Corporate Wellness Strategies: Medical Self-Care

by Matthew J. McMillin, MD
Optimum Health Solutions

U.S. healthcare costs continue to rise at a staggering pace, a fact with which American companies are all too painfully familiar. In 2008, health-related expenditures in this country will top $2.2 trillion—or 16 percent of the gross domestic product.

Employers who provide health benefits to their employees are increasingly feeling the burden as healthcare costs consume an ever-growing percentage of corporate profits. According to the Towers Perrin 2008 Health Care Cost Survey, it is projected that U.S. companies will pay an average of $9,312 per employee for healthcare services alone—up from $6,384 in 2003. Companies, however, aren’t the only ones feeling the crunch. Employees are increasingly being forced to pay a greater share of these costs. The average out-of-pocket cost for healthcare coverage has increased from $1,284 per employee in 2003 to $2,040 in 2008—a 59-percent increase over the last five years.

Over the years, companies have tried a number of supply management tactics to combat rising healthcare costs, including increased co-pays, higher deductibles, negotiated discounts and switching insurance providers altogether to find the best bargains. While this approach initially showed promise, over the course of time, it has failed to stabilize costs.

The principles of wellness management, on the other hand, encourage an alternative approach to healthcare cost containment by focusing on employee lifestyle issues. This is accomplished by helping employees live healthier lifestyles and educating them on how to be wiser healthcare consumers. It has been reported that as much as 70 percent of the nation’s healthcare cost is lifestyle-related and preventable. Comprehensive corporate wellness programs are the cornerstone of this preventive approach and have proven in multiple studies to be effective in reducing direct healthcare costs, improving employee productivity and reducing indirect costs associated with absenteeism, presenteeism, disability and workers’ compensation. According to the Society for Human Resource Management, 81 percent of all U. S. companies with 50 or more employees are offering some form of wellness program to their employees, a number that continues to grow every year.

Medical Self-Care
One proven way to reduce employer healthcare costs is by minimizing the demand for unnecessary medical services, including office and emergency room visits, medications and costly medical procedures. This can be accomplished as part of an ongoing wellness program by educating employees, spouses and retirees about the skills of medical self-care. According to the American Institute for Preventative Medicine, medical self-care is defined as a decision-making process that helps increase efficient and appropriate use of medical services and to make more informed healthcare decisions. These skills involve knowing:

  • When a real medical emergency occurs
  • When and when not to see/consult a physician
  • When and how to treat oneself or family members at home
  • When to use outpatient, rather than inpatient, services
  • When diagnostic procedures are necessary
  • When and how to question a provider’s recommendations or seek a “second opinion.”

Medical self-care is not intended to replace the advice of a physician or other licensed healthcare provider. Rather, it is intended to enhance and strengthen the provider-patient relationship by relying on the patient to become a more informed healthcare consumer. Even though our nation’s healthcare system continues to advance and evolve at an amazingly fast pace, making confident decisions about personal and family healthcare issues is possible when armed with the right information and a solid, trusting patient-provider bond.

Why is medical self-care important? The National Hospital Medical Care Survey reported that in 2005, Americans went to hospital emergency departments 114 million times—at an average cost of $383 per visit. The CDC estimates that 55 percent of emergency department visits are for non-urgent conditions including such ailments as headaches, upper respiratory infections and minor injuries. Furthermore, the National Ambulatory Medical Care Survey in 2005 reported that there were approximately 911 million visits to office-based medical providers. It is estimated that 25 percent of these visits are unnecessary, or could be effectively treated without a costly trip to the doctor’s office.

Medical self-care has the potential to benefit employers who actively engage their employees, spouses and retirees in an ongoing self-care educational program. These benefits include:

  • Reduced healthcare costs. Data from 18 independent case studies conducted by the American Institute for Preventive Medicine, revealed that implementing medical self-care guidelines resulted in average savings of $71.42 per employee over a nine-month period due to reduced physician and emergency department visits alone.
  • Reduced absenteeism
  • Improved quality of care
  • Increased patient satisfaction with care
  • Improved employee interest in their overall health.

There are many ways to disseminate medical self-care knowledge to employees through the corporate wellness provider or wellness committee, including:

  • Self-care publications—printed guides that can be customized to address broad self-care topics such as medical consumerism, or more specific health-risk-related topics geared toward a more specialized target group. The American Institute for Preventative Medicine publishes 15 self-care guides that address different target groups, including families, women, children, seniors, pregnancy, adolescents and mental health. The Wellness Councils of America also offers a comprehensive guide entitled “Self-Care Essentials” which provides a very straightforward, easy-to-read guide to help employees manage their healthcare and live well.
  • On-site self-care workshops—trained healthcare providers or instructors available on-site to present self-care topics directly to employees. This approach allows for an effective exchange of information and the ability to answer questions or address concerns as they arise.
  • Nurse advice line or Health Coach service—companies that wish to offer a more comprehensive self-care program could provide employees with a toll-free health counseling hotline. This allows employees a direct link to a health professional for general health information or questions about diseases, wellness exams, the corporate wellness program, medical procedures, etc.
  • Online wellness center—self-care guidelines and educational material provided on the company intranet or wellness website.
  • Self-care promotional materials—such as posters, flyers, refrigerator magnets, postcard reminders or payroll stuffers. These items promote the overall wellness and self-care philosophy of the company and improve the utilization of other educational materials.

In summary, comprehensive worksite wellness programs and medical self-care guidelines are very effective tools in the battle U.S companies are waging with escalating healthcare costs. By minimizing health-related risk factors and improving employees’ lifestyle and self-care choices, health-related costs can realistically be contained. These programs have also been shown to be very cost-effective investments, with excellent return on investment potential. iBi