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Healthcare As An Investment, Not A Cost. From the perspective of a General Manager Southern Company/Georgia Power. Speaker Bios. David W. Connell, PE Region Manager – Metro West Region (today)
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Healthcare As An Investment, Not A Cost From the perspective of a General Manager Southern Company/Georgia Power
Speaker Bios • David W. Connell, PE • Region Manager – Metro West Region (today) • Northwest Quadrant of Atlanta, $500 Million Revenue, Line Function - Customer Service, Engineering and Construction, Sales, External Affairs, etc. • Auburn University (Engineering), Univ. of Southern Miss (MBA), Whorton Business School (Finance), Harvard Business School (GMP) • 39 Years with Southern Company (Cust Operations, Plant Eng and Const, Org Dev, Corporate Education and Learning, Strategic Planning, Budget and Finance, Market Research, etc.) • External Involvement: WellStar, Cobb Chamber, RBC, UW, MAACC, Chattahoochee Tech College, Atlanta Opera, BODS, etc. • Jan W. Carter, RN • Health Services Supervisor , Georgia Power and SoCo Retirees (today) • Southern Company/Georgia Power Wellness since 2004 • 4 On-site medical clinics, statewide lab draws, health fairs, oversight of vendor relationships, supervision of staff of RN’s and admin staff, other services • Develop, implement, and evaluate wellness and health initiatives • Columbus College (Nursing) • RN since 1982, 22 years – critical care and coronary care • Certified Critical Care Nurse and Advanced Life Support Instructor 2
Who is Southern Company? • Atlanta-based Southern Company (NYSE:SO) is the premier energy company serving the Southeast. • 4.3 million customers with more than 42,000 megawatts of electric generating capacity. • A leading U.S. producer of electricity, owning electric utilities in four states, growing competitive generation company, as well as fiber optics and wireless communications • Listed as top ranking U.S. electric service provider in customer satisfaction for 8 consecutive years by American Customer Satisfaction Index (ACSI) • SouthernStyle: Superior Performance; Total Commitment; Unquestionable Trust • A strong, deep-rooted culture of employee Safety. • Self-Insured Health Care 3
Southern Company Demographics • 74% male • Average age is 46 • About 40% union organized • Average tenure is 17 years • 61% Hourly, 39% Salaried 4
Why Health and Wellness? • 70% of the causes of disease and death are related to modifiable lifestyle behaviors (CDC report, 2002) • Health Risks include: diet, physical activity, weight, BP, Cholesterol, tobacco use, alcohol use, drug use, stress, depression, sun exposure, seat belt usage • Health risks are a leading indicator of medical costs, pharmacy costs and absenteeism (“Cost follows risk”) • Correlation between health risks and safety performance 5
Additional Resources • University of Michigan, Health Management Research Center – • Centers for Disease Control and Prevention – 2002 • Union Pacific RR Wellness Study – 1999 • Edington, JOEM – 2001 • Lockheed-Martin, Aetna Productivity Study – 2001 - 2,000 lives 6
“The End in Mind” • Improve company health risk profile • Create a culture and expectation of employee health and well-being • Slow the increase in health care costs • Increase employee availability / productivity • Prepare employees to be better consumers of health care Healthy People = Healthy Company 7
SouthernLifeStyleMission Statement Promote a culture that embraces healthy lifestyle choices by providing tools and resources to increase awareness and influence behavior. 8
SouthernLifeStyleWellness Program Strategy • Assist employees in identifying their individual health risks and conditions • Provide tools to impact those risks • Eliminate risks • Minimize risks • Maintain low risk “Daily choices… for lifetime results.” 9
Program Components SouthernLifeStyle Annual Health Profile, Lab Profile & Monthly Claims Data Analysis Lifestyle Prgs Health Mgt Health Education Fitness Services Diabetes CAD CHF Asthma COPD Depression Obesity Hypertension Hyperlipidemia Low Back Pain Cancer Support Onsite Fitness Center Local Facilities Reimbursements Awareness Prevention Consumerism Family History 24 hr. Healthline Web Knowledgebase Tobacco Stress Weight Diet Exercise Screenings 10
Medical Rooms • 4 on-site medical rooms • Staffed with a full time Registered Nurse • Health Monitoring - Physicals • First Aid - Consults / Referrals • Medical Emergency Response - Centers of Expertise • Onsite lab draws / Health Fairs 11
Fitness Services • Full Service Corporate Fitness Center • Field Fitness Rooms • Fitness Reimbursement Program 12
Partnership with Safety & Health Organization Health Topics Safety Topics Meth Labs MRSA Awareness Ladder Safety Physical Fitness Slips, Trips & Falls Healthy Muscles & Joints Sun Safety Heat Stress Defensive Driving Resources to Manage Your Health Lawnmower Safety Back Health Ladder Safety Weight Management Holiday Safety Alcohol Awareness Hand Safety Stress Management 14
