Post-COVID Healthy Living: program for providers in hospitals, medical centers – Mary T. O’Sullivan

by Mary T. O’Sullivan MSOL – contributing writer on business leadership

“Good health is not something we can buy. However, it can be an extremely valuable savings account.” Anne Wilson Schaef

Over the past five years, and specifically in the post-COVID era, many medical centers have experienced increasing health care costs, illness-related absenteeism, and challenges in recruiting and retaining seasoned health care professionals. Currently, this trend is reflected nationally and is impacting hospitals and health care facilities across the nation. A study recently released by Reuters found that, “the average annual cost of healthcare for hospital employees and their dependents was at least $4,662, outpacing the general population by $538. In fact, the study shows that, “healthcare spending is 10 percent higher for hospital employees than it is for the general employee population. And, post COVID, it is only going up.

Statistics show that most comprehensive corporate wellness programs cost from $200-$400 per employee. In tight financial times, a hospital or local medical center may not be able to afford that price tag. With an average population of 2500, if the notional budget is as low as approximately $150,000, the cost of the program is limited to approximately $60 per employee, implying that employees will need to share the cost burden of the program, and that establishing metrics for return-on-investment (ROI) calculations are key to the program’s survival. Health care professionals today are not likely to accept the extra cost burden in addition to increased workload.

The strategic advantage – To counter this threat to a hospital’s growing health care costs and, ultimately, its ability to attract and retain skilled staff, medical centers may be exploring the costs and benefits of creating a comprehensive employee wellness program, called Healthy Living, to promote and support health and well-being throughout its employee base. Many hospitals may now be urged to quickly move past the discovery stage of this project and solidify research in alternatives to reverse unhealthy trends, aiming for a subsequent reduction of overall health care costs to the hospital and its employees.  

Improvements in attendance, less time off for illness, and as an additional benefit, enhance the hospital’s ability to gain competitive parity in attracting and retaining a highly skilled workforce are all incentives for a medical center to make these needed changes. Also, by exploring both a self-administered approach as engagement of third-party providers, the hospital can hope to gain insight into all cost options, including liability insurance, workman’s compensation, and cost per employee.  Moreover, as stated earlier, with shrinking operating budgets, a hospital’s return on investment or ROI is a primary concern.

Why it is needed – Statistics have shown that employee absences due to illness costs a company $602 per person per employee per year, with the resultant increases in health insurance costs by a rate of 8-14% annually. In addition, employee morale decreases due to lack of wellness programs, and average employee vitals degrade, body weights are higher, medications are increased, etc.

For example, on a recent ER visit, it was noted that many nurses in the emergency department are overweight, most likely due to stress, poor eating habits, lack of exercise and motivation.  Along with obesity comes increases in blood pressure and diabetes, as well as other negative biometrics, including exposure to communicable diseases such as COVID and new advantageous viruses such as Monkeypox.

These facts all strongly demonstrate the need for an intervention in the form of an employer sponsored wellness approach, which is also convenient for the staff. Furthermore, studies have shown that health and well-being are directly related to employee morale; and where morale is improved, health and wellness are also improved, and therefore health care costs go down. This project supports a hospital’s search for an alternative, healthier way of living for its employees as well as a path to overall health care cost reduction. Through wellness education programs, coupled with leveraging the hospital’s existing personnel and out-patient wellness facilities in the form of employee access to exercise equipment, nutrition counseling, smoking-cessation, diabetes monitoring and weight loss, the hospital has a clear strategy for improved employee health as well as cost reduction in overall health costs and realized return on investment.  

Hospital CEOs may decide to begin gauging interest in a Healthy Living program by encouraging senior staff to communicate current obstacles to employee morale and physical and mental wellness and to offer ideas that will support staff addressing these obstacles. Maybe a CEO will assign a few direct reports to brainstorm ideas on moving this project forward.  Some of the methods used may be:

• Creating a focus team of direct reports whose mission will be employee’s motivation and engagement strategies. 
  
• CEO’s involvement by sending out personal voicemails and email reminders to participate in health assessments and showing a presence in many wellness activities
  
• Analyzing third party wellness organizations offering plans specifically designed for hospital employees
  
• Financial incentives for employees to get fit and stay healthy.
  
• Mass distributed communication materials, such as posters, pamphlets, etc. addressing wellness practices and topics.
  
• Group programs at a discount rate such as Weight Watchers, Planet Fitness, outside gym membership and providing employee fitness centers.

The Value of the Project.   This project will explore how promoting employees’ healthy lifestyle choices could save the hospital, with about 2500 employees, one million dollars annually in medical and pharmacy costs and reduce illness-related absences by two percent.  Fewer medical claims, reduction in meds administered, and improved vitals are all metrics commonly used to determine program success. Emerging questions are many. Therefore, surveying the employee base will provide the rationale for the project and determine which programs employees will find valuable, while offering relief to hospital budgets and potentially offsetting any staffing crisis.

Initial questions to consider are: Why health care workers are so unhealthy?  Is it due to the stress of constantly caring for others that many in the healthcare industry don’t sufficiently care for themselves?  Is it due to the inordinate amounts of shift work and long hours that interferes with their sleep patterns and dietary habits?  Potential exposure to disease, or is it a combination of all the above?  Whatever the solution may be, studies show it is highly recommended for healthcare facilities to address this situation quickly, as employees will quit, rather than risk their health. Furthermore, multiple third-party providers should be engaged for an analysis of which programs offer the hospital the biggest bang for its buck, healthier employees, reduced costs, and meaningful ROI.

