David Lewis is one of a number of Gulf Coast health industry executives that advocate a corporate commitment to controlling health care costs.
T. David Lewis, chief executive officer of UnitedHealthcare in Tampa, is in charge of 63 of Florida's 67 counties for the statewide leader in market share.
Lewis knows that if that 2.5 million pool of customers is healthy, insurance premiums will offset the rising costs of health care generated by sick customers.
But Lewis works to go beyond that. He wants companies to be more proactive in controlling health care costs, so everyone can benefit. His staff keeps loads of data on it.
Lewis mentioned four things companies can do:
A top-down commitment from the CEO that employees will develop good health habits. Some insurers provide free health risk assessments online, so employees can track their progress in getting healthier.
The selection of good quality doctors, who are efficient at practicing medicine, getting procedures done correctly the first time and not doing unnecessary procedures.
Offering employees two or three options in their health insurance coverage.
Considering wellness programs, a proactive series of programs, services and classes as a way to improve employee health and limit absenteeism.
Tampa's Syniverse Technologies is in the process of installing a health clinic in its office, with a licensed nurse practitioner, for its 700 employees.
“A lot of large employers are looking at clinics,” Lewis says. “The jury is out on them.”
Companies, doctors and insurers are all concerned about quality health care and healthy patients. The health insurance industry even coined a new term for pro-active health: presenteeism (instead of absenteeism).
But insurers are also concerned about efficient care and even limiting time in doctors' offices through preventative, health habits. Sometimes the medical industry and the health insurance industry do not line up equally on that goal, Lewis says.
But sometimes insurers are not realistic about how effective wellness programs are or how quickly they will pay off.
“United is a very good company...but sometimes insurers have rose-colored glasses on,” says Jim Rogan, senior vice president and corporate benefits division manager at M.E. Wilson Co. in Tampa. “They want these tools to mitigate risk. Day to day, they don't see the customer as much. They are vendors.”
United is able to control its costs through good relationships with doctors and hospitals, communicating best practices with the medical community, Lewis says.
“That's the blocking and tackling of our business,” he says.
So what can Gulf Coast companies do to control their health care costs? A number of things that fit under the wellness umbrella, Lewis and others say. But it is not a one-solution-fits-all program.
Wellness programs promoting preventative health, have been around for years, but are gaining in popularity. There is a National Wellness Counsel Of America that companies can consult. Wellness is one of the essential components of a health insurance program, Rogan says.
Some companies provide personalized wellness coaching as well as group classes.
“It doesn't make sense for every employer,” Rogan says. “Large employers adopt it more readily than smaller ones.”
To encourage people to attend some wellness programs, some companies have used financial incentives. But Rogan favors a buy-in from employees without a monetary incentive.
“It has to be done for the right reasons,” he says. “Not to just save money on health care.”
Rogan applauded the move by Syniverse, USAA and other companies to add a clinic inside their offices. But he said some people are hesitant to see a doctor or nurse practitioner at work.
“A fully staffed clinic is very generous,” he says. “But people want it to be private. That's the problem with some wellness programs. They are not going to be the magic bullet. But they could be very vital.”
Step one for wellness programs for employers is disease management, a way to control acute or chronic illness for curing the employee and watching health care costs. That's only possible if an employee knows what he has.
Besides a physical, free health risk assessments can be done online and anonymously. They cover a number of areas, including stress management. United provides one at www.myuhc.com. Biometric screening, measuring a person's height, weight and cholesterol, is also helpful.
With this data, employees can work with health care providers to identify their risk for diseases and then work with health advocates to stay motivated on the path to better health and get the right care from the right provider. Gulf Coast companies such as
Delphi work with employers on these efficiencies, says Rob Pariseau, chief executive officer of Benefits Solutions Group Inc. in Tampa.
The other steps in the wellness chain include prevention, done through promoting healthy lifestyles and health screenings; personal health records, keeping them in a safe and accessible place; and motivation, incentives to change risk factors including communications, rewards and contests, Pariseau says.
Getting doctors and other health care providers to put health care files in electronic form would be a great service for patients because they could better manage their own health, he says.
“Right now, your medical files are in a manila folder in the back of a doctor's office somewhere and you can't get to them quickly,” Pariseau says.
“Wellness is all of this: disease management, identifying risk and health advocacy,” Pariseau says. “You're not going to solve them all, but you have to be working toward it.”
Most wellness programs can take five to six years to see a financial return for a company, he says.
“Some programs can work more quickly,” he says. “Disease management can work tomorrow. Prevention and changing motivation, that's a tough one. It takes a long time to change a person's habit.”
Lelia Davis, chief executive officer of Harmony Research Network in St. Petersburg, said company wellness programs are evolving.
“There are tons and tons of data to support keeping people well,” Davis says. “In five years, this will be a passe conversation.”
At more companies, wellness is becoming a team approach, between employers and employees. As wellness evolves, there is more data to show a return on investment, Davis says.
Some companies are bringing on on-site wellness coaches to keep employees motivated and on-track to consistently better health, to control health care costs and keep employees at work instead of in the hospital or at home.
“We don't want to offer these services as fluff, but rather this is something companies do so we all can be more productive,” Davis says.