A health risk is considered, or can be related to, chronic diseases, genetic conditions, body type, lifestyle habits, occupations or sports, or any number of human attribute or everyday activity. Implementing strategies to identify a full spectrum of health risks among your employee population will not only help to reduce expensive treatment due to larger complications, but can also guide initiatives for wellness and management programs overall. As a result, health risks can be mitigated at all levels promoting greater productivity and cost savings for the employer.
The advent of managed care and the increasing importance of consumer-centered care is resulting in a move from traditional “fee-for-service” models to quality and results-based healthcare models. Therefore, businesses are learning the importance of healthcare risk management and its impact on both the health of their employees and on the company’s bottom line.
Healthcare Risk Management
Healthcare risk management is the identification and evaluation of health risks in an employee population as a means to reduce or prevent injuries or chronic health conditions. The goals of healthcare risk management are twofold: 1) employee health and satisfaction and 2) cost reduction. Many employers are discovering that by implementing an onsite or near-site health clinic provides them not only with acute care coverage for their employees, but with a healthcare risk management team composed of clinicians and collaborative care managers who will work to risk stratify the employee population and provide outreach, improving health and reducing claims costs for the employer.
Determining Health Risk
It’s not a surprise that healthy employees are happy, and more productive, employees. Marathon Health’s patient-centric, total population health model provides a collaborative care team to manage healthcare risks through risk stratification of the employee population. Through the use of Health Risk Assessments (HRAs), Comprehensive Health Reviews (CHRs), claims data and health coaching visits, Marathon Health is able to determine which employees are at high-risk of developing a chronic health condition. Once the population has been risk stratified, patient lists are created for Marathon Health clinicians to engage in proactive outreach to the at-risk population to begin managing and improving their condition through evidence-based disease management protocols, educational tools and programs, group sessions and health coaching based on motivational interviewing techniques. For those employees who already have a chronic condition, Marathon Health has disease management programs that will assist the employee with managing their health, bringing them towards the point of care for their condition.
The healthcare risk management model provided at Marathon Health’s onsite and near-site health centers not only benefits employees, but their employers as well. A healthier workforce results in greatly reduced costs for employers, whether it be indirectly (through reduced rates of absenteeism or presenteeism [employees who report for work, but have greatly diminished productivity due to illness]) or directly, through a substantial reduction in claims costs for frequent hospital and specialist visits. These costs are prevented through Marathon Health’s total population healthcare risk management program of preventive care, risk stratification and proactive outreach to patients with chronic conditions or at high-risk of developing them.
Marathon Health’s focus on total population health risk management, including health assessments, primary care, coaching, and disease management services, allows us to change the way businesses and their employees experience healthcare. As a result, we are able to reduce health and productivity costs, improve the overall health status of the workforce, promote greater adherence to evidence-based medicine, and influence the way employees perceive and receive their healthcare and healthcare risk management.
Limiting Health Risk Factors
Population risk management looks at all the factors impacting an individual’s health, including genetic predisposition to disease, environmental conditions such as air and water quality, and, in particular, lifestyle risks such as tobacco use, alcohol and substance abuse, eating habits, and levels of physical activity. Population risk management also embodies whether people with chronic conditions such as diabetes and asthma are able to manage their condition and are at the standard of care, an important factor in preventing serious complications. Population risk management is necessary to help companies combat runaway medical expenses, unproductive workplaces, and sick workers.
The key to population health management is working with patients of all risk levels, not just medium and high-risk patients. Because as the Edington data indicates, when workers move out of the medium- and high-risk categories, others are already moving in. Companies need programs that prevent the upward flow from low-risk to medium- and high-risk. “Not getting worse” is imperative in containing costs for employers.
Benchmarking Health
Marathon Health has demonstrated how employers can and should begin looking at their healthcare costs as the end product of a system absolutely within their control. Healthcare should be thought of in the same way as production, distribution, and other business systems: a set of interdependent parts that can be measured, benchmarked, and improved. Improvement will not occur without managing a total population’s health – from the fit and healthy to the obese – and providing a lasting health and wellness culture.
We believe population health risk management is the only way to true healthcare reform.
Be Proactive, Not Reactive With Health Risks
One way to determine the health status of your workforce population is to analyze historical claims data, as well as conducting annual mass biometric screening events and health history and risk assessments within the organization. Marathon Health utilizes this combined data alongside our risk quantification methodology to provide each participant with a “wellness scorecard” developed around key measures of health such as blood pressure, lipids, body-mass index, blood sugar, tobacco and alcohol use, and stress. The population as a whole is stratified by three risk levels: high, medium, and low. These three tiers are used as a blueprint to develop outreach protocol and communication for member intervention. It will also help to establish benchmarks for measuring the health status and progress of the population as programs are initiated.
Setting the stage to mitigate risks requires a holistic approach. Once risks and conditions have been identified, it is important to provide services that will not only address the conditions themselves, but all aspects of health (physical, behavioral, environmental, and social) through primary care, health coaching, and condition management. Providing these services onsite will allow for convenient access to high quality and affordable care
Onsite Healthcare Helps Achieve Healthy Employees
Onsite providers are able to build meaningful relationships vital to establishing personalized and effective plans for treatment and actionable behaviors in line with patient goals. This process may begin with a Comprehensive Health Review which will determine the patient’s health history and offer an opportunity for the provider to discuss health concerns and evaluate the patient’s readiness to address those concerns through ongoing health coaching.
Incentivizing preventative care through regular health screenings for the mass population as well as enrollment in disease management programs for those with an existing condition will help to ensure that those with chronic conditions are consistently at the standard of care. Health education programs can also be provided year-round to align with initiatives specific to the population and may include lunch-and-learns, healthy activities and health challenges. As outreach and wellness programs continue, we recommend assessing data regularly in order to confirm or adjust action plans and determine outcomes.
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