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Latest Posts

Patient-Driven Primary Care – A Cornerstone Of The Health & Wellness Movement?

Health and wellness go hand in hand; there is little question of this. I therefore ask why isn’t primary care at the heart of the health and wellness movement? This, I feel, would make outstanding economic sense for all involved.

In an effort to survive these sour economic times, more and more companies are trying to stave off the escalating cost of healthcare by pushing for wellness. There is good reason for this. According to Buck Consultant’s third annual global wellness survey which was cited on the Society of Human Resources Management web site those U.S. companies who measured financial outcomes of their wellness programs reported a 43% reduction in healthcare costs or about two to five percentage points per year. Read more »

Why Educating People Is Rarely Enough To Fix A Problem

Every year it happens: people come to me telling of what they are going to be doing different in this fresh new year.  People are going to stop smoking, start exercising, and (especially) lose weight.  This year, I am among the resolvers.

Every year, most people fail.

Which makes me wonder what it is about us humans that allows us to act against what we know is best.  Why is it that educating people is rarely enough to fix a problem?  Why should we have an obesity “epidemic” when very few people really want to be obese? Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Healthcare Engagement: Most Companies Are Not Meeting Employee Expectations

nancyturettEdelman has been a leader in surveying and analyzing consumer health opinion on a global scale. In 2008 they released the results of a Health Engagement Barometer, confirming the public’s strong desire for personal engagement with health experts and peers online and beyond. I clearly remember Edelman’s revelation that medical bloggers (particularly healthcare professional bloggers) are one of the most trusted sources of health information online. That made me feel good.

This time around, Edelman created a new survey (The Health Engagement Pulse) focused on consumer expectations of their employers. The results reflect a further shift away from traditional siloed roles and relationships (where employers have nothing directly to do with healthcare) and a new era of blended responsibility. To understand this shift, I interviewed Nancy Turett, Edelman’s Global President of Health. Please listen to the audio interview or enjoy the synopsis below.

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Consumer-Directed Healthcare Leader, OptumHealth, Wants To Influence How Patients Choose Their Care

robwebb1OptumHealth is one of the largest health and wellness companies in the United States, providing services to about 58 million people. It is the umbrella organization for 12 consumer-directed healthcare companies recently purchased by UnitedHealth Group. I caught up with the CEO of OptumHealth Care Solutions, Rob Webb, at Health 2.0 to find out what they’re up to and how they’re hoping to contribute to healthcare reform.

Dr. Val: What does Optum Health do?

Webb: We work with about 300,000 people a day. We’re focused on the consumer-provider interaction and we try to help consumers make better decisions in four key areas: 1) help them find the right provider for their needs,  2) to provide them with an unbiased set of information about what their treatment options are 3) optimize their pharmaceutical regimens and medication compliance and 4) help them improve their lifestyle choices. In the past we focused a lot of our efforts on #3 because it’s so tangible and there’s an entire PBM (pharmacy benefits management) industry to help. Read more »

Unintended Consequences: Penalizing Insurers Kills Employer-Based Wellness Programs

I thought everyone knew the major goal of health care reform is to control spending.

Then why are Democratic leaders proposing changes that would outlaw some of the most successful cost-savings programs in the country?

Today’s The Hill reports on the new strategy to attack insurance companies as “villains.”  No doubt, health insurers have a bad reputation and have done plenty to earn it.  As the Hill reports, the message is going to be that the reform plan will lead to “capping what [insurers] can force you to pay in out-of-pocket expenses, co-pays and deductibles.”

But for at least half of Americans – those who work for large and mid-sized companies and their families – their “insurer” is actually their employer.  And many of these employers have been using out-of-pocket expenses, co-pays and deductibles to improve employee health, and reduce the cost of care.  They are creating strong wellness programs and creating financial rewards and penalties, all based on employee participation.

As I wrote in April:

Companies like Safeway, Wal-Mart, Michelin, General Mills, Marriott and so many others have implemented programs to create a “culture” of wellness among their employees and their families.  Leaders at these companies constantly talk about living healthy lifestyles, and are paying to make it happen.  At Michelin, employees get a cash reward for getting a biometric screening and for participating in company-sponsored health improvement programs.  It even started work-site exercise programs, including yoga (although it found that with a workforce that was 82% male it had to call its yoga classes “strengthening and conditioning”).

General Mills published wellness statistics about its different plants and found that the workers in each one competed with the others to get the best scores for BMI and other important health metrics.  Marriott found that by eliminating co-pays on drugs for certain chronic diseases, more employees followed doctors’ orders to take them, and although Mariott’s drug costs went up, overall health expenses went down.  Abbott Labs brings in motivational speakers and set up weigh-in kiosks in its offices that took pictures of employees as they got healthier so they could see the difference.  All of these companies reported on enthusiastic participation, and a sense among employees that their company cared about their well-being.

Safeway has taken this idea even further, and redesigned its entire benefits plan around this concept.  Employees who live unhealthy lifestyles and refuse to participate in wellness programs pay more for their health insurance — just like a bad driver pays more for  auto insurance.  Safeway did this in a highly positive and motivational way, making available a wide array of free services to help employees be more healthy and enjoy lower health premiums.  The results have been dramatic:  Steve Burd, Safeway’s CEO reported at the WHCC that Safeway’s health costs have been flat since 2005.

This Safeway model – creating both soft and hard incentives for employee health – is one of the fastest growing trends in plan design.  The idea is to give employees control over their own health care, including financial  responsibility.  When this happens, employees live healthier, look for value in their health care spending, and overall costs are lower.

And yet the statements from the Congressional leadership suggest they want to severely limit these kinds of innovations.

It may be good politics to demonize the insurers, but we should realize that “insurers” aren’t exactly who we think they are.   Health reform that stifles the innovation that’s working at America’s best companies is no reform at all.

*This blog post was originally published at See First Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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