A Routine of Maintenance
Every year millions of Americans take their vehicles to autoÂ shops for routine maintenance. They have the oil changed, hosesÂ replaced, and tires rotated. If the car’s owner is on schedule, theyÂ will do this at least four times per year. And at the point they handÂ the keys over to the mechanic, there will be nothing seeminglyÂ wrong with their vehicles.
Maintenance is important because vehicles are expensive, andÂ proper updates can keep them on the road for decades. The alternative is to drive the vehicle on overused oil and risk damagingÂ the engine beyond repair.
While routine maintenance is a given with vehicles, many peopleÂ do not treat their own bodies with as much care. Waiting roomsÂ at clinics are full of sick patients waiting to be fixed, rather thanÂ healthy people trying to maintain their conditions.
The truth is, no matter how well-maintained, one day the engineÂ is going to knock. Maintenance might give that vehicle a long andÂ healthy life, but the owner is eventually going to pay a fortune toÂ have it fixed or buy a new one.
The same scenario is going to happen with our bodies. ExceptÂ we do not have the option to trade in our clunker for a new one.
Need for Change
A number of area businesses are trying to change the mindsetÂ that health plans are around to fix, rather than maintain or improve, health. They are going about it through wellness coaching,Â preventative screenings, more intensive doctor visits and more.Â It is a shift from a mentality in which a company’s definition ofÂ promoting wellness was a once-a-yearÂ pamphlets and healthy snacks.
“There were just activities,” says Julia Valdez, Director of HumanÂ Resources for the City of Rockford. “It was just checking theÂ boxes, so to speak.” But those employers, especially here inÂ northern Illinois, are realizing that healthier employees can doÂ a lot for productivity and the bottom line. And there are a lot ofÂ changes needed. According to The County Health Rankings andÂ Roadmaps program, a collaboration between the Robert WoodÂ Johnson Foundation and the University of Wisconsin PopulationÂ Health Institute, Winnebago County ranks 72nd out of 102 IllinoisÂ counties in terms of health.
About 29 percent of adults here are obese, 27 percent reportÂ doing no leisure-time physical activity and 11 percent have beenÂ diagnosed with diabetes. There is one primary care physician perÂ 1,340 residents in Winnebago County compared to one for everyÂ 1,266 in all of Illinois. And there is one mental health provider perÂ 721 residents here, compared to one for every 604 for the state.
It is not just a problem in Winnebago County. Throughout theÂ United States, people are getting sicker, often from things theyÂ could avoid through lifestyle changes. In 2010, Dr. Steven H.Â Woolf of Virginia Commonwealth University gave a report toÂ the National Center for Biotechnology Information, part of theÂ National Institutes of Health, called “The Price Paid for NotÂ Preventing Diseases.” In that report, he said between 2005 andÂ 2030, the number of individuals with chronic disease is expected to increase nearly 29 percent, to 171 million people. He alsoÂ stated that 38 percent of all deaths in the U.S. are due to fourÂ health behaviors: smoking, unhealthy diet, physical inactivity andÂ problem drinking.
“We talk about sustaining programsÂ rather than ‘Biggest Loser’ projectsÂ where you lose 100 pounds and gainÂ 90 of it back.”
“Randomized trials have demonstrated that intensive lifestyleÂ change can reduce new cases of diabetes by more than 50Â percent,” the report said. “Early detection of certain cancers andÂ other chronic diseases through screening can reduce mortalityÂ from these conditions by 15 to 20 percent. Taken together, theÂ potential leverage of prevention in calibrating the morbidity andÂ costs associated with chronic disease isÂ averting 70 percent of such cases.”
All that adds to big costs for employers, who often foot theÂ majority of health insurance premiums. In that same report, WoolfÂ cited a study from the Milken Institute that showed chronic illnessÂ costs the economy $4 in lost productivity for every $1 spent onÂ health care. He also cited a Trust for America’s Health study thatÂ showed community-based interventions could save an estimatedÂ $5 for every $1 invested.
A new employee who walks through the doors of Rockford Acromatic Products for the first time goes through many of the usualÂ new-hire procedures. There are tours, training and discussionsÂ about benefits. But before they walk out the door, they will haveÂ two things most employersÂ health club membership.
“In addition to the usual things, we are telling employees thatÂ basic health is also important,” says Jim Knutson, Risk ManagerÂ at Rockford Acromatic Products. The self-care book containsÂ basic guides on first aid, as well as information about health conditions, such as high blood pressure and diabetes. Knutson saysÂ employees are encouraged to use their health club memberships,Â including scheduling time with wellness coaches and personalÂ trainers so they are getting the most out of the benefit. The goal,Â he says, is healthy living.“We talk about sustaining programs rather than ‘Biggest Loser’ projects where you lose 100 pounds andÂ gain 90 of it back,” Knutson says. A key to that working, KnutsonÂ says, is to make sure it is not a one-size-fits-all approach withÂ wellness and having a willingness to adapt when necessary. “TheÂ program you use for a 62-year-old grandfather should probablyÂ be different than that of a 25-year-old triathlete,” Knutson says.Â “The program that is designed on the third floor of a consultingÂ office and rolled out is not really as effective as a pilot where youÂ receive feedback on the elements that are working and use thatÂ to improve the program.”
