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Wellness: Bending the Cost Curve

Wellness and Health Care Costs in IowaWill wellness programs stem the tide of rising health care costs?

That’s the million dollar question.

Health insurance rates in Iowa increased an average of 10.2% annually during the last five years, according to our Iowa Employer Benefits Study©. No wonder employers are looking for ways to bend the cost curve.

So are wellness programs going to provide the magic bullet? I have to say, “Possibly, however…”

There are at least two major forces—upstream and downstream—that adversely affect health care costs, and only one is affected by wellness programs.

  1. Upstream force: unhealthy lifestyle behaviors        
  2. Downstream force: a dysfunctional health care delivery system

Conventional wisdom suggests that if we identify and minimize or treat health risks upstream before they become major (and more expensive), we should eventually incur fewer costs downstream.

I admit there is truth to this. Decrease unhealthy behaviors that lead to the “lifestyle diseases” —heart disease, stroke, some cancers, type 2 diabetes, metabolic disorder and a few others—and you lower the need for expensive procedures.

But for most people, improving lifestyle behaviors leads to involvement with the health care delivery system – the downstream force – and this fragmented system is not geared to provide efficient, coordinated and recommended care. In fact, in 2003 the Rand Corporation released shocking results from the largest and most comprehensive analysis ever undertaken on health care quality in the U.S.

Adults in the U.S. fail to receive recommended health care nearly half the time!

Unbelievable, you say. We have the best health care system in the world, you say. Well, here are a few examples:

  • Less than a quarter of diabetics had their blood sugar levels checked regularly, putting them at risk for kidney failure, blindness and amputation.
  • Just 45% of heart attack patients received medications that would reduce risk of death by more than 20%.
  • Patients with high blood pressure received less than 65% of recommended care, putting them at increased risk for heart disease, stroke and death.

Just as staggering—according to the study, inappropriate care happens everywhere! While a study that came out in 2003 may seem dated, the reality on the ground has not improved. The Dartmouth Atlas of Health Care continues to support the Rand findings by documenting the variations of how health care is delivered in this country.

So by all means, implement a well-designed wellness program. But don’t expect miracles when it comes to bending the cost curve. Until we address our dysfunctional delivery system, your payoff may come in healthier and more productive employees.

A New Acronym in Iowa: ACOs

David P. Lind BenchmarkRecently, my interactions with the health care system have been up close and personal. I can tell you that my wife and I have experienced great frustration when seeking coordinated care for our daughter in recent months, both in and out of the hospital.

Having to reconstruct her medical history over and over and over for each new health care provider has been discouraging, annoying, and frankly, unnecessary. If you’ve been there, you know what I mean.

Lack of coordination between different health care providers for the same patient is a major concern in this country. Not only is it incredibly frustrating to the patient and family members, it’s potentially dangerous and very costly due to inefficiencies and duplication of services.

Your insurance premiums, by the way, are adversely affected by this current delivery of care.

What about ACOs

Accountable Care Organizations (ACOs) are the latest trendy model for delivering health care services by doctors and hospitals.

In a nutshell, an ACO is a network of doctors and hospitals who share responsibility for providing care to their patients.

Sounds good to me! However, I recently read that ACOs are being compared to the elusive unicorn: everyone seems to know what it looks like, but no one has actually seen one.

Imbedded in the massive new health law, ACOs were allotted only seven pages of provisions, but they’re causing a tremendous amount of interest with many stakeholders (patients being one!).

The intent of an ACO is to bring together the different aspects of care for the patient— primary care, specialists, hospitals, home care, etc.—and make providers jointly accountable for the health care of their patients.

Through the new health law, financial incentives will be given to providers to cooperate and save money by avoiding unnecessary tests and procedures. To do this, they must seamlessly share a patient’s medical information between themselves. So instead of the patient and family members having to educate each provider on the medical history, the ACO team would have all information at their fingertips.

Personally, I hope that ACOs (or something like them) become the “new normal” in our delivery system. It cannot come soon enough for this parent!

To learn more about the Final Regulations for ACOs, click here.

What Iowa Employees REALLY Want

David P. Lind BenchmarkRaises? Vacations? Insurance? Ever asked your employees what’s important to them? You might be surprised.

In 2007, our firm undertook the Iowa Employment Values Study©. This study illustrates many opportunities for executives to improve employee satisfaction, even in tough times, with a limited budget.

R-E-S-P-E-C-T

Aretha nailed it. Being appreciated and valued is the number one workplace value for employees.

Question: “What is the one main thing your organization could do better?”

The consistent answer:  “Show appreciation for hard work.”

The cost: Better communication.

Employees want their employers to open channels of communication and recognize (acknowledge) hard workers. The study revealed that having better communication within the organization is essential to employees’ overall positive perceptions of their jobs.

High-quality communication improves virtually every aspect of employee opinion, our research found, and employers should provide plenty of opportunities for meaningful feedback from employees.

The payback: Employees who know they’re valued are proud of their organization and are significantly more positive about ALL aspects of their job.

Employees value RESPECT and ACHIEVEMENT most at work versus what their bosses think they value most. Other than the two top values, bosses clearly underestimated the order and importance of each workplace value.

Here’s the disturbing trend:  Bosses consistently underestimate the importance of a well-rounded lifestyle to their employees.

These workplace values describe organizational culture. Creating and maintaining a positive culture is the DNA of any successful organization. Understanding what employees really want is key to a positive work environment and loyalty among your workforce. What values are strongly reflected in your organization?