Poor quality care leads to as many as 45 million avoidable sick days per year, the equivalent of 180,000 full-time employees calling in sick every day for a full year. Employers' productivity losses come despite the bloated bills they pay to provide employee health care coverage.
Employers are the primary source of health care coverage for Americans under age 65, and they are starting to use their influence to help reshape health care to improve employee health and increase the value of their employees' health care dollars.
In Northeast Ohio, three large employers are taking action to try to bend the cost curve and improve the lives of their employees and employees' families.
A sizeable concentration of employees of The Lubrizol Corporation, the Progressive Group of Insurance Companies and Lake County Schools Council obtain health care services for themselves and family members from the Lake Health system. Understanding the foundational role of primary care in effective management of costly conditions, the employers are partnering with Lake Health to support the Patient Centered Medical Home (PCMH) model of care, which has demonstrated better health outcomes at lower costs nationwide.
In the PCMH model, the patient, primary health care provider and other members of the medical team work together to create and implement a care plan that covers all aspects of the patient’s health and care. The primary care practice serves as “home base” for patients whose care the team helps manage. A key player in the team is the care coordinator, typically a nurse, who uses electronic health record tools to help patients organize preventive care, specialist care, medication and other health needs -- functions that are especially important for well-managed chronic illness.
The program launched in Fall 2014 by Lubrizol, Progressive and Lake County Schools supports nurse care coordinators for employees and their dependents who are patients of Lake Health primary care practices. The goals are to improve patients’ care, outcomes and health care experience, as well as reduce costs as a result of improved care, namely fewer emergency department visits and hospital stays. Care coordination plays a starring role in driving more value, benefitting both employees and employers.
The Lake Health project was facilitated by Health Action Council (HAC), a not-for-profit organization composed of large, self-insured employers that provide health care coverage for nearly 2 million people, and Better Health Partnership. Better Health's role is to provide any practice development services Lake Health primary care practices may need to reach program goals, as well as provide ongoing data analyses to monitor the effectiveness of the initiative.
Lessons Learned...so far
Employers have the muscle to help improve health care quality, reduce costs and improve the health of the communities in which they operate. National data show that employees who receive enhanced primary care have better outcomes, a better care experience and lower costs than patients cared for in traditional health care delivery models. Measures of success in a well-designed partnership to create more value will be multi-dimensional and take into account quality of care, outcomes, expense and productivity, as well the impact of employer and provider empowerment. The Lake Health project is a strong example of the important role employers can play to improve the health of their employees and the return on their investments in their health.
Better Health and its 70+ primary care practice partners support coordinated, patient-centered care and optimization of the PCMH model. Over eight years of measuring quality of care and outcomes in chronic disease and helping practices transform how they deliver care for measurably better results, we invite collaboration in the development and evaluation of programs to bring more value to health care.
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