Targeted Population Health Management Can Help a Hospital Grow Market Share

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1 REPRINT JUNE 2012 healthcare financial management association Gary Olson Pearson Talbert Targeted Population Health Management Can Help a Hospital Grow Market Share

2 Gary Olson Pearson Talbert targeted population health management can help a hospital grow market share By implementing a targeted and measurable employer wellness strategy, St. Luke s Hospital has improved its reputation as a hospital of choice for employers and employees in the greater St. Louis area. AT A GLANCE > In 2005, St. Luke s Hospital in Chesterfield, Mo., launched the Passport to Wellness program to help employers reduce preventable illnesses by providing access to screenings, health education, health coaching, disease management, and healthy lifestyle programs. > The program was designed to influence consumer choice of hospitals and physicians and influence health insurance purchasing decisions. > St. Luke s program also met goals created by local businesses, including identifying health risks of each employer s workforce and reducing health-related costs. St. Luke s Hospital in Chesterfield, Mo., has been a longtime proponent perhaps even a pioneer of population health management. From its earliest wellness initiatives providing community childbirth classes in the 1960s to its current Wellness College lecture series on healthy aging and its health partnerships with local organizations, St. Luke s believes a healthy community is stronger and more prosperous. St. Luke s believes good health care is not only about treating disease, but also about bringing the message of healthy living to the community where people work, play, and raise their families. It has always embraced the idea that keeping people healthy is much more efficient than providing care once they develop chronic illnesses a notion that has received much attention through healthcare reform. Skyrocketing healthcare costs and payment challenges are forcing all hospitals to closely examine expenditures and eliminate inefficiencies while maximizing cost savings. St. Luke s is no exception. Not only is it examining existing operations, St. Luke s is also looking for new opportunities to add value to its core operations and stand out from other hospitals in its immediate market. The hospital has realized that although wellness is one of its core competencies, it needs to leverage its commitment in more strategic ways to enhance its value to the community. At the same time, increased healthcare costs are challenging employers everywhere to look for innovative approaches to reduce health claims and insurance costs and to improve the overall health of their employees. Increasingly, employers are asking for solutions to their population health 2 JUNE 2012 healthcare financial management

3 management issues. St. Luke s recognized that its track record in community wellness gave it a tremendous potential for offering wellness programs customized to the needs of both employers and employees. To meet the growing demands of the business community, St. Luke s began developing a new employer wellness program that could deliver tangible results by: > Influencing consumer choice of hospitals and physicians > Creating lasting relationships with consumers > Influencing health insurance purchasing decisions > Measurably improving the health of the community > Initiating new services to meet the changing needs of consumers St. Luke s also structured its program to meet the goals of local businesses by: > Identifying health risks of each employer s workforce > Providing targeted solutions to their population health management issues > Measurably improving the health of their employees > Reducing health-related costs, such as health insurance premiums and claims and workers compensation utilization > Providing a positive new health benefit that would be well received by employees To achieve these goals, St. Luke s hired a consultant specializing in hospital/employer relationship strategies in The consultant brought key areas of expertise in data management and tracking, targeted educational outreach, and relationship building. Installing a dedicated expert on-site at the hospital to spearhead relationship management and wellness initiatives took the program to the next level. St. Luke s spent approximately four months developing the program and introduced it to key stakeholders within the hospital. By November 2005, St. Luke s launched its Passport to Wellness workforce health initiative, aimed at helping employers reduce preventable illnesses. Today, the program has been implemented at 170 employer worksites, where more than 150,000 employees have access to screenings, health education, health coaching, disease management, and healthy lifestyle programs. Passport to Wellness has proven that by implementing the right program with the right internal support and tracking systems, St. Luke s could achieve measurable results. Mechanics of the Program An employer relations specialist provided by the consultant was placed at St. Luke s Hospital in October The specialist assisted in developing the Passport to Wellness program, helping St. Luke s identify employer groups interested in the program. The specialist facilitated breakfast meetings with key employers to provide them with education on wellness topics and opportunities to network with other employers and to meet hospital management. Later, the employer relations specialist was integrated into St. Luke s existing community outreach team, which supports all subsequent Passport to Wellness initiatives. Together, the specialist and other team members coordinate education, screenings, health events, and other community health initiatives. About St. Luke s Hospital St. Luke s Hospital is a not-for-profit hospital based in St. Louis. The hospital serves more than 150,000 patients each year at 20 locations in Missouri s St. Louis and St. Charles counties. For more than 30 years, St. Luke s has been dedicated to improving the overall health and wellness of the community. St. Luke s provided more than $9 million at cost in charity, Medicaid, and other uninsured and underinsured services in FY11. hfma.org JUNE

4 PASSPORT TO WELLNESS GROWTH, , , , ,991 10,578 4, Employers Enrolled Employees at participating employer groups were introduced to the Passport to Wellness program through on-site Health Information Centers, which were installed at health fairs and at worksite locations with high employee traffic. Employees were encouraged to complete confidential health risk assessments and participate in health screenings to gather baseline health data. Based on the health profiles, employers received aggregated worksite health profiles that identified health risks such as obesity, diabetes, and tobacco use that were contributing to higher medical claims, absenteeism, decreased productivity, and other issues. Employees received personalized health profiles, tailored to meet or exceed HIPAA requirements, which identified health risks warranting a change in lifestyle or a specific medical action. St. Luke s then offered employers customdesigned health improvement programs to mitigate future risks based on the worksite s risk trends. These programs which included exercise Employees Enrolled and healthy eating classes, smoking cessation, back safety, and diabetes management were offered through the hospital and supported its targeted service lines. Aggregated worksite health profiles, likewise tailored to meet or exceed HIPAA requirements, assisted hospital management in projecting potential growth for each service area so the hospital could plan accordingly. The employer relations specialist and hospital management met with employers regularly to review employee participation and cost trends and to make program adjustments as needed. Program Costs The partnership arrangement with the consultant allowed St. Luke s to build a program at minimal cost. Because the consultant brought unique data tracking and marketing expertise to the table, St. Luke s did not make major investments in this area. The hospital invested in additional staffing to support the projected increase in new business and the cost of the consultant in establishing the 4 JUNE 2012 healthcare financial management

