A Routine of Maintenance

Every year millions of Americans take their vehicles to auto shops for routine maintenance. They have the oil changed, hoses replaced, and tires rotated. If the car’s owner is on schedule, they will do this at least four times per year. And at the point they hand the keys over to the mechanic, there will be nothing seemingly wrong with their vehicles.

Maintenance is important because vehicles are expensive, and proper updates can keep them on the road for decades. The alternative is to drive the vehicle on overused oil and risk damaging the engine beyond repair.

While routine maintenance is a given with vehicles, many people do not treat their own bodies with as much care. Waiting rooms at clinics are full of sick patients waiting to be fixed, rather than healthy people trying to maintain their conditions.

The truth is, no matter how well-maintained, one day the engine is going to knock. Maintenance might give that vehicle a long and healthy life, but the owner is eventually going to pay a fortune to have it fixed or buy a new one.

The same scenario is going to happen with our bodies. Except 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 mindset that health plans are around to fix, rather than maintain or improve, health. They are going about it through wellness coaching, preventative screenings, more intensive doctor visits and more. It is a shift from a mentality in which a company’s definition of promoting wellness was a once-a-year pamphlets and healthy snacks.

“There were just activities,” says Julia Valdez, Director of Human Resources for the City of Rockford. “It was just checking the boxes, so to speak.” But those employers, especially here in northern Illinois, are realizing that healthier employees can do a lot for productivity and the bottom line. And there are a lot of changes needed. According to The County Health Rankings and Roadmaps program, a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, Winnebago County ranks 72nd out of 102 Illinois counties in terms of health.

About 29 percent of adults here are obese, 27 percent report doing no leisure-time physical activity and 11 percent have been diagnosed with diabetes. There is one primary care physician per 1,340 residents in Winnebago County compared to one for every 1,266 in all of Illinois. And there is one mental health provider per 721 residents here, compared to one for every 604 for the state.

It is not just a problem in Winnebago County. Throughout the United States, people are getting sicker, often from things they could avoid through lifestyle changes. In 2010, Dr. Steven H. Woolf of Virginia Commonwealth University gave a report to the National Center for Biotechnology Information, part of the National Institutes of Health, called “The Price Paid for Not Preventing Diseases.” In that report, he said between 2005 and 2030, the number of individuals with chronic disease is expected to increase nearly 29 percent, to 171 million people. He also stated that 38 percent of all deaths in the U.S. are due to four health behaviors: smoking, unhealthy diet, physical inactivity and problem drinking.

“We talk about sustaining programs rather than ‘Biggest Loser’ projects where you lose 100 pounds and gain 90 of it back.”

“Randomized trials have demonstrated that intensive lifestyle change can reduce new cases of diabetes by more than 50 percent,” the report said. “Early detection of certain cancers and other chronic diseases through screening can reduce mortality from these conditions by 15 to 20 percent. Taken together, the potential leverage of prevention in calibrating the morbidity and costs associated with chronic disease is averting 70 percent of such cases.”

All that adds to big costs for employers, who often foot the majority of health insurance premiums. In that same report, Woolf cited a study from the Milken Institute that showed chronic illness costs the economy $4 in lost productivity for every $1 spent on health care. He also cited a Trust for America’s Health study that showed community-based interventions could save an estimated $5 for every $1 invested.

Individual Goals

A new employee who walks through the doors of Rockford Acromatic Products for the first time goes through many of the usual new-hire procedures. There are tours, training and discussions about benefits. But before they walk out the door, they will have two things most employers health club membership.

“In addition to the usual things, we are telling employees that basic health is also important,” says Jim Knutson, Risk Manager at Rockford Acromatic Products. The self-care book contains basic guides on first aid, as well as information about health conditions, such as high blood pressure and diabetes. Knutson says employees are encouraged to use their health club memberships, including scheduling time with wellness coaches and personal trainers so they are getting the most out of the benefit. The goal, he says, is healthy living.“We talk about sustaining programs rather than ‘Biggest Loser’ projects where you lose 100 pounds and gain 90 of it back,” Knutson says. A key to that working, Knutson says, is to make sure it is not a one-size-fits-all approach with wellness and having a willingness to adapt when necessary. “The program you use for a 62-year-old grandfather should probably be different than that of a 25-year-old triathlete,” Knutson says. “The program that is designed on the third floor of a consulting office and rolled out is not really as effective as a pilot where you receive feedback on the elements that are working and use that to improve the program.”