Overview of the Project –

Once a budget, required resources, and project evaluation team are established, a trade analysis of various programs can be conducted.  The project team must first agree on the project’s scope within the budget limits determined by the CEO. What will be included in the program needs to be established by generating a Work Breakdown Structure (WBS) prior to issuing a detailed Statement of Work (SOW) and Request for Proposal (RFP). Whether or not the program will mirror exactly all out-patient wellness services, become a cafeteria style plan, or be limited to a few options such as the cardio rehab center or weight loss at work, or whether certain programs can be phased in over time, will be determined by the resources the hospital is willing to commit. In addition, staffing for various services also needs to be determined. Will the in-house staff be paid, or act as volunteers, what is their liability, etc. all are questions needing answers prior to project start up. Once the plan is selected, employee needs assessment through use of a survey should be conducted, a comprehensive communications plan, as well as employee incentives need to be initiated. All activities in the program’s WBS must be identified with cost targets, including dependencies, growth opportunities, and a detailed schedule for rollout established. Annual ROI data points must be established and documented, including biometrics of all participants, along with number of insurance claims, absenteeism, “presenteeism”, ER visits, etc. According to Corporate Wellness, there are four areas to consider to accurately measure ROI: design a comprehensive program to apply to all employees, integrate incentives into plan design, validate efforts with biometric screenings, offer multiple program modalities. If the hospital realizes a credible ROI compared year to year, the program is likely to continue. Furthermore, the program is more likely to survive with a high visibility champion or local celebrity sponsor. A notional rollout schedule may resemble the following:

Week 1 – Establish leadership team/project manager. Establish 30-, 60-, and 90-day project plan. Issue detailed schedule.

• Seek project champion among hospital management team. Introduce communications plan. Survey employees for needs assessment. Initiate free voluntary employee health screenings and follow up evaluations. Conduct trade analysis of employee motivational tools and techniques. Consider offering liability waivers to participants if liability insurance costs are too high. Consider implications of waivers in the workplace and potential impact on worker’s compensation claims. Present insurance approach to management for approval.
• – Tailor program services and determine limitations (Statement of Work and WBS). Engage appropriate staff.  Roll-out motivation plan.
• – Negotiate budget with management. Create cost elements for each WBS item, including staffing and liability insurance.
• Month 4 – Roll-out 30-, 60-, and 90-day implementation plan. Evaluate individual program participation for continuance.

Objectives – Goals and Targets

Goals: The immediate goals of this project are to first demonstrate how ROI will be realized, how health related costs can be reduced, how the hospital attains a reduction in overall medical claims, absenteeism, and to show a demonstrated improvement in the standard biometric categories of blood pressure, body weight, body mass index, and cholesterol levels.  A workplace safety assessment should also be included.  Prevention of exposure to COVID and Monkeypox must also be established as well as proper quantities of Personal Protective Equipment (PPE). The American Hospital Association’s (AHA) study “A Call to Action: Creating a Culture of Health”, also points out that these metrics should be collected on an annual basis for evaluating the program’s effectiveness, in particular as communicable diseases are on the rise.

Relevant goals can be found in the American Hospital Association’s study “A Call to Action: Creating a Culture of Health”, which summarize five key elements of success in workplace wellness programs: Leadership and Commitment, A Comprehensive Set of programs, Ongoing Promotion and Communication, Participation and Outcome Metrics, Use of Both “Carrots” and “Sticks” as incentives. The study goes on to suggest seven goals with specific strategies described to achieve them; serve as a role model of health for the community, create a culture of healthy living, provide a variety of program offerings, provide positive and negative incentives, track participation and outcomes, measure for ROI, focus on sustainability.  

Targets: According to Corporate Wellness, full participation of all employees increases ROI while improving the overall health and wellness metrics being measured. Therefore an important target for any medical center is to achieve 100% employee participation. Once participation has been established, biometrics must be baselined for each employee, with an overall target of a two percent improvement per year. Within six months of program start up, all participating employees should have their initial screening completed and documented. Employees could be incentivized for monthly recording of their own statistics, with a target of 10% improvement per month in participation. Targeted populations such as pregnant women and the obese as well as other high risk categories, such as exposure to COVID-19 can opt for more preventive measures as well, with outreach to those individuals planned into the overall program. 

“Your health account, your bank account, they’re the same thing. The more you put in, the more you can take out.” Jack LaLanne

Connect with Mary:

www.visionaryleaderbook.com

www.encoreexecutivecoaching.com

[email protected]

https://www.linkedin.com/in/marytosullivan/

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Read all Mary’s columns here: https://rinewstoday.com/mary-t-osullivan-msol-pcc-shrm-scp/

Mary T. O’Sullivan, Master of Science, Organizational Leadership, International Coaching Federation Professional Certified Coach, Society of Human Resource Management, “Senior Certified Professional. Graduate Certificate in Executive and Professional Career Coaching, University of Texas at Dallas. Member, Beta Gamma Sigma, the International Honor Society. Advanced Studies in Education from Montclair University, SUNY Oswego and Syracuse University. Mary is also a certified Six Sigma Specialist, Contract Specialist, IPT Leader and holds a Certificate in Essentials of Human Resource Management from SHRM.