Driving health benefits up, and costs down

Most hospitals and healthcare organizations offer benefit programs aimed at keeping workers in both good physical and mental health. But less common are healthcare employers that can prove those same programs actually save the organization money.

Two examples of healthcare employers that have done exactly that are Parkland Health and Hospital Systems in Dallas, and Methodist LeBonheur Germantown (Tenn.) Hospital. Both organizations offer their staff traditional medical benefits. But they also place special focus on disease management, and take a “carrot and stick” approach to getting employees to manage their individual benefit plans.

These two organizations provide programs that go beyond addressing the health and wellness needs of plan participants, and actually reduce overall operating costs, or at least keep them below the competition.

Parkland Health and Hospital Systems employs more than 10,000 workers at its 20 community-based clinics and 12 school-based clinics, which in turn treat more than one million patients annually.

“We offer a very robust wellness program and disease management program, which complements our health plan,” said Marnese Elder, vice president of talent management operations at Parkland. “Our health plan is the Parkland Employee Health Plan, and is a self-insured product. As part of that, we have what we call Parkland Wellness at Work. That program incorporates our wellness and disease programs.”

In order to curb rising plan expenses, Parkland has targeted two particularly high cost areas: diabetes management and maternity care.

[See also: 7 tips for preventing staff burnout in healthcare.]

In the case of maternity management, Parkland developed a program for employees in the first or second trimester of a pregnancy that teams those employees with nurse case managers for a variety of individual support services. Those include prenatal care information, counseling, high-risk pregnancy identification, case management for high risk mothers, and first year of life education.

Deductibles and co-payments are waved for program participants. The goal is to help employees have the safest pregnancy possible, as well as healthy outcomes for infants following birth. The benefits to both employee and employer are obvious., said Elder.

“Ninety-nine percent of the members that started it remained engaged in the program,” she noted. “The reason we know it is successful: we implemented this maternity management program in 2011 and in 24 months our [participation] rates increased from 7 percent to 64 percent. Of the 64 percent, 50 percent joined in their first trimester. So it is really taking off and the word is spreading about the success of the program.”

Equally important to the health system are the bottom line numbers.

“We found that the maternity management program contributed to the reduction of our plan’s total claims for pre-term infants, short gestation, and low birth rates. These claims have continued to decrease, and in this 24 month period, claims dropped on average from $148,256 for 33 patients in 2011, to $48,553 for 15 patients in 2013,” Elder said.

It is a similar story for Parkland’s diabetes management program. Participating employees agree to an individualized disease management program in exchange for free diabetic supplies. Like the maternity program, insurance claims have dropped dramatically during the 24-month period.

Diabetes management and maternity management programs are obviously ideal for a select few, but they hardly serve the broader employee base. That is why Parkland is targeting a new incentive program in 2015 involving wearable tracking devices. Healthcare workers walk many miles and perform thousands of activities in the course of a day. Parkland will begin collecting a variety of health data on how they engage in those activities, and what the health implications might be.

The goal, Elder explained, is to collect a wealth of data that can help hospital officials best target future health and wellness efforts. The data will provide a comprehensive health profile of the total employee population.

In the meantime, Parkland has “what are known as wellness liaisons that are attached to our Parkland Wellness at Work program,” Elder explained. “They are people who are in the trenches alongside our staff, taking feedback from their colleagues on how they think the program is working, and what changes they would like to see. We have as many as 50 liaisons working at one time.”

At Methodist LeBonheur Germantown Hospital, a competitive benefits program is a key recruiting tool, and much of the program strategy is developed around attracting and retaining staff. But just as much focus is placed on reducing “healthcare spend” as on improving the health of associates (as hospital employees are called).

“We have for many years had a pretty strong and vibrant wellness program and we continue to grow and build it,” said Carol Ross-Spang, senior vice president of human resources. “At the same time we continue to put things in our healthcare plan that are both carrots and sticks to help encourage and incent people to do the right thing in relation to their health.”

[See also: 5 tips for effectively recruiting, engaging and retaining top healthcare employees.]

Again, the goal is to help employees remain healthy, both physically and mentally. But the organization also keeps operating costs considerably below their regional competitors.

“We employ a lot of associates and have a lot of benefit costs, but we manage and measure our benefits extensively,” Ross-Spang explained.

As with Parkland Health, Methodist has a self-insured health insurance plan. It includes lots of education and free exercise programs, weight loss programs and sports leagues, as well as wellness, massage and relaxation offerings.

Perhaps the most important step to encourage staff to maintain their health was an annual health assessment screening. Associates are asked to have a complete annual physical. If they comply, they avoid having a $15 surcharge placed on each paycheck, which goes toward the company health plan cost.

“We found that less than 50 percent of our associates were getting an annual physical,” said program manager Jane Van Deren. But with the implementation of the $15 paycheck surcharge, Methodist has seen the participation rate climb to over 90 percent.

“We want you to get all the healthcare you need, but to think about it,” Ross-Spang said. “If you’re going to spend some of your own money, you’re going to make different choices, you’re going to ask different questions. We’ve done many of these initiatives without having to move to a high-deductible health plan, which many companies in our area have adopted.”