Longer Visits

Doctors these days are rushed. Kaiser Health News reported last year that the average doctor visit was just under 21 minutes. But half of those were under 15 minutes. “A 1999 study of 29 family physician practices found that doctors let patients speak for only 23 seconds before redirecting them. Only one in four patients got to finish their statement,” the story says. “For a primary care physician to have a reasonable income, he or she needs to see about 45 patients a day,” says Guy Clifton, CEO of Actin Care “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 to take me three weeks to see my primary,’” Valdez says.

Clifton is working on opening a care facility in Rockford that would address that issue. He wants to work with self-insured companies to offer primary care physicians dedicated to only those companies’ employees and their dependents. “We would offer 24/7 availability to people by phone, appointments within 24 hours and as much time with a physician as you need,” says Clifton, who believes his business will be offering services later this summer.

Scott Eckburg, President of Direct Care at Eckburg Insurance Group Inc., is doing something similar. He is partnering with companies that are partially self-funded to give employees access to what he calls “all-you-can-eat health care.” His strategy combines higher deductibles with primary care on a per-month basis. Since the companies are partially self-funded, insurance can underwrite some of the expenses.

“We are able to take the large model that people are going to in droves because of the cost savings and take that to a smaller scale to meet the needs of small and mid-sized businesses,” Eckburg says. The physicians working with Eckburg’s groups will see about 600 patients max, compared with the average physician who sees more than 2,300 patients, according to a 2012 article in the Annals of Family Medicine. “That burden is taken off the doctor,” Eckburg says.

Focus on the Whole

When someone walks through the door of FitMe Wellness and tells owner and founder, Greg Georgis, they want to lose 5 pounds, he calls them on it. “If you wanted to lose 5 pounds, that is not hard to do. You would have already done it,” Georgis says. “I ask, ‘What do you really want to do?’”

Georgis says, he often hears that people want to be around for their grandchildren, to not be so tired after playing with the kids for just a few minutes or to lose the soreness they experience from an hour of yard work. In short, they want to be healthier.

“The motivation is simply living a more fulfilling life,” Georgis says. “You want to feel good.” We are programmed to see health and fitness as maintaining a certain weight. But that is just part of it. Georgis says someone could be “pleasantly plump” and still be reasonably healthy. “We do not really care about the weight. We want to know how you are feeling,” Georgis says. “That is a wellness program, not numbers on a scale.”

“If you wanted to lose 5 pounds, that is not hard to do. You would have already done it.”

While health professionals point to obesity as a major factor in rising health costs, it is really the results of obesity that take a toll. FitMe Wellness works with individuals and corporate partners to focus on overall wellness, specifically strength, flexibility and better diet. The company partners with dozens of businesses in the area whose employees get access to health coaching, personalized wellness plans and more. “We are looking at managing the health of a community or a giant corporation, to a large company or a small company,” Georgis says.

Those companies, in return, are hoping for happier employees who will call in sick less often and maximize their potential. And less turnover means reduced hiring and training costs.

“What the most innovative employers are doing is trying to make it clear that employees’ health is important to them, and it is showing the employee that it should be important to them as well,” Georgis says. “If we can dust those cobwebs from a company, if we can get those people moving more and eating better, that employer is better served with a better workforce. “They are absolutely hammered on the health care costs and that is because the workforce is unhealthy,” Georgis says. The city of Rockford opened its own wellness facility downtown last year, and Valdez says she is hearing positive things from employees. Those employees average 40 minutes to an hour with physicians and are forming groups that help each other manage health issues like diabetes and high cholesterol. Valdez says it is too early to tell if the wellness center is the cause or an aspect of the cause, but city health costs are starting to plateau. She expects in a few years to see results that she can peg to the changes city workers are encountering.

A big part of the cause is employees buying in because they are more in control of their situations than they have been in a long time. “A lot of the ideas are coming from the employees and growing from there,” Valdez says. “It is very much a cultural change.”