How to Reduce Health Costs and Save Lives
Reduce Costs and Save Lives
It’s a rare feat in today’s business world when an organization can avoid reducing health insurance benefits or shifting costs onto employees in the face of runaway healthcare expenses. And there are plenty of cynics who believe the Patient Protection and Affordable Care Act (known as the ACA) will further tie the hands of employers that are trying to accomplish these goals, and making it impossible to save money.
But truth be told, there’s no reason for Corporate America to believe it cannot defy those odds, nor is it necessary to fear the long arm of government. Success is achievable, regardless of the nation’s economic or political climate, and it hinges on the establishment of a “culture of health” wherein beneficial lifestyle, health and wellness distinctive choices are made from a convergence of interests and support systems, as well as structures and processes. Only then can forward-thinking employers improve the health and productivity of their workforce, and in that manner, bend the curve of their healthcare costs.
The linchpin of this high-touch approach combines the tenets of early detection and effective intervention with direct physician and behaviorist involvement for a more holistic result. Together, these elements have the power to substantively change – and even avoid a catastrophic incident. Known as an Individual Health Opportunity Assessment (IHOA), it offers employees and their spouses a face-to-face annual assessment and clinical consultation with a trusted physician and health behaviorist who integrates with an employee assistance program (EAP).
These meetings, which last about 8 minutes because of the sheer volume of many employee populations, drive a process that can be likened to speed dating, but the result is anything but superficial. Behaviorists are trained to ask key questions that get people to open up as they would during a counseling session, in roughly 10% of the time. Afterward, they may be referred to an EAP or a health behavior coach. What is so compelling about this process is that it removes much of the mystery or stigma around behavioral health and EAP, an incredibly valuable but underused resource that can guide people to embrace relevant information and make wiser choices and pursue the right course of action.
HRA on steroids
One creative way to describe an IHOA is that it’s like a health-risk appraisal (HRA) on steroids. How so? In a nutshell, there are enough moving parts to achieve a more meaningful outcome than traditional programs. Here’s how it works: Once all the necessary forms are filled out, employees meet with a team of clinicians that include a phlebotomist, nutritionist, physician and psychologist to review their personal health profile and make recommendations. The main objective is to motivate more people to align themselves with a trusted clinician and/or embrace a more aggressive ongoing treatment regimen with their family physician.
This tool tracks process indicators that include the extent to which employees are participating in HRAs, biometric and cancer screenings, immunizations and health fairs and gauges their willingness to make important lifestyle changes. An IHOA also promotes annual physicals and lunch-and-learn sessions, while also providing guidance before specialty care needs to be accessed. In addition, follow-up coaching and education lead willing participants down the path of a healthier lifestyle.
The larger point is to engage people where they work, whether it’s in an office setting or on the factory floor, which can have a very positive influence on how they choose to live since so much time is spent in the workplace. An IHOA fits nicely in the emerging age of employee engagement and population health promotion. And, with a proven track record of high impact engagement and intervention at various large corporations, this approach raises the bar in terms of what an organization can expect from employees who may have been reluctant to improve their health, but are given the tools they need to move from simply contemplating solutions into taking action.
Since the IHOA resembles a health fair, it could be turned into an event where people who have not chosen a physician would have an opportunity to see a local primary care physician (PCP) from their provider network (also known as the “medical home” concept) in action and decide whether or not to seek his or her services in the future. This phenomenon is surprisingly widespread among people with health insurance who aren’t taking full advantage of the resources that are available to them, and it is counterintuitive to the notion of expanding access to healthcare under the ACA.
One area that’s ripe for a significant return on investment and improved health outcomes as part of an IHOA is when a team of clinicians can better ensure that patients suffering from leading chronic disease states are adhering to their prescription drug regimen. It is commonplace for a segment of this employee population to cut back on their dosage because of side effects or ration their supply of medication out of financial necessity. But the fact is that more prescriptions are written as a result of IHOA interventions because patients are receiving proper medications, which can help reduce or eliminate needless – and costly – trips to the ER.
If an employer is trying to avoid cost, C-Suite executives and front line management must become heavily engaged creating a culture of health that showcases prevention. “Sick care” costs money. Prevention saves. It’s that simple.
Following up on patient care is an integral part of every IHOA, buttressed by an extensive database with physician and behaviorist notes concerning elevated blood work or other risk factors. This enables almost verbatim quotes from previous conversations that were delegated to various members of the clinician team and easily identify each individual’s particular needs.
An IHOA is one of seven core programs developed in recent years to help employers benchmark their health promotion vis-à-vis competitors, determine how they can improve those efforts to the point of bending the cost curve, and conduct what-if scenarios for planning and budgeting purposes. Similar tools include an Employer Health Opportunity Assessment and Community Provider Opportunity Assessment. Rounding out the toolkit are productive advantage dashboards, care management centers-of-excellence support to improve efficiency in the delivery of care for costly chronic, catastrophic and disability cases, physician executive solutions, and community provider reward and recognition programs.
This multi-pronged approach helps pave the way for several opportunities to create meaningful productive interactions with the workforce, reduce an employer’s healthcare costs and improve personalized experiences of consumers and population wellbeing outcomes. They include fewer inpatient admissions, medication compliance or adherence, the establishment of a PCP relationship and interaction with a behaviorist. Of course, it all starts with creating a self-perpetuating culture of health. There are five common denominators for employers that share this vision. They have taken the time to develop an integrated multi-year strategic scorecard and roadmap for improving the wellbeing of their workforces, as well as expand their focus on sick care to integrated population health improvement. Other characteristics include engaging employees in early detection and prevention programs, recruiting and rewarding the best community providers and empowering a dedicated physician executive to assist in program design, implementation and vendor management.
Once these innovative components are in place, it becomes much easier to chart higher expectations in regard to employee health and productivity. This leads to creating the culture of health necessary to bend the healthcare cost curve – even at a time when achieving such actions has become one of the biggest challenges that any business encounters.
About the Authors
Edward J. Haaz, M.ED., LPC, ABMPP, clinical behaviorist, David Spratt, D.O., FAOEM, wellbeing specialist and Les C. Meyer, M.B.A., healthcare strategist are business partners in HealthNEXT, an emerging leader in establishing corporate cultures of health and work life wellbeing initiatives as a measurable competitive advantage. Les C. Meyer can be reached at 303-916-0017 or [email protected]