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It Takes a CEO
HERO
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Vol. 23 No. 1
February 2012
Greetings!

We met last week in Chicago to advance the development of the NAWHC (National Association of Worksite Health Centers).  Larry Boress is contacting prospective Board members from among those who have expressed interest in joining the association, and he reported that initial membership was very promising.  He detailed results from a survey that was recently conducted on the prevalence and progression of on-site clinics at a NAWHC-sponsored webinar, and he reported a lot of interest from both existing as well as soon-to-be-launched programs.
 
We have also developed a slate of activities to share with the Board as a potential first-year action plan.  These include a general informational session, some business-only roundtables, a library of resource material, and links with many of the other national business and health-related groups.  In addition, we think there is a need for lobbying and for some type of standardization.  Of course, the Board will make the final determination. When we have additional material to share, we will let you know.
It Takes a CEO
This was the subject of an op-ed done by Darrell Moon on Bloomberg.com recently.  Funny, he didn't say it will take Congress or the President to save the health-care system.  He said it takes the corporate CEO.   He pointed out a few statistics, with which all of us are already too familiar.  For example, healthcare premiums have risen to an average of more than $15,000 for a family annually; and health costs in general are the third largest expense for businesses in the United States.
 
He lists seven things that CEOs can do to stem this rising tide.  Some of these are already in your toolkit, we are sure; like #3,
give incentives to healthier employees; #4, employ disease management programs; probably #5, too, negotiate harder with your PBM; and #7, pay for results not services (he points to the on-site clinics of Disney, Amex, and others as examples).   But, how about #1 - give an incentive to your broker (if you use one) that rewards the amount by which they can reduce your plan premium expense with no erosion in benefits, or #2 - give incentives to your HR managers for reducing claims costs? 
 
If you are wondering who Darrell Moon is, he is a CEO at Orriant, a company offering wellness services, but that doesn't make his advice any less appropriate.   
HERO - Health Enhancement Research Organization
I recently stumbled across this organization and have added it to our list of resources on our companion Web site, because I was impressed with what they are doing and what they have to offer.  It is a non-profit formed in 1996, so it has been around awhile.   They state that their goal is to develop and offer research, education, policy, strategy, leadership, and infrastructure in the field of employee health management.  
 
They have created a Think Tank, offer membership, and offer a "Best Practice Scorecard," which your organization can complete to see how you compare to others in the industry.  Some of their Research Project listings include:  1) The Gender-Specific Effects of Modifiable Health Risk Factors on Coronary Heart Disease and Related Expenditures; and 2) Projecting Future Medical Care Costs Using Four Scenarios of Lifestyle Risk Ratios.  We suggest you check it out.  
For more on-site clinic news, visit our website at www.onsiteclinics.org  
Consumer access continues to spin.  The NYT recently reported on trucker health and fitness and programs that will capture a population that cannot really use an on-site clinic, since they have no real site to be near.  The article by Abby Ellin references some important statistics relating to on-the-road challenges, and it also reminds us that there are some firms that are targeting consumers, as well as travelers, by setting up retail access in rest areas and highway oases.  For a reference to retail clinics, see the Retail Healthcare News.
 
Now your car can also act as a health care provider surrogate (if it is a Ford).  The new tech and new car concepts are highlighted each year in January, and the one that overlaps both areas is the Ford/Microsoft "Doctor in Your Car" concept that can take biometric data and link it to HealthVault, which can then send it back to the driver for any number of applications.  Linking this to a mapping program or a retail clinic operation can get a sick driver to a pharmacy and a midlevel provider, who could then provide a script and, maybe, a referral to a specialist.  This could definitely have an application in a preventive manner to keep sick (impaired?) drivers off the road.
 
If you are a self-funded firm with consumers, beneficiaries, health costs, an employee population, and a provider network to manage, these new services (above) are advances that will make it all tougher.  Choice is great, but informed choice is even better.  If we are seeking value in health care and trying to move beneficiaries to a pattern of health management, more access points and information channels may not be the key.
 
If the patient-centered medical home is working (see our Web report on WELLPOINT's recent success in lowering both admissions and ED use), then we have to make sure that consumers are channeling medical decisions along the lines that have been created to support the on-site programming.  Truck stops, vehicular robotics, and cell phone apps (see iTraige), again, may not be the answer.
 
Employees who are sick need access to a system and not an information channel that is linked to a fee-for-service network.  These emerging ideas are great, and we welcome technology; but it seems that the consumer is getting "wired" faster than the on-site clinic providers can accommodate them.
 
People seeking health care are looking for information along with access, and the problem is that they don't have access to information in any useful form.  Both the GAO and the Wall Street Journal recently tried to price procedures by calling hospitals and doing it the way that you or I might do it - by asking for estimates of cost for specific procedures.  The GAO study found that for the price of a full knee replacement surgery, several hospital representatives quoted a range from about $33,000 to about $101,000.  Time for a narrow network?
 
Sincerely,

Mike La Penna
The La Penna Group, Inc.