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Happy 15th Birthday!

Birthday Cake for 2013 Iowa Employer Benefits Study

Our annual Iowa Employer Benefits Study© is about to take place. I’m really looking forward to this year’s survey for these important reasons:

  • This will be the 15th Study conducted since we started this particular survey in 1999. Some ‘birthdates’ are celebrated with more meaning than others…and 15 is a significant amount of time to show trending patterns and establish a credible track record!
  • Three new modules of questions will be added in this year’s Study.

1. The first module will gauge whether employers will keep their health plans (this would apply to those employers with 50+ employees). In addition, we will determine how prepared employers are regarding health reform requirements. This module is extremely relevant because employers will be making decisions for 2014, the first year most health reform provisions will take effect.

2.  The second new module will be added that will determine how Iowa employers view their local community health care providers – specifically hospitals and physicians. Modules two and three will begin to address the upstream portion of ‘Our Health Care River.’ Our newly established company, Heartland Health Research Institute, will then begin to tackle the implications of the results from these two modules.

In this module, employers will grade hospitals and physicians on 11 key issues, including: transparency of costs, outcomes, coordination of care, concern for patient satisfaction, ability to engage patients, and so on. In addition, employers will be asked to measure their TRUST of these providers. Measuring trust is extremely important for a number of reasons. David Shore, Founding Director of the Trust Initiative at Harvard School of Public Health, once said that ‘trust is the currency of commerce.’

To learn more about the trust issue in health care, please see my earlier blogs:

The Currency of Commerce (Part 1)
Trust – A Distinguished Healthcare Trait (Part 2)
Trust – Now is a Good Time (Part 3)

3.  The third module will address the type of data needed by employers to manage employee health costs. It will help identify who should have the responsibility to supply the primary source of this data to employers and their employees (i.e. health insurers, government or health providers – such as hospitals or physicians.) In addition, we will learn how knowledgeable employers are regarding the Iowa-based web resources currently available on our Iowa hospitals.

Rest assured, we will continue to ask our core questions about the benefit components being offered by Iowa employers. After all, this is the initial reason we began this groundbreaking Study 15 years ago. One thing I have learned over the years of conducting this Study is the importance of constantly monitoring the marketplace — asking fresh questions and addressing new and potential trends.

If your organization is randomly selected to participate in this year’s Study, we highly encourage you to share in our celebration by participating in the survey. Here’s to adding the 15th candle to our cake!

To learn more, we invite you to subscribe to our blog.

A New Approach: Heartland Health Research Institute (Part 2 of 2)

HHRILast week’s blog, “A Bystander – No More!” has set the table for this week’s blog.

I have recently founded another organization with the vision to advance the transparency of facts through objective research and innovative solutions in the delivery and payment of health care. Our mission is to provide meaningful health care information to improve decision-making for consumers, employers, health care providers, policymakers and the general public.
The name of our new organization is Heartland Health Research Institute (HHRI).

Dr. Yogesh Shah

Dr. Yogesh Shah
Associate Dean of Global Health
Des Moines University

HHRI is a collaboration between Dr. Yogesh Shah and me. Dr. Shah serves as associate dean for Global Health at Des Moines University (DMU) – a position created to establish and increase international rotation opportunities, medical service sites and other global health experiences sought by DMU students. His passion includes improving the health of people around the world.

Dr. Shah is triple-board-certified in family medicine, geriatrics and hospice and palliative care. He is very involved through the World Health Organization (WHO) and was instrumental in making Des Moines a member of the WHO network of age-friendly cities. Dr. Shah led the creation of the Heartland Global Health Consortium, a collaboration of Iowa educational learning opportunities for students. He was awarded a Fulbright scholarship to develop a palliative care program in Rwanda. Dr. Shah was born in Mumbai, India.

Dr. Shah and I met a year ago while jointly working on a research project for Capital Crossroads. Through this interaction, we realized our passions about health care were very similar, and our seemingly disparate backgrounds are actually complimentary to one another. It was through our discussions that HHRI was conceived.
So what will HHRI do?
An ongoing need exists for objective, unbiased information regarding the local health care system, so that decisions affecting our system will be based on verifiable facts. HHRI was founded to conduct research and provide education focusing on a broad spectrum of health care issues. Topics covered are specifically from the patient’s perspective and measure patient confidence and trust in the health care system today and into the future.
HHRI will function strictly in an objective and unbiased manner and not as an advocate or opponent for any position. Frankly, we are not about advancing any particular political agenda, but rather, advancing factually-based evidence that will attempt to make sense out of this very complicated health care world in which we live. Topics addressed by HHRI may include:

  • Transparency in costs and outcomes
  • Quality of health care
  • Patient engagement and activation
  • Palliative care
  • End-of-life care
  • Employment-based health benefits
  • The value of health coverage
  • Population-based health
  • Attitudes toward health care reform
  • Identifying and understanding the unintentional consequences of public policies
  • Other tangential issues

HHRI is a knowledge-based organization serving Iowa and other Midwestern states, and will focus on:

  • Data to reveal major health challenges and opportunities.
  • Credible, reliable and objective research for decision-makers, policymakers, employers, media and the general public.
  • Exploring and presenting key health care issues with thought leaders from all sectors.

