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New Era in Iowa Healthcare (Needed)

Value in Health Care DeliveryI’ve recently been visiting with healthcare providers around Iowa discussing how employers view health insurance and the value of healthcare delivered to their employees and family members. The discussion has been both open and honest. In fact, Iowa hospitals and physicians appear to be both interested and concerned with what they are learning.

My presentations evolve around four key observations that I have made over the past 29 years, both as a benefits consultant (my past life) and as a researcher. The intent of sharing these observations with the provider community is to convey the ‘pain points’ experienced by Iowa organizations regarding exorbitant health care costs and to begin a new dialogue of collaborating resources to find meaningful solutions in our health care world. After all, we are all in this mammoth problem together, right?

Here are my four observations:

  • Observation #1 – Health insurance premiums for Iowa employers have increased by 164 percent from 1999 to 2012. A great deal of uncertainty exists about the future of the health care ‘system.’

Year-after-year, employers continue to pay a handsome portion of the insurance premium. We know that take-home pay continues to erode for employees, as cost-sharing continues upward through increased payroll deductions and benefit plan alterations that include both higher deductibles and out-of-pocket maximums. This is clearly unsustainable for ALL of us. For communities to remain healthy and vibrant, employers must find solutions to this escalating problem.

  • Observation #2 – Iowa employers continue to embrace wellness initiatives, as they desire to have a healthier and more productive workforce.

Gradually we are morphing into a new social conscience of embracing healthier lifestyles – as more Iowa employers continue to assess and implement wellness efforts. We also have the Healthiest State Initiative and Blue Zones Projects™ in the news. The statewide Capital Crossroads Community Wellness Study reported that Iowa employers are open to partnering with community-wide wellness programs. For those employers currently without wellness programs in place, only three percent feel that wellness programs don’t work! This is encouraging.

  • Observation #3 – Lack of transparency in health care is a major concern and frustration to Iowa employers and their employees. Health insurance has become a major distraction to employers.

There is a growing belief that the ‘market’ approach does not work for ‘buyers’ of health care. In the next few years, will we see a gradual shift by employers to a more defined contribution approach by limiting financial support for employee premiums? Will value-based benefits begin to take hold that will nudge employees to use ‘higher value’ health providers and utilize approved medical procedures requiring less out-of-pocket exposure? Transparency of costs and outcomes are essential for the private market(s) to exist as health providers WILL definitely be held more accountable in the future.

The Accountable Care Act (ACA) will not solve the cost issue for employers and their employees. In fact, the ACA adds greater complexity in the insurance markets, forcing employers to search for opportunities that will relieve tensions and uncertainties. A ‘Provider Renaissance’ is sorely needed to deliver great value for the insurance premium being paid.

So what does all of this mean to the healthcare provider community?

Employers want to TRUST that hospitals and physicians will:

  1. UNDERSTAND the employer perspective, which is the need to be competitive by having a healthy workforce. Health providers must have the employers’ best interest in mind.
  2. CONSISTENTLY provide quality outcomes at reasonable costs – i.e. receive greater value for the dollar paid.
  3. COMMIT to do these critical things on an on-going basis – long term.

As mentioned in a prior blog, our fragmented delivery system is really not a “system,” but rather a concoction of multiple temporary or expedient remedies that attempt to solve our problems as we confront our health care needs. No one is at fault, yet we ALL are.

Now is the time for employers and the healthcare provider community to work together – starting with a meaningful and trusting dialogue that will result in concrete solutions.

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A More Sensible Lifestyle

Now here is a study to stand up and take notice.

According to researchers who used data collected for the National Health and Nutrition Examination Survey (NHANES), reducing the number of hours spent watching television to fewer than two hours every day may extend life expectancy by nearly 1.4 years. In addition, if we can just limit our sitting down each day to no more than 3 hours, we can also increase our life expectancy by as much as two years!

I have read articles about sedentary life and the adverse outcomes that follow…higher obesity, diabetes, cardiovascular problems, etc. This study goes a step further by linking lower life expectancy to the unhealthy lifestyle choices we make, namely, living a sedentary life. The study does acknowledge, however, that the researchers “assume” a causal association rather than “proving” that sedentary lifestyle will negatively impact how long we may ultimately live. This seems to be an intuitive assumption…so I’ll buy into this.

As organizations attempt to make a more positive impact to the health of their employees, maybe Iowa employers should find creative ways to keep their employees standing for longer periods…such as providing adjustable desks that allow employees to stand up when using computers and phones, require staff meetings to be shorter in duration (less sitting), or simply encourage walking breaks. Standing all day at work, however, can cause our bodies to endure the natural force of gravity, pulling the body down and causing the muscles to be tense…resulting in pain, etc.

Clearly, living a more moderate lifestyle between sitting and standing seems to make the most sense!

Smart Phones – Smart Future!

David P. Lind BenchmarkIn March, on behalf of Humana, Inc., Forrester Research released their report, “Mobile Application Adoption Trends and Strategies To Engage The Workforce”. According to this report, the trend appears to be that more employers embrace the idea of interacting with their employees for personal and work-related activities using new technologies offered through smart phones, tablets and other mobile devices.

Three key conclusions come from this report:

  1. An emerging demand for health and wellness mobile applications. Such applications enable employees to locate healthcare provider sites, track exercise activities, or monitor various biological conditions such as heart rates, glucose levels, and other health-related.
  2.  Mobile recruitment applications are emerging. Capturing candidate information during job fairs, interviews, or sharing video clips to candidates about specific jobs available within the organization.
  3. HR and benefits professionals implement awareness campaigns to promote employee adoption of mobile applications.  Purposes may include rolling out a new wellness campaign, incentive programs, and other new initiatives that are central to employment.

This report allows human resource executives and benefits administrators to look into the future when attempting to engage their workforce…using existing and new technologies.

Consider this:

  • About 17,000 health-related mobile applications are on the market*
  • By 2015, the number of mobile health service users are expected to reach 500 million*

Sprint launched a 12-week “Get Fit” challenge during the summer of 2011 and found big success using social media tools to engage employees to participate in wellness activities, such as weight loss, exercise minutes and pedometer steps. The estimated savings from this challenge, according to Sprint, was approximately $1.1 million. Partnering with ShapeUp, a wellness software company, Sprint used social networking tools that allowed employees to log their progress online through a website portal in addition to using mobile devices. Employees interacted with other employees throughout the country with friendly competitions – holding each other accountable. Sprint attributes a big part of the programs’ success to social networking. Social media tools can be a good thing when used appropriately!

Hmm, maybe it is time to learn more about what Iowa employers plan to do in the future regarding this new technology! Stay tuned.

*Stetler, Mark, “Trends in Healthcare and Medical Apps