Is There a Doctor In the Firm? Businesses Hope Wellness Plans Save
By Susan Heavey
December 10, 2009
Liz Sequeira, a 52-year-old primary care physician, is too young to remember when U.S. doctors made routine house calls. So to her, seeing patients in her three exam rooms on the first floor of Discovery Communications Inc.’s modern headquarters in Silver Spring, Md. is like stepping back in time.
“It’s like being an old-time doctor, a town doctor,” said Sequeira, whose clinic in the company’s wellness center serves as many employees’ first stop for blood tests and medication.
As Democratic lawmakers in Washington inch ahead with plans to overhaul the U.S. healthcare system, companies like Discovery are striking out on their own — whether through on-site doctors or diet plans — to rein in soaring costs in a nation where employers still pay for the bulk of medical care.
Under proposals moving through Congress, employers of all sizes would get incentives to entice workers into corporate wellness programs, even though it is still unclear whether the programs improve employees’ health let alone companies’ bottom lines. Despite the lack of solid evidence, a growing number of companies expect it will do both, and they’re spending real money to find out.
Of course, for some recession-battered companies, wellness programs are an unaffordable luxury in the face of health insurance costs that according to the Kaiser Family Foundation shot up to more than $13,000 per employee — 131 percent more than in 1999.
Discovery, for one, needed no further persuasion. It opened a second wellness center at its New York office this year and plans one in Miami in 2010. Hiring on-site doctors and nudging employees to take better care of themselves helped halt the growth of its health costs — it was flat last year, which is more of an achievement than it sounds like considering that most companies saw a 10 percent rise over the same period, Discovery officials said.
“Every time an employee walks into the clinic, we save money,” said Evelyne Steward, Discovery’s global vice president who oversees wellness and diversity issues.
Without some kind of reform, U.S. health insurance costs per employee will triple to nearly $29,000 in 2019, according to the Business Roundtable, which represents large employers. Costs have already jumped 131 percent since 1999 to $13,375 in 2009, a Kaiser Family Foundation study found.
When an employee gets a physical exam from Dr. Sequeira instead of a private physician, Discovery saves about $100, Steward said. It also gets increased productivity by saving workers’ time and detecting serious health issues sooner.
All in all, the parent of Animal Planet and the Discovery Channel calculates it saved $5 million since opening the Silver Spring clinic and launching other programs five years ago. About $4 million of that is from lower medical claim costs.
While current proposals before Congress do not provide direct incentives for on-site clinics, they do offer companies tens of thousands of dollars for broad wellness initiatives such as weight management plans, counseling and more.
On-site clinics are still relatively rare in corporate America, but are growing fast. They serve four percent of working Americans and could rise to 10 percent in five years, according to research firm Fuld & Co. About 1,200 companies now host 2,200 clinics, a number seen rising to 7,000 facilities by 2015, Fuld found.
An even larger number of companies have adopted more modest programs to promote “wellness” among workers and help them manage costly, chronic diseases such as diabetes. Nearly 40 percent of 626 employers in the United States surveyed by consulting firm Buck Consultants said they would offer healthier vending machines or targeted websites, while about 25 percent planned new health-oriented websites.
Employers are also hiring nutrition counselors, holding on-site fitness classes and offering discounted gym memberships to keep workers healthy. Using third-party vendors or certain insurance plans also aim to help companies ensure patients take prescribed medications and follow doctors’ orders.
MEASURING SUCCESS
Doctor visits, medications, hospital care and more all add up to a $2.5 trillion U.S. healthcare industry, or one-sixth of the nation’s economy. The federal government foots the bill for some 45 million elderly and disabled Americans, and for millions more who are poor, including children.
That leaves employers to take care of the rest.
Still, less than a quarter of U.S. companies offering wellness benefits actually measure whether they save money, Buck Consultants found. Among those that did measure, two-thirds said their rate of cost increases fell about two percentage points per year — “not an insignificant return on investment,” according to the survey.
IBM Corp. said it saved about $190 million in health costs between 2005 and 2007 covering more preventive care and introducing cash incentives for smoking cessation and better nutrition. Next year it will also offer employees up to $300 to monitor their habits.
Others with successful wellness programs include Pitney Bowes, Safeway and Johnson & Johnson.
But pressure from the nation’s worst economy in decades has forced some companies to scale back efforts.
Industrial equipment maker Caterpillar Inc., which laid off tens of thousands of employees amid a plunge in sales, also laid off health coaches at many of its facilities and halted some programs helping patients control diabetes, a chronic condition linked to obesity.
“That part of the program had to be temporarily suspended just because of the economic recession. But we have plans in place to get them back in place as soon as possible,” said Dr. Mike Taylor, Caterpillar’s medical director.
Caterpillar spends about $650 million a year on health care for its employees and its annual increase in health care costs is about 1 percent since various programs began in 2002.
Copyright 2009 Reuters.
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Utah’s uninsured rate held steady in 2008
Children » The percentage of Utah kids without coverage dropped
By Sheila R. Mccann
The Salt Lake Tribune
Updated: 03/23/2009 05:48:02 PM MDT
A Family Enrollment Fair will be held Tuesday, March 24, from 5 p.m. to 7 p.m. at the Sorenson Multi-Cultural Center, 855 W. California Avenue, in Salt Lake City.
