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Making Wellness Work

Elyas Bakhtiari, for HealthLeaders Magazine, August 12, 2009
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Northwestern has several "corporate wellness" targeted programs designed to capitalize on this market. It sends physicians and nurses to workplaces to perform physical exams and biometric screenings; it offers a "learn at lunch" series in which speakers visit a workplace and educate employees about wellness and weight loss topics, as well. In each case, the company, not the patient, foots the bill.

"I'm getting more and more requests for nutritionists, registered dieticians, going and doing short consultations with employees, or exercise physiologists who can come and teach employees how to exercise," says Trad. "Companies, as their healthcare costs are going up, are looking for ways to decrease expenses and finding it's cheaper to bring someone in to keep their employees healthy than pay their healthcare bills."

The most eager employers to focus on employee wellness are often hospitals themselves. Froedtert & Community Health's wellness plan, for instance, covers about 5,000 employees in three hospitals and a large clinic. Employees are eligible for a discount of $30 off their medical plan premium if they undergo a health risk appraisal, and the system partners with a disease management company to help high-risk staff.

The goal is to ultimately save money by reducing employees' health risks, says Menard-Rothe, who oversees the plan. "Participants who have multiple risk factors cost about three times as much as a staff member who has zero risk factors. If you're healthy, your average medical claims per year are about $1,350. If you're in that higher risk group, if you have multiple risk factors, your average medical claims are over $3,000. Our goal is to move people away from those risk factors."

This is where the managed care approach to wellness and wellness as a hospital service line converge. One priority of the program is to educate employees about primary care services, particularly if they don't currently have a primary care physician or haven't seen one in a long time. The wellness program refers patients who are interested to primary care doctors who practice at the hospital, creating a cycle that benefits the organization more than once.

Key No. 3: Prioritize the patient experience
Whether a patient is self-pay or part of a corporate or managed care wellness initiative, the real benefit of the service line is often seen in indirect or longer-term financial contributions.

"One of the reasons the hospital is so willing to support the service and keep it kind of upfront is because even though it doesn't make money per se, it's a huge feeder and a huge satisfier to patients," says Trad. "It makes the whole brand look better, plus any referrals we do are done within the system."

But that potential for loyalty is only realized if patients feel they've gotten their money's worth, particularly if they're paying out of pocket. In most of the healthcare system, reimbursement cuts are forcing physicians to spend less time with each patient to increase volume. The financial dynamics of wellness or weight loss require an almost opposite approach.

"It's a very labor-intensive effort," says Cheskin. "I spend an hour with each patient who starts, and that's virtually unheard of in other forms of treatment. This is a means of having perhaps one of the closest relationships with patients that we as care providers and institutions have."

Before starting the weight loss program 20 years ago, Cheskin practiced as a gastroenterologist. While patients are grateful when a doctor can cure an ailment like an ulcer, successful weight loss programs can be more life changing and ultimately earn more patient appreciation, he says.

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