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- 1. Ingrams H e a l t h + W e l l n e s R e p o r t 49 Winds of Change Swirl Around Health-Care Interests Winds of Change Swirl Around Health-Care Interests Participants (from left) Joe Sweeney, Ingrams Jill Monroe, City of Kansas City,油Missouri Scott Hall, Greater Kansas City Chamber油of油Commerce Adam Rossbach, Mosaic油Life Care CiCi Rojas, The油Central Exchange Jaren Pippitt, Mosaic油Life Care Polly Thomas, CBIZ Matt Benge, Assured SRA Bill Redinger, Park油Hill School Dist. Gregg Laiben, Blue Cross Blue Shield of Kansas City Jim Fight, Kansas City Area Transportation Authority The current challenges facing the U.S. health care system seem to be as varied as the 318 million Americans that system serves: individual customers with unique health and wellness issues, insurance companies adjusting business models in the post- Affordable Care Act world, insurance brokers trying to help clients navigate waterways that are changing routes daily (sometimes hourly), employers trying to figure out ways to cope with dramatic increases in insurance premiums, and employees who may or may notbe doing what they can on a personal level to help their employers win that fight. Those are just for starters. Each of those stakeholders will view the current and emerging challenges of the health-care sector from different perspectives. And a dozen of those perspectives on issues that are key to the quality of life in the Kansas City area, broadly, and to the regions sprawling Northland, in particular, convened on Dec. 10 for a unique roundtable sponsored by Mosaic Life Care and hosted at the companys extraordinary Shoal Creek clinic. Mosaic Life Cares Adam Rossbach, director of business solutions, and Jaren Pippitt, home-centric administrator, served as co-chairs for a fast-paced two-hour conversation that covered strategies to bend the cost curve for health care, effective employer wellness programming, technical advan- ces in care and record-keeping, evolution of care settings and other vital topics. Current Challenges Around the table, participants sounded com- mon themes about the need for more education and engagement, at multiple levels. In addition to rising drug costs, for example, Jaren Pippitt of Mosaic Life Care and Matt Benge of Assured SRA both identified need to engage and Sponsored by: HEALTH + WELLNESS REPORT
- 2. Ingrams H e a l t h + W e l l n e s R e p o r tH e a l t h + W e l l n e s R e p o r t Ingrams 5150 incentivize employees in ways that get them both involved and excited around improving their own well being. Scott Hall, whos involved with the Greater Kansas City Chamber of Commerces Healthy KC initiative, saw the need for engagement at the business ownership level. Theres still a reluctance to drive to workplace wellness, because in the short term, it can cost money, and getting past that initial gut reaction is a huge challenge for many chamber members. Its also important, said Bill Redinger, assistant super- intendent, human resources for the Park Hill School District, for employees to understand that we are all in the fight together, specifically around costs. Employees cant have the impression that its merely a matter for their bosses; they have to step up, too. Barriers, said Polly Thomas, director of clinical consulting services for CBIZ, must fall, particularly those that keep employees from doing a better job of managing health, such as time constraints for working parents, or those caught in a sandwich generation. Employees also need better tools, she said, to determine where to receive quality care, and to understand the cost implications of their own choices about care providers. For some employers, said Jill Monroe, wellness manger for the city of Kansas City, the challenge is one of location: Companies with multiple offices have a harder time keeping employees on the same page. We have more than 100 locations, she said, so how do we engage those employees and keep wellness in the forefront? What Works Cici Rojas, CEO of The Central Exchange and a former Truman Medical Center executive, said incentives play a huge role in getting employees on boardand keeping them therebecause we have to change the behavior of people taking care of well-being. Matt Benge cited the benefits of customizing a strategy to the work force. Technology, he said, can help, but wellness is not a one-time-in-a-year, open-enrollment thing. Youve got to build your strategy year to year, and leaders have to go all- in on it, or else its not going to work. Committee-driven cha- nge, with broad input, is effective, said Polly Thomas. Thats the most successful way to build a sustainable effort, she said. It takes on a life of its own and becomes self-driven. Gregg Laiben of Blue Cross Blue Shield of Kansas City said a multi-pronged approach is vital. The more you can touch folks, the better chance youll have of getting them engaged and keeping them engaged, he said. For Jaren Pippitt, more than a decade of concentration on obesity and tobacco use, for example, hasnt had the impact we might like for reducing the effects of those conditions, which, ultimately, require long-term lifestyle changes. How do we align incentives for a payoff thats immediate and tangible, but is still a motivator? she said. Tangible tools that work, said Polly Thomas, show employees