Cardone Industries, Inc., founded in 1970, is a leading supplier of automotive replacement parts with 6,000 employees across the United States, Canada and Mexico. A family-owned business, health benefit plans are self-funded at Cardone, which serves both as employer and insurer. Like many companies, Cardone found its annual healthcare cost escalation was unsustainable. Unlike other companies, cost-shifting through the introduction of a consumer directed health plan was not an option.
At Cardone, such a move would represent a barrier to care rather than an enhancement. Let's look at why. To begin with, the Cardone health plan (United States) employee demographics are a bit unique. Cardone North (Philadelphia) is an urban manufacturing company with a large union membership. The company has a relatively low wage base. So far, so good. This is where it gets fun.
At Cardone, English is the first language of about 40 percent of the employees. The remainder speaks any one of 39 other languages. That's right -- 39, with the second largest language group after English is Malayalam. Did you get that? Our employees represent more than 50 different countries. A walk through a Cardone factory is a tour around the world. So, the challenge is to imbue a comprehensive, effective wellness culture into a mini United Nations of low wage-based manufacturing workers.
Piece of cake - right? Where do you start? Well, first thing's first: we start at the top. If there is one thing that the wellness fraternity agrees on, it is that for any program to have any chance of success, it has to have senior leadership. At Cardone, that person was an executive VP who was a fitness convert, a true believer and a tenacious pit-bull when it came to wellness. He was unrelenting both in keeping the cause before the executive team and in advocating for the programs that the wellness team wanted to advance. One down.
Secondly, we needed a baseline; some way to access the composite health of the organization and find the strengths and weaknesses. For us, that was biometric testing. From this data, we could determine such things as what chronic conditions were most prevalent, where we had metabolic syndrome challenges, and what our corporate girth was. From here, we could begin to outline programs to attack our weak points and shore them up.
Thirdly, we needed data. We tried to get what we needed from the canned reports our TPA produced, but it didn't suffice. Eventually, we contracted for a powerful, proprietary data warehouse that has met our needs very well. They take data feeds from medical and pharmacy claims and raw scores on all biometric tests. From this, we can do predictive modeling, risk stratification, gaps in care, ad hoc reporting or build data cubes.
Only one piece remaining: someone to put it all together. At Cardone, we call this our "wellness architect." Our mission was simple: "success is having healthy and productive people at work every day." Our method was simpler and it is not new. In fact, it appeared in a New England Journal of Medicine article co-authored by C. Everett Koop, in 1993.
It read: "If there were no illnesses and no accidents, healthcare costs for a society would theoretically be a zero. We reduce the need and thus the demand for medical services. Ideally, a society of healthy people does not smoke, does not consume alcohol to excess, exercises regularly, eats wisely, uses seat belts, treats hypertension - people assume more responsibility for their own health..."
So we began trying different ideas to see what worked. Communications became an essential component and we determined that we needed internal full-time health coaches to effectively engage employees one at a time. They are driven to communicate, build participation and increase engagement one employee or family member at a time.
We have all heard it said that wellness is a marathon not a sprint and we were committed to the long haul. It was to become part of the culture. Each day, the wellness team comes to work knowing that if we succeed a little bit each day we will help people change their lives for the better. Healthier employees are happier, have fewer difficulties, better handle stress, are more productive, are absent less and have less need to see healthcare providers.
Thus, the spend goes down and all the metrics move in the right direction. We are less concerned about shifting the cost of care than we are about making sure that when an employee or his/their family needs care, they get it. No Barriers! We found that co-pays for maintenance medications were a barrier. We eliminated them. We found that primary care co-pays were a barrier. We subsidized them. We know that a $3,000 deductible would be a barrier. We don't have them.
If our employees are not healthy, they will not be at work or working to capacity. When that happens, production falls, profits fall -- everything falls. More important than a dollar spent on healthcare is a healthy productive worker on the production floor. In fact, due to the great success of the wellness efforts, our plan is very rich and very successful. Our lowest-priced single plan with our direct contract healthcare system, for someone who qualifies for our wellness incentive, is $36 per month.
There is no deductible, no co-insurance, and no co-pay for maintenance medications and subsidized primary care co-pays. In 2015, we were able to lower the aggregate premium paid by employees by 28 percent. If you ask to what we attribute our great success -- three consecutive years as a "Healthiest Employer in Philadelphia" and an American Heart Association Gold Level Fit-Friendly Workplace award -- we would have to say everything and everyone.
If it becomes the culture, it is contagious and once everyone catches the wellness bug, it spreads and grows. Next stop: Cardone Wellness Mexico as we look to a new wellness challenge in a new country and culture. At Cardone, wellness works.
About the Author
James Wilton, who administers Cardone Industries' self-insured Group Health Plan, is also the architect and manager of the company's integrated wellness program. Prior to joining Cardone, he served under the Delaware Secretary of Health as the chief administrator of the Managed Care Unit for Delaware Medicaid.
He is a certified mediator and mediation trainer as well as a Certified Corporate Wellness Specialist. In his spare time, he works with clients as a certified personal trainer as well as a Pilates and qigong instructor and a student of tai chi.