Staff from the state’s public health care programs, including Medicaid and the Children’s Health Insurance Program or CHIP, will help uninsured Utahns apply for low-cost or free coverage. Activities will be provided for children. The event is part of national Cover the Uninsured Week.
To learn how to apply for CHIP, visit utahchip.org or call 1-877-KIDS-NOW.
Enrollment in the state’s Primary Care Network, a basic preventive plan, is open through April 30. For information, visit health.utah.gov/pcn or call 1-888-222-2542.
National pharmaceutical companies have expanded eligibility for their Together Rx Access cards, which help the uninsured with prescription costs. For information, call 1-800-966-0407 or visit TogetherRxAccess.com.
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An estimated 10.7 percent of Utahns – or 298,200 residents – did not have health insurance last year, a rate that essentially remained steady from 2007, according to a newly-released state study.
Results of the annual Utah Healthcare Access Survey showed a small increase of an additional 11,000 Utahns without coverage. But health care advocates believe the state’s results undercount the uninsured, arguing the survey via land line phones isn’t as effective in reaching low-income families or young adults who use only cell phones.
The good news: the number of uninsured children in Utah dropped by more than 13 percent, and state health officials say they will work to extend the trend. They attributed the boost in insured children to easier enrollment in CHIP, the state Children’s Health Insurance Program. Funding approved last year allowed year-round enrollment for the first time since 2001.
By the end of 2008, CHIP enrollment had jumped to more than 37,000 children, from approximately 25,000 children in July 2007 when enrollment last opened. David Sundwall, executive director of the Utah Department of Health, said he has an “ambitious” goal of having CHIP enrollment at 50,000, despite a recent cut to CHIP’s marketing budget.
“Having health insurance is healthy for you,” he said, urging parents to investigate their eligibility. CHIP enrollment is especially important with the poor economy, he said, because it helps ensure children’s health
screenings and vaccinations continue.
The statewide telephone survey found 76,000 Utah children are uninsured, and state health officials estimate 55,000 of them meet income requirements for CHIP or other state programs.
Based on national data, the Utah Health Policy Project believes Utah’s uninsured rate is closer to 15 percent, said executive director Judi Hilman. That data shows 26 percent of Utah children living under 100 percent of the federal poverty level are uninsured, compared to 20 percent nationally.
With children, “We’re headed in the right direction,” Hilman said, “but if you look down at the detail, we are much less impressed. … We’re not doing a very good job with the poorest of the poor.”
To attract and keep families in Utah’s public insurance programs, the state needs to continue efforts to adopt best practices, Hilman said. Examples include simplifying enrollment and removing Medicaid’s asset test for eligibility, a step 47 other states have taken, she said.
Sundwall said he is concerned that the survey showed 37 percent of the state’s Latinos were uninsured. The health department has spent $75,000 over the past year and a half on targeting Latinos to enroll in CHIP, including a grant to Comunidades Unidas in Salt Lake City.
The center used the funding to go to Latino churches and businesses and make door-to-door visits, said Candace Gibson, program coordinator. Personal, culturally-competent approaches “tend to really work more,” she said.
She also cites bureaucracy in the programs — from lost applications to uncertainty among families about providing continuing information to maintain eligibility — as a barrier.
The state survey showed the number of uninsured adults, ages 19 to 64, increased by 12.3 percent in 2008. One option for adults: The state’s Primary Care Network (PCN), a basic preventive plan, which has enrollment open through April 30.
But Hilman argues the plan is so “bare bones,” with no coverage for catastrophic care, that enrollees should not be counted as insured. Moving forward, she said, the state’s health care reform efforts should be focused on ensuring adequate coverage for everyone.
And reform efforts will need accurate data about the uninsured, added Elizabeth Garbe, coverage initiatives director for the Utah Health Policy Project. Amid recent efforts to cover residents in Massachusetts, officials were surprised by a state undercount of the uninsured needing coverage, she noted.
Utah’s survey also showed the key role workplace insurance continues to play. Of state residents insured in 2008, 78 percent had coverage through a current or former employer or union. That was down slightly from 79.5 percent in 2007.
The Utah Health Policy Project will hold a statewide discussion Wednesday at 4 p.m. at multiple sites regarding health system reform. In addition to a statewide Webcast, sites include:
Salt Lake City: 650 Komas Dr., research park
Murray: Salt Lake Valley Environmental Health
Ogden: McKay-Dee Hospital
Farmington: Davis County Health Department
Provo: State Regional Office Building
St. George: Dixie Regional Medical Center
To participate, contact Jessica@healthpolicyproject.org or 801-433-2299. Utahns enrolled in the state’s Primary Care Network plan are encouraged to participate.
The Utah Department of Health’s annual telephone survey found that 10.7 percent of Utahns were uninsured in 2008, compared to 10.6 in 2007. It also found:
» Of the 298,200 uninsured Utahns, more than 72,000 had incomes that fell below the federal poverty level.
» More than 100,000 were employed full-time.
» More than 41,000 were self-employed.
The survey also found:
» 37 percent of Latinos were uninsured.
» 42 percent of adults without a high school diploma were uninsured.
» 16 percent of self-employed Utahns were uninsured.
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