found from a recent data at the time that the most important thing for the health of patients undergoing surgery was not even their brain function, lung function, or heart function, but their physiological age, as opposed to their real, biological age,” Dr. Roizen said. 

Dr. Roizen explained the physiological basis of wellness solutions. In one study he cited, he noted that people had their peak quality of life between the ages of 25 and 35 and lose about 5% of their function every year afterward. However, a similar study from Massachusetts General Hospital found that people lost 5% of their IQ yearly, only a group of people did not in the study. The 25% of people who did not were shown to regularly engage in wellness exercises including speed of processing games and physical activity. Essentially, this group of people had younger brain functions and slowed down their rate of aging. 

This essentially sets the target for wellness, pinning wellness success not only on preventing disease but also on making people younger, from a physiologic standpoint. For example, while it may be entirely physiologic and normal for arterial blood pressure to increase after a certain age, a useful health metric and goal would be to reduce it to a level that may be considered “normal” for a younger population. 

Dr. Roizen noted that when the Cleveland Clinic established the Global Wellness Institute, the target was to help employees achieve what they called “six normals.” The basis for this was a 1946 study among Chicago public workers which monitored their health variables until they died. They found that after age 65, they lived 30% longer, and their net healthcare costs were reduced by about 50%, having achieved healthy values across these six normals. 

These six normals include blood pressure, LDL cholesterol level, blood sugar, body mass index, stress levels, and smoking status. Dr. Roizen asserted that if you could get these indices to a healthy level, you could reduce your risk of chronic disease by 80-90%. These six normals evolved to be “6+2” with the additional metrics being immunization status and yearly visits to a primary care physician. The primary care physician, in this case, records findings for each employee every time they visit for all the 6+2 metrics, and provided the needed health education and recommendation to employees who were falling short of the goals. 

These targets helped drive the right health and wellness solutions for the workforce to” keep the healthy ones healthy and help the unhealthy become healthy,” Dr. Roizen said. “We’ve now gone from 6% to 44% of our employees achieving those 6+2 normals, and $180 million in healthcare cost savings over the last few years,” he added. 

Further, Dr. Roizen noted that while there have been no major changes in employee benefits, these wellness goals have improved employee healthcare cost savings and made them healthier and more productive, as absentee days have reduced dramatically and the prevalence of chronic diseases among employees has dropped.” 

Much of these collective goals were hinged on increasing employee wellness participation by over six-fold, from 12% to 75%. According to Dr. Roizen, the major drivers for this increase were CEO-led participation and incentives. Fitness centers and smoking cessation programs were free for workers, and on campuses where fitness facilities were absent, the organization offered subsidized membership at major fitness centers around. 

“As long as we are saving 30% of their premiums, they are getting all of that back, and that is about $1600 per family now,” Dr. Roizen said. 

Further, to facilitate the achievement of the wellness goals, the organization’s leadership ensured that if there was a consequence for defaulting on any wellness or health exercise, it affected every tier of the workforce. In one case, the Wellness Institute focused on smoking cessation and ensured the rule cut across all strata of the workforce, such that workers who refused to quit smoking in no-smoke zones of the organization, regardless of what level they were in the organization’s structure, were dismissed. 

In addition to the Clinic’s unique and incentivized smoke cessation programs, fitness programs, and stress management classes, Cleveland Clinic’s leadership also initiated a complete overhaul of food offerings on its campuses, shifting menus toward low-sugar, low-fat diets. This, in fact, led to hiring a series of food service companies to achieve these strict diet plans. In one case, a McDonald's restaurant located on one of its campuses was replaced with a vegan restaurant. 

Essentially, for Dr. Roizen, much of the health goals of the Wellness Institute have been achieved as employees are not only productive but healthier and physiologically younger. While many of the initiatives have evolved to become more innovative and personalized, the 6+2 goals remain a useful motivation for employees participating in the programs. 

GHA For Business

Global Healthcare Accreditation (GHA) has created a program to help your organization achieve this level of employee health and productivity. With the GHA For Business, your employees and clients recognize your commitment to creating an environment that supports their well-being and helps them achieve their healthiest selves. 

This accreditation not only evaluates your well-being and health structure but offers training, resources, and tools to help your organization curate the right well-being solutions for our workforce. There is a shift in the wellness conundrum, employers are gradually realizing the role they play in the health and wellbeing of the employees, and workers are driving this change. Leverage the tools, resources, and training from the GHA For Business to rethink your employee wellness journey and retain the best talent. 

Learn about how you can become a Certified Corporate Wellness Specialist→