n the continuing
battle against rising health care costs, some employers are finding they can best
help themselves by helping others.
Increasingly, employers are engaging with local providers,
inviting outsiders to take part in their on-site health fairs or investing in health
information technology and health improvement research projects.
While much of this collaborative work is being performed
in conjunction with local business health coalitions, in some cases individual employers
are breaking free from the pack and taking leading roles.
Dr. Michael Cryer, senior medical director at Hewitt
Associates in Woodlands, Texas, likens the phenomenon to years ago when large industrial
employers began investing in school science programs because "they knew they were
educating their future workforce."
Working with the community on health care consumerism
can also help inform current and future employees. Some employer efforts, such as
doctor and hospital report cards, are intended to foster consumerism on a communitywide
basis, suggests Dr. Charles Smith, a principal at Towers Perrin in New York.
"Then if they come to work for that employer, they will
already have a certain level of knowledge" about how to be a better health care
consumer, he says.
Indeed, "the degree to which employers can promote community
health, and a culture of health in the communities where they operate, that's good
for business," says Andrew Webber, president of the National Business Coalition
on Health in Washington.
"An employer can obviously do a lot at the workplace
to promote healthy behavior," he says, but they have little or no influence over
how their employees act once they enter the community at large. As such, "we are
definitely encouraging our coalitions and the employer members of our coalitions
to get more involved in community health."
"This is the pool, the community, from which they draw
not only their current workforce, but their future workforce," Webber says. "And
employers’ No. 1 goal is to have healthy and productive workers."
As part of this effort, the National Business Coalition
on Health recently entered into a five-year cooperative agreement with the Centers
for Disease Control and Prevention in Atlanta to pair member coalitions with public
health agencies so they can collaborate on community health initiatives, Webber
says.
The Florida Health Care Coalition in Miami hosts communitywide
health fairs. Other employers have also teamed up to improve the health care delivery
system.
"It’s not just for the employees of members of the coalition.
The coalition is trying to do health fairs that can impact the community at large,"
Webber says.
"In community after community, business coalitions are
working with physician groups, with hospitals, with consumer and labor groups to
try and improve quality in their community," says Peter Lee, executive director
of health policy at the Pacific Business Group on Health in San Francisco.
Those efforts are anchored in the understanding that
providers don’t discriminate in how they deliver care based on who an individual
works for, he explained.
"If you go to a hospital and get a surgical-site infection,
someone doesn’t say, ‘Excuse me, we’re going to make sure the Chevron employees
don’t get infections, but the rest of you, we don't really care about,’ " Lee says.
"You can't really address the affordability and quality
issues for an individual employer without addressing it for the entire system,"
he says.
A government program spearheaded by Secretary of Health
and Human Services Michael Leavitt is also encouraging more employers to become
involved in community health improvement efforts via the Chartered Value Exchange
program, which enables them to gain access to performance information from Medicare
that gauges how well physicians treat patients.
"Those community efforts have to have, by definition,
the employer community at the table," Lee notes.
Likewise, the Robert Wood Johnson Foundation, a Washington-based
philanthropic organization that focuses on health care issues, is requiring major
employer involvement in order for a community to qualify for grants totaling $300
million under its Aligning Forces for Quality program, Lee says.
"To really have improvement throughout a community,
everyone has to be at the table. For many years, business coalitions in some ways
have been at the cutting edge of these efforts, but now I think we're seeing a real
growth in really robust collaboration," he says.
But sometimes it takes the driving force of an individual
employer to give these efforts the spark needed to get started, Lee says, pointing
to an effort led by Caterpillar Inc. in Peoria, Illinois, as an example.
In 2006, Caterpillar joined forces with Peoria-based
OSF Healthcare System, which operates seven acute care facilities, to form the state's
first regional health care improvement coalition, Quality Quest for Health.
Since Caterpillar and OSF are the region’s two largest
employers, providing coverage to a substantial number of individuals living in the
community either as employees, retirees or their dependents, the two organizations
realized they could have a significant impact on the region if they worked together.
"Quality Quest for Health’s mission is to achieve exceptional
patient service and outcomes by serving as a catalyst health care transformation,"
says Dr. Gail Amundson, president and CEO of the coalition.
The program’s initial focus was on increasing the affordability
of medications by boosting generic prescribing rates among local providers, implementing
preventive care treatment guidelines developed by the Institute for Clinical Systems
Improvement, and improving the quality of colorectal cancer screenings performed
in the community, Amundson says.
This year, the alliance is also working on reducing
secondary cardiovascular risks by helping people with heart disease and diabetes
better manage their conditions and collecting data on healthy lifestyles using the
health risk assessment that more than 90 percent of Caterpillar’s employees complete
twice each year, she says.
Although Caterpillar will be the primary beneficiary
of its work in the Peoria area, there may be another reason why employers like it
are reaching out into their communities rather than keeping to themselves, suggests
Bruce Kelley, a senior group health care consultant at Watson Wyatt Worldwide in
Minneapolis.
"If the big employers just used their power to achieve
a specific cost reduction they desire, they would likely experience backlash from
the much larger number of smaller employers that do not have that market power,"
he says. "So they’re not doing it for altruism’s sake."
But even if employers’ motives are not purely selfless,
"there has to be a champion" in the community for any significant change to occur,
says Debra Draper, associate director at the Center for Studying Health System Change
in Washington.
"The time of employers keeping to themselves has passed.
They have to become more of a community citizen. There are real synergies when they
work collectively with health plans, providers and other employers. Everyone’s got
ownership and has a role in improving health care," says Webber of the National
Business Coalition on Health.
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