5 relationship management program. Fees paid by employer groups covered some costs. Employer groups were charged a flat fee for every completed employee health profile and baseline screening. St. Luke s offered customized on-site wellness programs to each group, including two free health education programs and additional services at a nominal fee. It also provided additional health education programs to groups at an hourly rate. Fees charged to employers were intended to help reimburse St. Luke s for expenses associated with the program and were not intended to produce substantial net revenue. The data gathered from the health screenings allowed St. Luke s to offer hospital services to specific employees in need, which increased volumes for the hospital s programs and physicians. Program Engagement and Growth St. Luke s targeted wellness program has reached more than 150,000 employees who have received or are likely to receive services at the hospital. On average, worksites attain 60 percent participation in the health-risk assessments. The Passport to Wellness program also has contributed a substantial increase in utilization of St. Luke s existing therapy centers. This result has been achieved through health-risk profiling, which identifies patient health needs and guides employees via exercise, wellness, and other programs. By working with area businesses and addressing their needs, the hospital has added new services, such as health coaching for metabolic syndrome prevention. St. Luke s Population Health Management Strategy at a Glance Like most hospitals, St. Luke s faces declining reimbursements and significant competition. In response, the hospital continually identifies and pursues new opportunities that: > Improve the community s health > Reach targeted populations > Leverage decades-long expertise in community wellness > Meet local employer demand to better manage healthcare costs and improve overall employee wellness > Enhance its reputation as a hospital of choice Six Steps to Success Reflecting upon more than 30 years of success in connecting with local residents and implementing health management programs, St. Luke s has identified six steps to a successful population health management initiative: > Identify hospital strengths and weaknesses within the market. > Implement a formal strategy for employer relationship management. > Secure program champions, including the hospital management team, board of directors, key physicians, program managers, and community relations and front-line staff. > Establish staff and support for the program to meet demand and ensure effectiveness. > Track the progress and measure the impact of the program. > Conduct frequent program reviews with customers and internal staff. Results To date, St. Luke s has achieved the following results through its population health management initiative: > St. Luke s has developed a unique and targeted employer-directed program that offers customized health and wellness programs to meet individual employer and employee needs. > The program now serves 170 employers, providing wellness services to approximately 150,000 employees. > More than 30,000 health profiles have been collected to help address employer health challenges. > Approximately 3,700 biometric assessments and 35 educational seminars through Passport to Wellness employer groups were delivered in 2010 alone. hfma.org JUNE

6 In addition, the program has allowed for crosspollination to St. Luke s overall community wellness programs. For example, every woman who has participated in the workforce health initiative has been invited to join St. Luke s nationally recognized Spirit of Women wellness program, which has helped increase overall membership. Lessons Learned St. Luke s believes that investing in population health management is an opportunity to create new value in the community. The hospital suggests that the following principles are keys to the success of such an initiative. Serve the mission while meeting the organization s financial objectives. Population health programs allow hospitals to address market demands while continuing their altruistic mission to serve needier populations. Be present in the conversation. Businesses are looking for solutions to contain health-related costs and often are forced to turn to their insurance companies to identify opportunities. The hospital can offer healthcare alternatives as a community partner by letting employers know about services and the value provided by the hospital. Obtain management team buy-in. Management support is imperative. It is critical that the management team, board of directors, and physician leaders pledge their support to the population health program for the long term. Challenges should be identified in advance, and clear strategies for addressing challenges will be needed to help overcome issues. Don t be afraid to bring in an outside partner. The hospital may not be able to develop all the resources it needs. By bringing in a partner with proven results, the hospital can get a jump start on the process. Based on the partner s history, the management team will know what to expect in the long and short term. Community outreach is the backbone for a workforce health initiative. The hospital should have a strong community liaison and support the liaison s efforts through a community relations team of marketing experts, volunteers, nurses, key community leaders, and program ambassadors. Build an expanded team of wellness experts to support workforce health initiatives. Health coaches, registered dietitians, exercise physiologists, health educators, and smoking cessation counselors are critical members of the hospital s outreach and health program fulfillment team. Leverage existing services. The hospital should cross-pollinate its wellness program with existing hospital services. Focus on results. Constantly reassessing program results and recommending opportunities for improvement help build and maintain employer trust and loyalty. Planning for the Future Hospitals should look at additional opportunities to enhance market share without incurring the expense of high-cost technology or bricks-andmortar expansion. Population health management and worksite wellness programs can help a hospital cement important business relationships in its own back yard and reach large segments of potential patients, while costing significantly less to implement than other initiatives. About the authors Gary Olson is president and CEO of St. Luke s Hospital, Chesterfield, Mo. Pearson Talbert is president and CEO of Aegis Health Group, Brentwood, Tenn. Reprinted from the June 2012 issue of hfm magazine. Copyright 2012 by Healthcare Financial Management Association, Three Westbrook Corporate Center, Suite 600, Westchester, IL For more information, call HFMA or visit

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