Awards & Recognition • Promina Cup in 1999, 2000, 2001, 2002, 2003, 2004 • Kaiser Permanente Corporate Cup 2007 & 2008 • 2000 “Leadership Award for Employer Developed Disease Management Programs” from the Disease Management Association of America • 2003 AAOHN “Innovation” award for employee wellness programs • 2001 George W. Merck Quality Award for disease management programs • 2005 “Employer Health Care Hero Award” from the Atlanta Business Chronicle • Published in EL&P (Oct, 2007), JOEM (March, 2008), presented at 2007 ACOEM, 2007 DMAA, and 2007 & 2008 SEE conferences • 2008 “Society” Award from the American Cancer Society 16
CEO Report (2007) • Participation: • Lab Draws Statewide 55% • Health Risk Appraisals 31% • Onsite Activities • Lab Draws • 149 on-site and clinics • Health Fairs • 28 on-site; average participation 162 • Fitness • Corporate fitness center (39%) • Reimbursement utilization(4%) • Success Stories / Employee Feedback • Early detection for conditions include: diabetes, pre-diabetes, high cholesterol, hypo and hyperthyroidism, goiter, thyroid cancer, parathyroidism, anemia, chronic kidney disease, prostate cancer, ovarian cancer, liver enzyme abnormalities, liver cancer, platelet disorder 17
Program Results • More than 4,891 (53%) employees were identified with having one or more chronic conditions or at High Risk • 38% identified as high-risk for chronic conditions • 57% identified as at-risk cardiac 18
Program Results Specific results include • Year 1: 2006 Year 2: 2007 • Inpatient admission decreased - Total ER Visits decreased by 6% for • Asthma – 67% managed population • CHF – 57% (unmanaged population increased by 11.5%) • Depression – 100% - Inpatient admissions static for managed population • Inpatient days decreased (unmanaged population increased by 19%) • CHF – 84% - High Risk population decline by ave. 1% yearly • COPD – 44% • Depression – 100% • Diabetes – 45% • ER visits decreased • CHF – 67% • COPD – 100% • Depression – 71% • Diabetes – 29% • Low back pain – 73% Return on Investment 2006 - 2.4:1 2007 - 2.2:1 19
Southern Company Healthcare Cost Trend • Self-insured • Over 5 year period (2003 – 2007) trend moved from approximately 13.5% to 9% • Trend impacted by plan design changes, health plan vendor change, introduction of wellness and disease management programs, introduction of disability nurse case managers, expanded use of generic drugs, and others 21
Employee Successes Mike TimberlakeErnest WilderBillie LanzLavoniah Sanders Scott McCarley • Other conditions identified include: diabetes, hypertension, high cholesterol, hypo and hyperthyroidism, goiter, chronic kidney disease, prostate cancer, ovarian cancer, liver enzyme abnormalities, platelet disorder 23
Success Story Demographics/Background • 51-year-old female • Self enrolled following health fair and lab draw Assessment • Member experiencing blurred vision, fatigue and increased thirst • Family history of diabetes • Tested own blood sugar, result was 500 • Followed up with doctor, had HbA1c of 10.5 and was diagnosed with type 2 diabetes • Started on oral hypoglycemic agent and later changed to insulin Intervention • Health coach provided education on diabetes, signs and symptoms of hypo and hyperglycemia, blood glucose monitoring, reinforced recommended ADA screenings, encouraged flu vaccination, carbohydrate counting • Health coach sent letter to doctor regarding program • Consult with APS dietitian who involved spouse since he does the cooking Results • Improved understanding of diabetes, medications and effects of food and exercise on blood sugar levels • 15 lb. weight loss in 4 months • Decreased HbA1c to 7.5 24
Success Story Demographics/Background • 49-year-old male with obesity • Self referred after attending health fair Assessment • Weight – 238 pounds • BMI – 35 • Waist circumference – 40 inches • Member is sedentary and is not motivated to exercise • Eats out daily, snacks on chips and sweets, drinks sweetened beverages, skips breakfast Intervention • Health coach sent educational materials, including food and weight loss journal and information on serving sizes • Health coach worked with member on strategies to overcome barriers to weight loss and exercise • Health coach encouraged member to begin a walking program and set small goals such as eating breakfast daily and reducing portion sizes • Results • BMI – 30 • Waist circumference – 36 • Quit drinking sweetened beverages • Started walking 2-3 times a week and increased to 2 miles 4 days a week • Member promotes the program when he receives compliments about weight loss 25
What’s Working…. • Knowing our population and culture • Having Management support • Communicating at all levels • Maintaining the momentum • On-site programs, incentives, reporting • Continue to develop internal and external partnerships • Establishing trust through reliable, credible and confidential programs • Celebrating employee success stories 26
Ongoing Challenges • Increase Participation Rates • Keep it Fresh • Ongoing Promotion/Engagement • Reporting and Metrics • Data Warehouse • Health & Productivity “Dashboard” • Better Aligned Incentives • Integration of Health, Safety & Productivity Programs • Value-driven benefit design decisions • Integration of Wellness into benefits design • Program Expansion • Dependents, Retirees 27