Doctors these days are rushed. Kaiser Health News reported lastÂ year that the average doctor visit was just under 21 minutes. ButÂ half of those were under 15 minutes. “A 1999 study of 29 familyÂ physician practices found that doctors let patients speak for onlyÂ 23 seconds before redirecting them. Only one in four patients gotÂ to finish their statement,” the story says. “For a primary care physician to have a reasonable income, he or she needs to see aboutÂ 45 patients a day,” says Guy Clifton, CEO of Actin CareÂ “The primary care system in the U.S. is really broken.”
In the city of Rockford, Valdez says she was hearing from employees that seeing doctors in a timely fashion was nearly impossible. “We would hear people saying, ‘I have this, but it is going toÂ take me three weeks to see my primary,’” Valdez says.
Clifton is working on opening a care facility in Rockford thatÂ would address that issue. He wants to work with self-insuredÂ companies to offer primary care physicians dedicated to onlyÂ those companies’ employees and their dependents. “We wouldÂ offer 24/7 availability to people by phone, appointments withinÂ 24 hours and as much time with a physician as you need,” saysÂ Clifton, who believes his business will be offering services laterÂ this summer.
Scott Eckburg, President of Direct Care at Eckburg InsuranceÂ Group Inc., is doing something similar. He is partnering with companies that are partially self-funded to give employees access toÂ what he calls “all-you-can-eat health care.” His strategy combines higher deductibles with primary care on a per-month basis.Â Since the companies are partially self-funded, insurance canÂ underwrite some of the expenses.
“We are able to take the large model that people are going to inÂ droves because of the cost savings and take that to a smallerÂ scale to meet the needs of small and mid-sized businesses,” Eckburg says. The physicians working with Eckburg’s groups will seeÂ about 600 patients max, compared with the average physicianÂ who sees more than 2,300 patients, according to a 2012 articleÂ in the Annals of Family Medicine. “That burden is taken off theÂ doctor,” Eckburg says.
Focus on the Whole
When someone walks through the door of FitMe Wellness andÂ tells owner and founder, Greg Georgis, they want to lose 5Â pounds, he calls them on it. “If you wanted to lose 5 pounds, thatÂ is not hard to do. You would have already done it,” Georgis says.Â “I ask, ‘What do you really want to do?’”
Georgis says, he often hears that people want to be around forÂ their grandchildren, to not be so tired after playing with the kidsÂ for just a few minutes or to lose the soreness they experienceÂ from an hour of yard work. In short, they want to be healthier.
“The motivation is simply living a more fulfilling life,” Georgis says.Â “You want to feel good.” We are programmed to see health andÂ fitness as maintaining a certain weight. But that is just part of it.Â Georgis says someone could be “pleasantly plump” and still beÂ reasonably healthy. “We do not really care about the weight. WeÂ want to know how you are feeling,” Georgis says. “ThatÂ is a wellness program, not numbers on a scale.”
“If you wanted to lose 5 pounds,Â that is not hard to do. You wouldÂ have already done it.”
While health professionals point to obesity as a major factor inÂ rising health costs, it is really the results of obesity that take a toll.Â FitMe Wellness works with individuals and corporate partners toÂ focus on overall wellness, specifically strength, flexibility and better diet. The company partners with dozens of businesses in theÂ area whose employees get access to health coaching, personalized wellness plans and more. “We are looking at managing theÂ health of a community or a giant corporation, to a large companyÂ or a small company,” Georgis says.
Those companies, in return, are hoping for happier employeesÂ who will call in sick less often and maximize their potential.Â And less turnover means reduced hiring and training costs.
“What the most innovative employers are doing is trying toÂ make it clear that employees’ health is important to them, andÂ it is showing the employee that it should be important to themÂ as well,” Georgis says. “If we can dust those cobwebs from aÂ company, if we can get those people moving more and eatingÂ better, that employer is better served with a better workforce.Â “They are absolutely hammered on the health care costs and thatÂ is because the workforce is unhealthy,” Georgis says. The city ofÂ Rockford opened its own wellness facility downtown last year,Â and Valdez says she is hearing positive things from employees.Â Those employees average 40 minutes to an hour with physiciansÂ and are forming groups that help each other manage healthÂ issues like diabetes and high cholesterol. Valdez says it is tooÂ early to tell if the wellness center is the cause or an aspect of theÂ cause, but city health costs are starting to plateau. She expectsÂ in a few years to see results that she can peg to the changes cityÂ workers are encountering.
A big part of the cause is employees buying in because they areÂ more in control of their situations than they have been inÂ a long time. “A lot of the ideas are coming from the employeesÂ and growing from there,” Valdez says. “It is very much aÂ cultural change.”