Employers Unlocking Health Care Expertise

By Joanne Wojcik

Aug. 5, 2008

In the continuing battle against rising health care costs, some employers are finding they can best help themselves by helping others.

Increasingly, employers are engaging with local providers, inviting outsiders to take part in their on-site health fairs or investing in health information technology and health improvement research projects.

While much of this collaborative work is being performed in conjunction with local business health coalitions, in some cases individual employers are breaking free from the pack and taking leading roles.

Dr. Michael Cryer, senior medical director at Hewitt Associates in Woodlands, Texas, likens the phenomenon to years ago when large industrial employers began investing in school science programs because “they knew they were educating their future workforce.”

Working with the community on health care consumerism can also help inform current and future employees. Some employer efforts, such as doctor and hospital report cards, are intended to foster consumerism on a communitywide basis, suggests Dr. Charles Smith, a principal at Towers Perrin in New York.

“Then if they come to work for that employer, they will already have a certain level of knowledge” about how to be a better health care consumer, he says.

Indeed, “the degree to which employers can promote community health, and a culture of health in the communities where they operate, that’s good for business,” says Andrew Webber, president of the National Business Coalition on Health in Washington.

“An employer can obviously do a lot at the workplace to promote healthy behavior,” he says, but they have little or no influence over how their employees act once they enter the community at large. As such, “we are definitely encouraging our coalitions and the employer members of our coalitions to get more involved in community health.”

“This is the pool, the community, from which they draw not only their current workforce, but their future workforce,” Webber says. “And employers’ No. 1 goal is to have healthy and productive workers.”

As part of this effort, the National Business Coalition on Health recently entered into a five-year cooperative agreement with the Centers for Disease Control and Prevention in Atlanta to pair member coalitions with public health agencies so they can collaborate on community health initiatives, Webber says.

The Florida Health Care Coalition in Miami hosts communitywide health fairs. Other employers have also teamed up to improve the health care delivery system.

“It’s not just for the employees of members of the coalition. The coalition is trying to do health fairs that can impact the community at large,” Webber says.

“In community after community, business coalitions are working with physician groups, with hospitals, with consumer and labor groups to try and improve quality in their community,” says Peter Lee, executive director of health policy at the Pacific Business Group on Health in San Francisco.

Those efforts are anchored in the understanding that providers don’t discriminate in how they deliver care based on who an individual works for, he explained.

“If you go to a hospital and get a surgical-site infection, someone doesn’t say, ‘Excuse me, we’re going to make sure the Chevron employees don’t get infections, but the rest of you, we don’t really care about,’ ” Lee says.

“You can’t really address the affordability and quality issues for an individual employer without addressing it for the entire system,” he says.

A government program spearheaded by Secretary of Health and Human Services Michael Leavitt is also encouraging more employers to become involved in community health improvement efforts via the Chartered Value Exchange program, which enables them to gain access to performance information from Medicare that gauges how well physicians treat patients.

“Those community efforts have to have, by definition, the employer community at the table,” Lee notes.

Likewise, the Robert Wood Johnson Foundation, a Washington-based philanthropic organization that focuses on health care issues, is requiring major employer involvement in order for a community to qualify for grants totaling $300 million under its Aligning Forces for Quality program, Lee says.

“To really have improvement throughout a community, everyone has to be at the table. For many years, business coalitions in some ways have been at the cutting edge of these efforts, but now I think we’re seeing a real growth in really robust collaboration,” he says.

But sometimes it takes the driving force of an individual employer to give these efforts the spark needed to get started, Lee says, pointing to an effort led by Caterpillar Inc. in Peoria, Illinois, as an example.

In 2006, Caterpillar joined forces with Peoria-based OSF Healthcare System, which operates seven acute care facilities, to form the state’s first regional health care improvement coalition, Quality Quest for Health.

Since Caterpillar and OSF are the region’s two largest employers, providing coverage to a substantial number of individuals living in the community either as employees, retirees or their dependents, the two organizations realized they could have a significant impact on the region if they worked together.

“Quality Quest for Health’s mission is to achieve exceptional patient service and outcomes by serving as a catalyst health care transformation,” says Dr. Gail Amundson, president and CEO of the coalition.

The program’s initial focus was on increasing the affordability of medications by boosting generic prescribing rates among local providers, implementing preventive care treatment guidelines developed by the Institute for Clinical Systems Improvement, and improving the quality of colorectal cancer screenings performed in the community, Amundson says.

This year, the alliance is also working on reducing secondary cardiovascular risks by helping people with heart disease and diabetes better manage their conditions and collecting data on healthy lifestyles using the health risk assessment that more than 90 percent of Caterpillar’s employees complete twice each year, she says.

Although Caterpillar will be the primary beneficiary of its work in the Peoria area, there may be another reason why employers like it are reaching out into their communities rather than keeping to themselves, suggests Bruce Kelley, a senior group health care consultant at Watson Wyatt Worldwide in Minneapolis.

“If the big employers just used their power to achieve a specific cost reduction they desire, they would likely experience backlash from the much larger number of smaller employers that do not have that market power,” he says. “So they’re not doing it for altruism’s sake.”

But even if employers’ motives are not purely selfless, “there has to be a champion” in the community for any significant change to occur, says Debra Draper, associate director at the Center for Studying Health System Change in Washington.

“The time of employers keeping to themselves has passed. They have to become more of a community citizen. There are real synergies when they work collectively with health plans, providers and other employers. Everyone’s got ownership and has a role in improving health care,” says Webber of the National Business Coalition on Health.

Joanne Wojcik writes for Business Insurance, a sister publication of Workforce Management.

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