We want to provide understandable information that can be used to solve the problems our health care system suffers from today. Our work must provide clear results that will be applied to everyday decision-making by employers, employees, policymakers, media and the general public. Having a healthy, robust workforce and population is critical to the economy of Iowa and other Midwestern states.

In the future, I will continue to monitor the downstream of Our Health Care River using the annual Iowa Employer Benefits Study. With the advent of HHRI, we will now be able to move upstream and pursue critical issues inherent within our health care world.
HHRI is new and fresh and created to make a real difference. You will be learning much more about our work in the months ahead! Should you have further questions about HHRI, I encourage you to contact Dr. Shah or me.

To learn more, we invite you to subscribe to our blog.

A Bystander – No More! (Part 1 of 2)

Similar to a bystander observing something that makes them feel uneasy, such as a mugging or a car wreck, a familiar ‘spectator-feeling’ applies when watching the evolution of our health care issues – at least for me.

It began in 1984, when I worked as an account consultant at Blue Cross and Blue Shield of Iowa (Wellmark), and I consulted with Iowa employers on the health benefits they provided to their employees. For those of us old enough to remember, health insurance premium increases were exorbitant in the eighties. In fact, they were even greater than what we have observed in the twenty-first century. Premium inflation in the eighties could certainly be considered a major car wreck or a mugging over which insureds had no control – and I was both a spectator and a participant tangentially tied to the carnage.

In the early-to mid-nineties, hospital expenses and revenue increased very slowly while insurance premium inflation tapered off. However, later that decade, premiums began to move upward again. As in the eighties, my observations allowed me to conclude that rising health care costs and insurance premiums were just too pervasive to successfully solve. We were all innocent bystanders standing with mouths agape, right?

Then came 1999…

In that year, we began our first annual “Iowa Employer Benefits Study,” which is now in its 15th year. Over the years, we have been monitoring the benefits offered by Iowa employers – with health insurance being the most salient of all benefits due to sheer runaway costs and social issues. I was now becoming very intrigued (if not obsessed) with the societal issues of health care and how it impacted health insurance premiums within Iowa and beyond. In short, understanding how health care could be delivered more safely and efficiently would, ultimately, favorably impact the direction of health insurance premiums paid by employers and their employees.

Unfortunately, it was just too easy and convenient for me to remain an ‘innocent’ bystander observing the smoldering wreck that is our health care system AND reporting the results in our annual Study. Again, I unconsciously watched the buildup of these wrecks, somehow rationalizing that others who were more knowledgable and capable could ‘fix’ the underlying reasons for the undeniable malfunctions.

The health care problem is just too vast to tackle – right?

Repetition drives habits, and habits can be extremely powerful over a period of years. My ‘habit’ was to witness this wreck of a health care system, shake my head in disgust and do little or nothing to try to assist others with possible solutions to fix the underlying cause of the problem.

As time went on, a nagging question became more of a roar:  “With the inability of our health care ‘system’ to deliver safe and efficient care to our population, should I continue as a bystander and perpetuate this troubling activity or try to do something to help remedy the situation?” I needed to decide how I would focus my efforts in the future.

Finally, in October 2011, I made my choice. I would no longer continue in the role as an employee benefits consultant. Instead, I would follow my passion to help others seek new and clear initiatives to pursue the core problems within our truly dysfunctional health care system.

As mentioned in a recent blog, we developed an infographic describing ‘Our Health Care River.’  The downstream portion of this infographic illustrates the rising health insurance premiums paid by Iowa employers and their employees, which is derived from our annual Study. That work will certainly continue. However, I will now focus more of my attention upstream. The landscape upstream shows two primary root causes for our health care cost problems:

  1. Fragmented Delivery System
  2. Unhealthy Lifestyles

You may have noticed the “Heartland Health Research Institute” (HHRI) logo within the infographics. HHRI is our new company that will begin to address some of these root causes upstream.

More about HHRI’s mission and vision in next week’s blog. My goal is to put our wreck of a health care system in the rearview mirror and concentrate my efforts on being a part of the solution…because we have to start somewhere.

To learn more, we invite you to subscribe to our blog.