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Driving Down Health Care Costs with Corporate Health Centers


Driving Down Health Care Costs with Corporate Health Centers CAJPA Conference September 16, 2015 David Zanze, President Pinnacle Claims Management, Inc. * – PowerPoint PPT presentation

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Title: Driving Down Health Care Costs with Corporate Health Centers

Driving Down Health Care Costs with Corporate
Health Centers
CAJPA Conference September 16, 2015
David Zanze, President
  • Todays Agenda
  • The Cost of Poor Health of Employees
  • The Evolution of Corporate Health Centers and the
    Benefits for Both Employers and Employees
  • Setting Up Your Health Center
  • Successful Case Studies
  • Ensuring High Utilization of Your Center
  • Next Steps
  • QA

Average Family Premium is 16,834 per year up
3 percent from last year Why are Health Care
Costs Still Going Up?
Source Kaiser Family Foundation 2014 Employer
Health Benefits Survey
Employees Poor Health is Costing the U.S.
Economy 576 Billion a Year
227 billion on lost productivity 117
billion from absences due to illness,
workers compensation and
short and long-term disability 232
billion from medical treatment and
pharmacy- related costs
Source Based on landmark employee productivity
survey conducted by the Integrated Business
Institute, a non-profit group. Statistics were
drawn using data from the U.S. Bureau of Labor
and the institutes benchmarking data based on
60,000 U.S. employers.
Employee Productivity Levels Affected by Habits
  • Employees with an unhealthy diet were 66 more
    likely to have a loss of productivity compared to
    healthy eaters.
  • Employees who rarely ate fruits or vegetables
    were 93 more likely to have a higher loss of
  • Employees who had difficulty exercising during
    the day were 96 more likely to experience a loss
    of productivity.
  • Unhealthy habits were found to have the most
    impact on employees between 30-40 years old.

Source Based on a survey of 20,000 employees
conducted by Brigham Young University and
published in the academic journal, Population
Health Management.
What Do Chronic Conditions Cost Us?
Chronic Condition Absenteeism cost per employee with condition How Many People in the United States it Affects Annually
COPD 9,823 12 million diagnosed
Coronary heart disease 7,963 375,000 die from it
Diabetes 7,900 29.1 million (9.3 of population)
Congestive heart failure 7,262 670,000 diagnosed
Depression 3,682 One in 10 diagnosed
Anxiety 2,382 40 million adults 18 and older (18 of population)
Chronic Insomnia 2,280 40 million
Obesity 1,429 78.6 million or 34.9 of adults
Irritable bowel disorder 1,147 25-45 million (10-15 of population)
Implementing Wellness Initiatives to Help Manage
Health Care Costs
  • Health risk assessments and biometric screenings
  • Discounts to local gyms and weight loss programs
  • Wellness programs including stress management,
    smoking cessation and walking clubs
  • Chronic disease management
  • Onsite corporate health centers

Who is Offering Wellness Programs?
  • According to Kaiser Family Foundation 2014 Annual
    Employer Health Benefits Survey
  • Nearly a third of employers who offer health
    benefits offer a health risk assessment but few
    make it a requirement to join program. 51 of
    large employers (200) are more likely to ask for
    a risk assessment compared to 32 of small
  • Among large firms that offer a risk assessment,
    51 report providing a financial incentive to
    employees to complete it.
  • 51 of large firms and 26 of smaller offer
    biometric screenings.
  • Virtually all large employers and most small
    employers offer at least one wellness program.

Economic Benefits of Preventing Disease
  • Those who increased their physical activity (2 ½
    hours a week) and lost 5-7 of their weight
    reduced risk of type 2 diabetes by 58
  • By reducing the average populations sodium
    intake to 2,300 milligrams per day, we could save
    18 billion in health costs annually
  • For a 1 reduction in weight, blood pressure,
    glucose and cholesterol risk factors, we would
    save 83 to 103 in medical costs per person
  • By increasing the use of preventive services to
    90 of the recommended levels, we could save 3.7
    billion annually in medical costs
  • Source Surgeon Generals National Prevention

Implementing a corporate onsite or near-site
health and wellness center (aka health care
clinic) can be an effective tool in driving
health care costs down.
Why are Onsite Health Care Centers Popular Again
and Part of a Winning Strategy?
They Started as Onsite Occupational Clinics
Todays Corporate Health Centers
Modern Day Health Centers Look at an Employees
Whole Health Not Just One Part
On-Site Health Center Services Offered
  • Traditional Services
  • Newer type services
  • Traditional occupational health services/worksite
  • Primary and urgent care needs
  • Promote health and wellness programs
  • Employee Assistance Program, mental health triage
  • Referrals to quality specialists and physicians
    when needed
  • Provide health coaching and care management
  • Dispense commonly prescribed Rx medications
  • Telemedicine
  • Visits to clinic from medical professionals

Helping Employees Be Compliant with Medications
is One of Many Potential Benefits for Employers
Many Potential Benefits for Employees
Success Case Study 1
Success Case Study 2
Success Case Study 3
Setting Up Your Health Care Center
Questions to Ask Yourself
Setting Up Your Health Care Center
Legal Considerations
  • Affordable Care Act (ACA)
  • Employee Retirement Income Security Act (ERISA)
  • Consolidated Omnibus Budget Reconciliation
  • Health Insurance Portability and Accountability
    Act (HIPAA)
  • Americans with Disability Act (ADA)
  • Genetic Information Nondiscrimination Act
  • State Laws

Setting Up Your Health Care Center
Factors in Measuring a Centers Effectiveness
Setting Up Your Health Care Center
Set Up Costs
  • Staffing
  • Services offered
  • Building costs
  • Outside vendor costs

Setting Up Your Health Care Center
What to Consider when Measuring your Return on
  • Cost savings from fewer visits to emergency room
  • Reduced employee absenteeism due to less time
    away when employees receive earlier treatment of
    illnesses or injuries
  • Cost savings price tag for visiting a health
    care center is lower than a traditional doctor
  • Improved retention of employees
  • Healthier employees means overall less costs in
    health care

Ensuring High Utilization of Your Center
Ensuring High Utilization of Your Center
Provide Incentives
Ensuring High Utilization of Your Center
Provide Frequent Communication
What Are Your Next Steps?
  • Questions?
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