As the battle over healthcare reform continues in Washington, we can begin our own "reform" movement by modifying individual use of the system and individual health beliefs.This is a great time of year for organizations to kick off their own initiatives around health care and use of health care benefits.  November is usually the beginning of open admission periods for employees to sign up or make changes to their benefit plan coverage and a great time to run a benefit plan communication campaign to insure employee know and understand their benefits. 

 

Major area that can help reduce costs is prevention. 

      *  Through providing prevention benefits

      *  Promoting preventative care

      *  Promoting Medical Self Care

      *  Engaging employees in becoming active partners in their health

All can help create happier, healthier more productive employees. 

 

Another benefit option is to promote Health Savings Accounts to employee benefits.  HSA's are great tools for employees to take control of their health spending using pretax dollars, dollars contributed to the fund do not expire at year end and can leave with the employee.  Generally a debit card is issued attached to the employee's individual account. 

 

Practicing medical self care is one way of taking more control. Medical self-care is defined as the things that one can do to treat minor illness and injuries at home. This includes preventing, detecting, and treating injury, illness and disease. For many self care is already a way of life, for example by taking an over-the-counter pain reliever for a headache one has practiced self care. Studies also suggest that an even larger number of health care problems could be treated at home. It is estimated that 70% of all visits to doctors for new problems have been termed unnecessary. For example, 11% of such visits are for uncomplicated colds, otherwise known as the common cold.  Many other visits are for minor cuts that do not require stitches, for minor burns that an over the counter remedy would work, for tetanus shots even though the person is current on their immunizations, and for minor ankle sprains. 

Medical self-care does not involve learning large amounts of information and is not a substitute for professional care.  Part of medical self care is making the decision to select the right care at the right time.  There are a few questions individuals should ask themselves, "Do I see my health care provider or do I apply home treatment?" If my health care provider is unavailable, "what kind of care do I need, is this life threatening?"  The goal is to protect health and to practice sound self care skills like the following:
 
·        * Use a medically sound self-care reference book, website, web-portal, or nurse helpline for triage and treatment plans.
·        * Use of urgent care facilities versus emergency rooms for non-life threatening emergencies
·        * Learn how to take some basic vital signs like temperature, pulse, and respiration and how to do some simple observations. These skills can help with making better use of self-care references and communicate more effectively with health care providers.
·        * Find a convenient and safe place for a "home health care center" which includes basic first aid supplies, medications and a self-care reference book or website/web portal address.
·         *Use over-the-counter and prescription drugs as directed to avoid over medication.

Learning and practicing how to do these tasks more effectively is no guarantee that we will stay healthy.  Learning how to handle common illnesses and injuries at home, knowing when and how to work with health care providers may save time, help reduce unnecessary doctor/ER visits and may reduce  health care costs for both the employee and the employer.  These steps can help change some of the attitudes we have around healthcare while empowering employees and their families to start on the road to being a wise consumer of health.

Aside from these steps wellness teams and worksites can do the following:

        * Offer first aid and CPR trainings or promote when these trainings when offered in the community.

       *  Share healthcare system quality data, sites such as The Leapfrog Group www.leapfroggroup.org or visit Maine Quality Counts at www.mainequalitycounts.org

       *  Share cost data of different healthcare systems

       *  Provide employees with quality medical self care guides

       *  Provide training to employees on what are the best questions to ask, and when to ask them

       *  Promote quality medical self care websites or the insurer web portal

       *  Promote the use of 211 Maine for employees to find resources

       *  Promote medical practices that are patient centered medical homes

       *  Promote use of Urgent Care Facilities

       *  Promote helplines like the Maine Tobacco Helpline 1-800-207-1230

       *  Promote the Employee Assistance Program(s) (EAP)

       *  Redesign benefits to promote the use of medical self care through a tier system that considers urgent care the same as a primary care visit (but not the same as for a prevention visit), require documentation of medical self care actions, higher co-pays of non-emergency room visits, health savings accounts and provide Employee Assistance Programs (EAP's)

      * Promote healthy lifestyles including healthy weight management (healthy eating and physical activity), preventative screenings, stress management as a part of self care.