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Charting a New Path. Why Creating New Habits Saves Money at Work.

By DrScott – Posted on February 11, 2014 on www.compassphs.com

Sixth in the How to Switch On Your Employees Series

For one Compass client, “Contact your Health Pro” became the mantra.

  • “Which plan should I choose: the PPO, HMO, or high deductible plan?” Contact your Health Pro.
  • “Who is a great female family doctor near my home?” Contact your Health Pro.
  • “Where do I get my colonoscopy done by the best doctor?” Contact your Health Pro.
  • “How do I find the best, lowest cost place to get an MRI of my back?” Contact your Health Pro.
  • “My doctor says I need glasses, how do I use the vision plan?” Contact your Health Pro.
  • “I have a 3 month prescription and I don’t know how to do mail order.” Contact your Health Pro.
  • “Where is the best cancer center and which doctor should I see?” Contact your Health Pro.
  • “Do I qualify for a weight loss program?” Contact your Health Pro.
  • “Have I met all the requirements for the best health plan next year?” You guessed it: Contact your Health Pro.

The human resources staff had only a few employees. The new outcomes based program had too many variables, something had to change. In the past employees called HR, they were given the phone number for the insurance plan, the wellness program, the PBM, the vision program, and so forth. But the number of phone calls and the complexity was too much. Often in frustration employees just gave up, the HR staff members were exhausted, participation in programs was low, and costs were not coming down.

A new concierge program was brought in. The Health Pro concept, telephone number and website link, were introduced through a number of communication venues that included:

  • Through open enrollment communication materials and meetings.
  • At company meetings.
  • On the back of the health, vision, and dental cards.
  • On the corporate intranet site.

Involvement in the program and services dramatically increased. Every contact was tracked, behaviors were followed, and results documented.

The results were significant:

  • Calls to the HR department went down 25%.
  • Over 40% of employees contacted their Health Pro.
  • Participation in mail order prescriptions, the employee assistance plan, smoking cessation and weight loss programs all increased by double digits.
  • Health care costs for CT scans, MRI scans, and colonoscopies were reduced by 50% for dozens of employees.
  • Use of the “Designated Physicians” who met quality and cost metrics increased by over 25%.

The financial return on investment for the new Health Pro program was reported quarterly and varied from 5:1 to 8:1. In addition, the Net Promoter Score for the Health Pro was 72 – the highest for any vendor the company used.

As Chip and Dan Heath share in Switch, managing the path forward required shaping a new path. The employees had to change their habit from relying on the HR department for all the answers to contacting their Health Pro first. They were beginning to use all of their benefits, and to provided cost and quality transparency information. The “herd” had made the turn and actually encouraging each other on this new path.

The third key ingredient in making the “switch” was successfully navigated and momentum was building. By managing the three aspects of change, the question was not “if” but “how much” success would occur each year. In the next blog we will complete this series and review how to successfully navigate to a high performance, outcome based system.

Making the Turn – Changing to Outcome Based Wellness

By DrScott – Posted on January 28, 2014 on www.compassphs.com

Third in the How to Switch On Your Employees Series

Recently an HR team met to plan next year’s health benefits. It started with a review of last year’s changes and outcomes. Health costs went up 5%, but the projection for this year was closer to 10% with the new Accountable Care Act changes. Their President made it clear that the company could not tolerate a 10% increase and they had to find a way to better manage the situation.

There was a general sense of frustration around the table. Catastrophic costs driven by diabetes, surgeries, cancer, and heart disease again were the top challenges, and little headway had been made. The wellness program had paid out thousands of dollars to encourage employees to eat better, exercise more, and get their biometric screenings, but participation was still in the low 30% range. The HR team knew they had to make a significant change to make progress.

They studied other companies that had been successful in managing costs and decided that the keys for success were for every employee and their spouse to do the following:

  1. Get their biometrics and normalize any that were not to goal,
  2. Get age and gender appropriate wellness tests and exams recommended by the United States Preventive Services Task Force (USPSTF) performed by a high quality primary care doctor (preferably a patient centered medical home), and
  3. Get the USPSTF recommended screening for cancer and treatment for diabetes, and heart disease performed at high value providers

All employees were to be moved to a high deductible health plan to increase their involvement and to create a personal investment in making sure they took care of their health and had “skin in the game.”

The HR team was really concerned about the reaction by the employees when this was announced. They appreciated their President wanting to save money on health care and wanted to have this go off without a hitch.  Therefore, they reached out to the HR staff at several companies that had successfully made this change and got their advice on how to roll out the plan.

In the next few blogs we will review how they decided to roll this out to insure success. To make it more accessible, and interesting, we will use the paradigm laid out in the book Switch by Dan and Chip Heath. We will explore how to change the direction of the “elephant” walking down the old familiar path, directing the rider, motivating the elephant, and re-shaping the path.

How the “I Feel Fine” Syndrome™ Is Costing You Millions – Part 2

By DrScott – Posted on December 31, 2013 on www.compassphs.com

In the last blog we examined the fact that during the early phases of disease development we don’t feel symptoms. Despite this, the disease is developing in our body and we can discover and cure it, but over 80% of us don’t take action.

So why don’t we do it? Why do 8 out of 10 of us put off these simple tests and condemn ourselves to years, or decades of pain and suffering?

Asked another way, why would a rational human being who is busy and challenged keeping up with obligations to family, employer, friends and social groups, stop what they are doing to:

  • go spend their time sitting on hold trying to make an appointment,
  • take time off from work – usually unpaid or using personal time,
  • take off their clothes and have a stranger probe their body, stick a needle in them,
  • go to another facility to have their body squished (mammogram) or a tube inserted (colonoscopy),
  • spend time worrying and waiting for results, and then,
  • often pay their hard earned money for additional tests or procedures that often turn out to be “nothing.”

This on top of the fact that this person has awoken for forty or more years and not discovered a problem, they don’t feel any different now, and frankly they really could not afford emotionally and financially if a problem was discovered.

Hard to imagine, isn’t it? Looked at from this perspective, one does wonder how we ever get anyone to get these tests done! To get people to overcome the “I Feel Fine” Syndrome, an effort to simplify and support employees’ acting effectively must occur.

The wonderful news is that it is happening. One company required their employees to have a biometric screening done and discovered that nearly a third of their employees were not only overweight or obese, but they had metabolic syndrome. Heart disease and diabetes were at the top of the list for health costs and their healthcare spend was rapidly increasing every year. They decided to actively engage in primary prevention with an aggressive metabolic syndrome program. Three years later heart disease and diabetes were costing them literally millions of dollars less and had fallen down on the list of causes of pain, suffering, disability, and death for their employees.

“Our costs were going up rapidly and difficult economic times created a very real challenge to our company. Our advisors were recommending that we change directions and become more proactive and aggressive with our health benefits by doing biometric testing and taking other steps that would mean more cost and a change in our culture towards wellness. The decision we made was to bet on the future health of our team members and not short measures to control cost.”

— Cary Evert, President Hilti North America

To learn more about their journey, request a copy of The Seven Numbers and read the introduction by Cary Every, President of Hilti North America.

In the next blog we will examine the issues companies are addressing to help overcome the “I Feel Fine” Syndrome.