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Healthcare cost containment is a key concern for politicians, with presidential candidate Hillary Clinton recently proposing to amend the Affordable Care Act. But while the Clinton proposal is stirring debate, it is unlikely to pass Congress.
Dr. Ron Loeppke, U.S Preventive Medicine’s (USPM) Vice Chairman doesn’t want to wait for Clinton – or anyone else – to have a speedy answer to the pressing problem of rising health care costs. His answer is a preventive health care agenda: “We need to the get to heart of the health care costs issue problem by leveraging the power of prevention. Organizations – especially companies - need to be thinking differently about how to reduce health care costs.”
A Living Laboratory Of Research
At USPM, Loeppke has a living laboratory to explore and find innovative ways to drive prevention. He’s created a UPSM’s Preventive Plan, a three-part health and well-being assessment combined with biometric screening designed to drive sustained behavior changes focused on wellness. Participants receives their own personalized Preventive Score and Preventive Plan.
“The key to the plan’s success is that it drives real sustained behavior changes,” Loeppke says. “The plan provides individual incentives for participants who reach achievements in the health and wellness program.” The program uses interactive competitions and personal progress tracking, which motivates people to address health issues before they cost the company large sums of healthcare costs. “This means healthier employees, which, in turn, means lower healthcare costs for the company.”
Loeppke’s research shows Preventive Plan participation significantly reduces health risks through wellness. His article in the Journal of Occupational and Environmental Medicine, “The Association of Technology in a Workplace Wellness Program with Health Risk Factor Reduction,” shows impressive results. Of those individuals starting in a high health risk category at baseline, 46% moved down to medium risk and 19% moved down to low risk, after participating for two years in a personalized Preventive Plan. The study also showed that those in the high risk group went down to 6% from 11%, while the medium risk category was reduced from 29% to 23%.
USPM’s Preventive Plan has grown, but not fast enough for Loeppke. The problem is that “evidence-based programs like ours are not free,” he says. “Nor are they cheap. One of the challenges has been that not enough employers adequately invest in evidence-based wellness and preventive programs to yield the return on investment that is achievable.”
Simply put, too many companies are unwilling to pay for preventive medicine, he continues, because they are already overwhelmed paying for all the “sick care” medicine.
A Partnership With A Purpose
Loeppke set out to find a solution that could help employers fund preventive programs. He teamed with Aflac’s Don Marette and Cristy Payne – strategic alliance experts at Aflac – and The Livingston Group’s Mark Lindsay and Duane Gibson - well known in the political arena as key lobbyists for healthcare issues.
The answer? The “Healthcare Cost Containment System”, a highly collaborative and innovative program that helps companies to fund the USPM Preventive Plan without any out of pocket costs.
The Healthcare Cost Containment System is built on an alliance between Aflac, USPM, and organizations that sponsor and use health insurance for their employees or group members. Lindsay, former Assistant to President Bill Clinton for the Office of Management and Administration is now director of the Health Care and Pharmaceuticals practice at the Livingston Group. Lindsay explains, “The system is like a three legged stool. Each of the alliance partners is like a leg of the stool. When fully implemented, the Healthcare Cost Containment System creates a self-funding approach to allow corporations to gain access to a world-class preventive health program with no net out of pocket costs.”
The Healthcare Cost Containment System In Action
The first leg of the system is USPM, which provides its powerful data analytics engine and wellness Preventive Plan.
Organizations that offer health care insurance to employees/group members are the second leg. The Cleveland Clinic Wellness Institute (CCWI) is one of the organizations championing the Healthcare Cost Containment System. Cleveland Clinic is one of the top five hospital systems in the United States. Cleveland Clinic’s Chief Wellness Officer, Dr. Michael Roizen says, “The best way for healthcare to cost less is to need less because you are well.”
Aflac, the world’s leading provider of voluntary insurance at the worksite, is the third leg of the system. Aflac’s role in the System is essential because it enables employers to save potentially millions of dollars annually in federal taxes. This is because U.S tax laws allow employers to receive tax savings when their employees sign up for supplemental insurance pre-tax such as Aflac. Companies then use the tax savings to invest in the U.S. Preventive Medicine’s wellness program, which in turn helps make the workforce healthier.
Lindsay describes Aflac’s role as the lynchpin in the system. “The tax savings generated from the Aflac component of the partnership are then devoted to funding the USPM/CCWI preventive programs for a company’s employees. The net-net is that organizations can self-fund the highly effective USPM/CCWI preventive programs with no upfront out of pocket costs. Without Aflac’s role in the system, organizations would still have been able to partner with U.S. Preventive Medicine and Cleveland Clinic Wellness Institute for a wellness program, but they would not benefit from the tax savings to generate a self-funding program.”
The team has added a fourth player in Healthcare Cost Containment System by working with Maestro Health. MaestroEdge is an insurance enrollment platform that provides a user-friendly experience that allows companies to track data, streamline enrollment and manage compliance simultaneously for additional savings.
Together Is Better
The magic of the Healthcare Cost Containment System is the way each leg of the stool works together in a highly collaborative manner. While Aflac, USPM and CCWI preventive options can and do work independently, the real benefit is when the three parties work as a unit.
Lindsay explains, “The more participation, the more tax savings, and ultimately greater wellness results for employers and their employees.” The Healthcare Cost Containment System has the potential to yield a 200-300 percent ROI.
“The system accomplishes our goals in a very creative and simple alliance partnership.” Roizen says. “Our partners are truly experts in public policy, medicine, health, employee benefits, insurance, and technology. Together they have assisted us implementing wellness through the Healthcare Cost Containment System. It directly addresses, in a comprehensive manner, the post-ACA and healthcare environment issues now faced by companies and employees.”
