Collaborative Business
I’m sorry for being late with this post. I was on vacation in California with my wife and 82 year-old mother, whom we try to get out of the cold, snowy Buffalo weather one week each winter. The 5-hour plane ride gave me time to read Why Healthcare Matters: How Business Leaders Can Drive Transformational Change by Frank Hone.
The premise of the book is that the solution to our healthcare crisis lies in individual responsibility and expanded employer involvement. The following examples from Chapter 7, “Early Adopters, Measurable Results,” clarify the premise:
- Aetna’s Informed Health Line gives employees and their families access to experienced nurses over a toll-free telephone line, 24 x 7; “Get Active Aetna” is a 4-month program that gives employees a chance to team up with co-workers in a variety of workouts that qualify for prizes, such as exercise clothing and related gear; over 16,000 employees logged over 850,000 hours of exercise in the first 4 months.
- Tony Zook, CEO of Astra Zeneca, noted in 2006 that over 75% of employers’ healthcare costs and productivity losses are related to employee lifestyle choices, including exercise, nutrition, cigarette smoking, early detection of cancer, and participation in evidence-based clinical trials; Astra Zeneca was one of the first companies to receve the accreditation of the CEO Roundtable on Cancer in 2006; they offer smoking cessation programs, fully reimbursed nicotine replacement therapy, free onsite screening programs for breast, colon, and prostate cancer, blood pressure and cholesterol measurement, and confidential health-risk assessments that help employees develop action plans for a healthy lifestyle; employees save $50 per month on their healthcare costs for participating and had a 97% participation rate.
- Baptist Health South Florida includes in its employee wellness program free fitness centers, trans-fat-free cafeterias, and Families Step Up, a comprehensive weight management program; non-smokers pay less for their healthcare insurance.
- Blue Ridge Paper Products provides free diabetic education classes, free onsite monitoring, and 24 x7 paramedics trained in diabetes management; they offer cash rewards to employees who obtain physical and dental exams, attain normal blood pressure, cholesterol, and weight levels, and who participate in ongoing exercise programs; an employee task force monitors benefits and outcomes, increasing employee buy-in and participation; as a result of these innovations, healthcare costs have decreased from 18% to 3.4% in 3 years.
- At Dell, 25% of the employee population accounted for 87% of healthcare costs, and 2% of the population accounted for 40%; they developed “Well at Dell” to develop customized employee health improvement programs, provide tools for healthy lifestyles, and assist employees in managing chronic and catastrophic conditions; since 2004, healthcare expenses have dropped 10% largely due to decreased hospitalization and emergency room use.
- Johnson & Johnson introduced a health and wellness program similar to the ones mentioned above that dropped absenteeism 15%.
- Motorola’s Health Advantage Plan (HAP) focused on wellness, including vision and hearing care, well-baby care, mental healthcare, and preventive screenings with no deductibles; a free annual health screening included weight, blood pressure, and cholesterol measurements; on-site participants could obtain prostate and colon cancer screening; wellness program participants’ annual healthcare costs increased just 2.5%, far less than the 18% increase for non-participants, a savings of $6.5 million on lifestyle-related medical expenses and $10.5 million in disability-related expenses; the savings amounted to a 4:1 return on investment.
- Union Pacific developed Project Health Track when it learned that it spent $40 million for services related to chronic conditions and poor lifestyle habits; telephone counseling led to a 40% reduction in patients with high blood pressure, 24% reduction in patients with high cholesterol, 21% reduction in cigarette smoking, and 47% reduction in obesity, for a 4.5:1 return on investment; they have expanded the program to include disease management programs for patients with coronary artery disease, congestive heart failure, and diabetes, 24 x7 nurse-run telephone hotline, cancer resource navigator, healthy baby program, and transplant management program.
What do you think?
- Do those of you who do not work for large companies wish that you could have these benefits
- Are you impressed with the long-term approach these companies took to invest in their employees
- Is corporate paternalism justified if it helps employees make choices that improve performance and increase quality and perhaps quantity of life
As always, I welcome your input to improve healthcare collaboration.
Kenneth H. Cohn
© 2009, all rights reserved
Posted in Learning
Comments
Comment from Dr. Cohn, another insight and innovative post, thanks! A lot to flesh in each bullet point but certainly throughout, the initiatives place the burden on the individual. Reading each of them, I was wondering where and how collaborative interactions fit into these approaches. In regards to your second question you pose, I think there are some serious concerns with the extent to which companies invest in their employees and through such approaches have reconstituted the meaning of work and therefore, the meaning of health. It’s like health as become another form of “work” and is achieved in a rather individualistic way — something that seems rather problematic for setting a new agenda with new values and goals for a collaboration model of healthcare. Yes, accountability and responsibility are significant but are the initiatives introduced so workers can perform more efficiently or have they been introduced for the overall well being of the employees? A larger question, too, might be how are these organizations goals consistent or inconsistent with the goals of the larger society? Who is regulating and controlling such approaches? And what, if any, organizational incentives are being used to encourage one to identify with one’s individual motives, and to communication – well act or refrain from action – about the organization to enhance one’s profit (i.e. ones health)??? Who is benefiting and who is not from such approaches? And finally, what does this mean for healthcare collaboration??
Comment from Dear Carey,
Thanks very much for your comments. My sense in summarizing the book chapter was that this was indeed a new face of healthcare collaboration, investing in employees’ well-being.
You built on the question I raised about paternalism to ask where does this process stop and to what extent does it constrain rather than enable workers.
I hope that additional readers join in to help us flesh out these points
Dr. Cohn, thank you for your response. Yes, it makes sense, a new version/agenda – albeit different – of healthcare collaboration through investing in employees’ well-being. I, too, would love to hear more on the emerging question about paternalism from the additional readers. Seems as though that may shed much light on how we approach other collaborative initiatives. Thank you again for starting a terrific discussion….
Time: February 28, 2009, 1:20 pm
[...] can citizens who are not part of big companies promote a more patient-friendly wellness [...]
Comment from You are a very smart person!
Comment from 
good stuffTime: September 5, 2009, 6:18 pm
[...] to seatbelt use, alcohol, and protective barriers in those who have multiple partners. As noted in Collaborative Business, here is an area where insurance companies and large corporations are providing innovative [...]
Comment from Best you should make changes to the blog name Collaborative Business | Healthcare Collaboration to something more suited for your content you create. I loved the blog post withal.
I am glad that you loved the blog post
Thanks for making the time to comment
Titling blog posts in 55 characters or less, which is all that the search crawlers see, I am told, remains an ongoing learning journey; perhaps Collaborative Wellness would have been more appropriate.
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