Employee Health Management - The Medical Fitness Role and Revenue Opportunity

Transcription

1 Employee Health Management - The Medical Fitness Role and Revenue Opportunity Maracie Wilson MSN, RN, PHN, CES Director Wellness & Health Improvement St. Joseph Health

2 Today s Dialogue American Healthcare today and tomorrow Incentive models today Population Health Management (PHM) as the future Medical Fitness model to support PHM Partnerships for Medical Fitness and PHM Employee Health Management (EHM) defined What do employers want Current expectations and commitments Value, Mission, and Business Proposition St. Joseph Health s experience

3 The American Health Care System Where is the Health?

4 How do we spend healthcare dollars today? Acute illness Management Health Management Disease Management Among national employers, only 5 cents on the dollar is spent towards prevention. The other 95 cents is spent on treatment. (CMS, 2011)

5 What will healthcare look like after reform?

6 Incentive Alignment for Health? Carrots: Fee for Service Hospitals get paid when people get sick Physicians and providers get paid when people get sick Outpatient diagnostic centers get paid to diagnose illness and treat Sticks: Weak but evolving incentives for quality care and positive health outcomes Accountable Care The current American healthcare system does not have aligned incentives to support wellness and prevention. However MEDICAL FITNESS does!!!

7 SYSTEM OF CARE Personal Well Being Community and Social Involvement Home Acute Care Hospitals Wellness and Health Improvement Recovery and Rehab Care Wellness Centers Integrated Medical Fitness Workplace Fitness Integrative Health Community Based Care Diagnostic Imaging and Urgent Care Medical Clinic and Ambulatory Procedure Retail Pharmacies Inpatient/Outpatient Rehab Skilled Nursing Facility Home Care

8 Population Health Management Population Health Management The coordination of health promotion and care delivery across a population to improve clinical and financial outcomes, through disease management, case management, and demand management through wellbeing support.

9 Population Health Intervention Domains Populations: Community wide environmental and cultural initiatives to drive optimized well being Groups: Programs to support wellness and interventions to address groups with health risks and disease Individuals: Personalized and individualized education and support for lifestyle change and disease management Populations Groups Individuals

10 Integrated Medical Fitness Integrated Medical Fitness Centers offer wellness, prevention, rehabilitation and fitness services including integrative health therapies to meet the needs of participant regardless of lifestyle, health status, age or physical condition.

11 Employee Health Management Employee Health Management The overarching goals are to help organizations optimize the well being, health, and performance of their workforce while reducing avoidable healthcare utilization to flatten the upward trend of healthcare benefit expenses.

12 What do Employers expect from their health management strategies? Employers Expectations High touch: real live people delivering real live support for health and wellness Consolidated vendors/partnerships Demonstrable Outcomes Managed benefit costs Employees actively engaged in their wellbeing Happy and healthy employees at their most innovative and productive state Medical Fitness Deliverables Medical Fitness practitioners! Medical Fitness can deliver on every aspect of a health management strategy including integrating with the medical care providers Medical Fitness is a proven best practice approach to health management With quality Medical Fitness programs and services, health improves to drive down costs Medical Fitness has high member retention due to excellent supportive engagement models The high quality service that Medical Fitness provides assures optimized wellbeing for engaged participants

13 Operationalizing EHM Develop the model Align the resources and strategy find great people to deliver great services Create the brand and mission for the service Leverage existing corporate relationships Implement, monitor, track, optimize, report Continue strengthening partnerships

14 Self Insured Catholic Healthcare Ministry Employees: 24,000 60,000+ Covered Lives 29 Locations Diverse Job Descriptions Diverse Cultures, Languages, education

15 The Return Caring for our Community of Healers Return on Mission: St. Joseph Health employees and their families represent a community vital to upholding and achieving the mission outcome goals and transformational statements of the healing ministry. We must care for our Community of Healers; our employees Return on Value: The financial and mission value of a saved life or averted near term health event and higher quality of life for just one of our employees is immeasurable. Return on Investment: St. Joseph Health has experienced nearly 10% annual increases in healthcare costs compared to a national average of 6%. By lowering this trend to Consumer Price Increase rates between now and 2020, SJH can avoid over $309 million dollars cumulative in cost plus realize improved performance in productivity, absenteeism, recruitment and retention.

16 Healthiest Communities Perfect Care Sacred Encounters Justice Dignity Excellence Service Foundation: Ministry Community of Healers with the highest Well Being, Vitality, Creativity, Enthusiasm, and Emotional and Spiritual Wholeness Delivering on The Healing Mission of

17 Indirect Benefits of Employee Wellness Improved productivity and morale: Increased patient satisfaction Healthy employees make fewer errors: Quality of care and clinical outcomes improved Health as a quality multiplier: increased community confidence and brand loyalty. Magnetic Culture: Attract and retain talented personnel while drawing patients.