whats in it for them, not just for their employers bottom line, but many employers arent willing to put the time and the cost into it to demonstrate that return. Others, said Matt Benge, court failure if they throw too much at employees, too soon: You have to do it incrementally, with a stair-step approach, he said. One-time classes on issues as complex as diabetes man- agement, said Jill Monroe, are a bust. Thats not going to change behavior, she said. Effective instruction has to be over a long period of time. Changing behavior takes time. Scott Hall said things as basic as a basket of apples in the break room can have an impact, as well as more intense efforts like fitness competitions. Not everyone is motivated by that, he said, but creating friendly ways to compete, to gamify this, really drives people to change behaviors. Delivery Innovation From clinics that may be on site or mobile, from the patient- centered medical home structure to satellite facilities built around holistic approaches to health and wellness, participants explored the changes in the way services are delivered. Bigger companies, Polly Thomas noted, can justify their investment and succeed with on-site facilitiesclinics, medical staff and fitness facilitiesbut mid-size and smaller organiza- tions are starting to succeed with near-site and shared models. These seem to be most successful when they integrate with a benefit plan and other resources an employer has, she said. Adam Rossbach noted that Mosaic Life Care itself was committed to innovative, low-cost approaches to wellness, including, he said, on-site care at a fraction of the cost including on-site telemedicine, which utilizes remote family-medicine physicians at sites like the Shoal Creek facility. We see the growth extend- ing the doctors into places theyve never been able to be, said Laiben. But even that is just a stopgap measure, because the real clinic were after, youre all carrying in your pocket is thesmartphone.Thedisruptive power of new technology, he said,couldcuthealth-careprem- iums by 30 percent if we lever- age that technology correctly. As Jill Monroe and CiCi Rojas noted, confidentiality of individual health records, and potential employer liability for inadvertent release of that information, are large issues. But with new methods of seeing a doctor, employees needtounderstandwhosonthe other end, and what are their credentials?saidPollyThomas. More are apt to use it if they know theyre seeing the same provider every time, or the same group of providers, vs a random person who rotates in. Changes to Come That ties in with the next generational tsunami of health- care patients: Millennials entering the work force, already in numbers that exceed the dwindling cohort of Baby Boomers and the subsequent Generation X. Millennials want to do everything on their iPhone, said Adam Rossbach, and that will include health-care delivery. People are busy, theyre working, they have kids, said Jaren Pippitt. Our goal is to meet them where they are. Mosaic, she said, is preparing for that shift to on-demand health-care, and smart phone, telemedicine and e-consultations are going to boom. Changes in the efficacy of health-care delivery and wellness programs are vital, said Scott Hall, because any organism that is healthy will grow faster and grow stronger and thrive more if its healthy. That can be a person, a company or a community. Most agreed that there will be an increasing emphasis on other dimensions of health and wellness besides physical well-being, including financial, mental and behavioral health, spiritual health, and the health of ones relationships. To that extent, employers should provide incentives, said Polly Thomas, that are not just focused on physical health, but other dimensions. Theres a lot of evidence on the power that volunteerism has. So a paid day off to work for a charitable cause has a place in a companys overall strategy, or allowing employees to direct any financial incentives due them toward a particular charity. In describing the pillars of wellness, from a human capital perspective, that gives us the opportunity to have a dialog with employees, and shows that, as an organization, we value our people, said Jim Fight, human resources officer for the Kansas City Area Transportation Authority. Were looking to be impactful in peoples lives beyond services they provide to us to improve our bottom line. I HEALTH + WELLNESS REPORT 1. Jaren Pippitt, left, and Adam Rossbach, right, served as co-chairs for the Health and Wellness Assembly, steering a two-hour discussion that touched on a wide range of topics. 2. Smaller companies, said Polly Thomas, are beginning to see success with alternative models of medical care for employees. | 3. Gregg Laiben said broad advances in mobile health-related technologies, properly leveraged, could sharply reduce insurance premiums. 1. Employees, said Bill Redinger, cant be left to think of health-care costs as an administrative concern alone. | 2. Jill Monroe expressed the concerns felt by employers operating from many locations, and the challenge of consistent employee communications . | 3. Scott Hall wondered how long huge increases in insurance costs could continue. | 4. CiCi Rojas cited the innovative strategies like using accrued paid time off to be used for employees health-related expenses.