When a health system deepens its ties with local employers, everyone in the community benefits.
- A well-designed population health strategy makes the system far less dependent on Medicare reimbursement and able to remain competitive with other area hospitals. It also drives revenue to the system’s employed physicians, aligned practices and service lines, which is a boon even in an ACO model.
- Employers benefit because the health system identifies and helps their at-risk employees – the ones who account for the lion’s share of healthcare spending. These employees almost invariably need individualized, in-person coaching. The employer and health system can create a shared platform that ensures that coaching aligns with a defined wellness plan and/or employee incentives. This usually means that at-risk individuals make steady, measurable progress – and the employer enjoys steady, measurable cost reductions.
- Best of all, at-risk employees benefit because the “coach” is a hospital clinician with full access to their protected health information (PHI).
- As a trusted, local healthcare resource, health systems offer solutions and treatments that are medically sound and evidence-based. In contrast, outside coaching companies have no data to guide them. Their solutions are seldom targeted to address specific issues and programs are not measured by outcomes.
So why aren’t more health systems forging direct alliances with local employers? Believe it or not, not all hospitals have a clear strategy for reaching out to area companies. In some cases, they have a half-dozen internal groups (on-site screening, hospital foundation/fundraising, occupational health, etc.) that are making an effort, but it is not a coordinated initiative. Hospitals are typically swimming in data, but that data is often too overwhelming or fragmented to make it actionable.
One solution is to invest in a software platform that lets the health system and employer share data that is actionable. For example, the system could conduct evidence-based health risk assessments (HRAs) and biometric assessments to determine which employees are most in need of coaching. The employer would then get an aggregate view (minus PHI) of how many diabetics, smokers and obese employees they have.
Metrics are the key to making this shared platform successful. By carefully analyzing the data, the health system can determine which coaching interventions work best – and the employer can pinpoint which incentives work best.
Here is an example:
A leading Southeast health system is working with a large manufacturer to create a population health management initiative. Together, they offer at-risk employees an array of incentives to make lifestyle changes – some of which are extrinsic (cash payouts, lower premium costs) while others are intrinsic (greater certainty that the employee would be able to enjoy a healthy retirement, and so on).
These incentives are tied to employee participation (like making regular visits to a gym or primary care physician) and healthy outcomes (like lowering cholesterol or BMI). The employer rewards progress rather than perfection. Employees need not turn into Olympic athletes. If they simply make measurable progress in four categories (weight, blood pressure, glucose level and smoking cessation), they qualify for the financial incentives. Expectations are meaningful and sustainable.
By working directly with area employers, a health system experiences greater volume and value. Many at-risk employees either do not have a primary care physician or have not had a routine check-up in years. When required to do so, the employees drive business to the hospital’s affiliated physicians, deepening hospital/physician ties. Endemic health conditions are often identified and treated before a catastrophic situation occurs.
Commercial health insurers are in danger of becoming irrelevant as more health systems work directly with local employers to analyze and improve population health. At-risk employees are often afraid to honestly answer health questions posed by an insurance carrier, fearing that their premiums will rise. The health system/employer alliance allows them to be both honest and accountable. After all, the ultimate goal is to move healthcare from the acute into the ambulatory setting and make sure these employees are healthier during their working years and long after.