18 Employee Health Management as a serious economic strategy $310 Million Cumulative cost avoidance

19 Health Risk Assessments Personalized wellness and risk factor reports sent out to participants Meaningful Incentives Resources: Pedometer with social networking support and challenges Activity Tracking Biometric Screening Employee Health Management The Wellness Culture Campaign Disease Management Health Coaching Unlimited contacts with personal health coaches Social Networking Web based health resource portal Health Education

20 Meaningful Participant Incentives Carrot: $200 HRA: $25 incentive Biometric Testing: $50 Fitness Activity Program: $125 Stick: $650 $25 per pay-period discount on health plan premium contributions TOTAL = $850 annual benefit

21 Partnerships to Deliver on the Return IMFC Team Leads the initiative and outcomes Medical Community Partners with IMFC Team to support total care resources Employer Drives the initiative directly with employees

22 Making a difference and improving health: How will we know we are heading in the right direction? Tracking Metrics and Outcomes Driving Towards Zero Trends Participation and Engagement Health Risk Stratification Well Being Index Healthcare Cost Trends

23 Participation and Engagement 81% of Employees enrolled in medical participated in the FY12 program year Well Being Assessment and Ministry Biometrics St. Jude Medical Center 96% St. Joseph Heritage Central 96% St. Joseph Hospital, Orange 95% Covenant Health 93% Motherhouse and Taller San Jose 93% St. Jude Heritage 92% Mission Hospital 91% Queen of the Valley 82% Home Health Agency 82% Home Health North 82% System Office 80% SJHS Non-Union Average 92% Sonoma County 40% St. Mary 40% Humboldt County 33% SJHS Union Average 38% All SJHS Roll-up Average 81%

24 Health Risk Stratification GOAL: increase the percentage of the population in the Low Risk (Living Right) category and maintain or decrease the percentage of the population in the High Risk (Facing Challenges) category 24

25 Well Being Index St. Joseph and Covenant Health Findings Well Being Index Domains Southern US Region Covenant Health Western US Region SJH California Well Being Index - Overall Score Life Evaluation: Perceived Standard of Living today and in the future Emotional Health: Array of emotions and coping skills Physical Health: How individuals are managing their health Healthy Behavior: Healthy lifestyle practices Work Environment: How people feel about their work culture and environment Basic Access: Access to basic needs such as healthcare, healthy foods, exercise, and personal safety Sample size: approx 15,000 employees participated across CA and TX Ministries between July 2011 through January 2012 Color Key Code Better than US regional benchmark Equal to US regional benchmark Poorer than US regional benchmark 25

26 What areas of wellbeing disparity must EHM address? SJH Employees reported significantly less favorable responses in the following specific areas: These rates are also reflective of America s workforce in general

27 OBESITY 53% of SJH Employees have a BMI 30

28 51% Report having a poor diet with inadequate access to and intake of fruits and vegetables

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30 47% Experience frequent stress and worry

31 31% Do not feel well rested

32 20% Have not experienced recent happiness or enjoyment

33 20% Take medications/drugs daily for relaxation (not including alcohol)

34 20% Feel job overload beyond their capacities

35 Stress is Quickly Becoming the #1 Health Risk How do we address this in the workplace and minimize stressors?

36 Creating Less Stressful Work Environments

37 35% Feel that boss/supervisor does not partner and collaborate with employees 30% Feel that their boss does not create a trusting and open work environment 15% Report that they are not treated with respect

38 The key to top productivity is optimized health.

39 The good news.. SJH employees are experiencing significant wins in well being improvement

40 What employees are saying. I have lost over 75lbs in the past year because I made major changes and now realize that my wellness is important. After starting to walk more and eat healthier, I have been able to get off medications for my blood pressure and diabetes. Last year, I couldn t walk up one flight of stairs. Now I walk 6 miles everyday to work. My doctor told me that the biometric screening probably saved my life. I am now on medications and being treated for high blood pressure that I didn t even know I had. My family is so proud of me because I just completed my first Couch to 5K run. I have a much better handle on my stress levels now that I am focusing more on making healthy choices in my life.

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42 In the past year, Employees have logged enough steps to complete 16 round trips to the moon and back

43 Employees participating in weight loss challenges at 3 ministries have lost over 6 tons of combined weight. These tires represent weight lost at St. Jude Medical Center

44 Creating a Workplace Culture of Well Being

45 In every person lies undiscovered genius and ingenuity. What could we accomplish if every employee could optimize their well being and uncover these hidden gifts?

46 The optimal healing environment for wellbeing can be supported by medical fitness practitioners and centers.

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48 DIALOGUE Does EHM make sense as a business strategy for Medical Fitness? How much of a stretch is it to capture this opportunity?

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