Industry Leadership

Health Care Coalitions Can Effect System Change

The new head of the NBCH believes that the administration of occupational and nonoccupational conditions should be integrated wherever possible.
By: | March 25, 2016 • 5 min read

Michael Thompson likes to hit the ground running. In his new role as president and CEO of the National Business Coalition on Health for just a few days, he’s already going full steam ahead with an ambitious agenda to tackle many of the challenges facing the health care industry.

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He believes, for example, that the administration of occupational and nonoccupational injuries and illnesses should be integrated wherever possible to provide more effective care for patients.

Among his other goals are: fostering an independent system to evaluate returns-on-investment to identify truly effective health care strategies, helping employers generate employee engagement in their own health care decision-making, incorporating community resources into wellness campaigns, and creating a strong infrastructure on the topic of well-being.

“We really want to make sure the focus of NBCH is leveraging the collective efforts of the coalitions,” Thompson said. “This coalition infrastructure is an unbelievable opportunity to accelerate the change that we, as employers, or the country is looking for.”

Michael Thompson, president and CEO, National Business Coalition on Health

Michael Thompson, president and CEO, National Business Coalition on Health

The National Business Coalition on Health is a 24-year-old not-for-profit company consisting of 51 purchaser-led health care coalitions. Described as a “coalition of coalitions,” the organization “provides expertise, resources, and a voice to its member coalitions across the country and represents each community coalition at the national level,” according to its website.

Thompson, who was named to the top post after spending 20 years with PricewaterhouseCoopers LLP where he was a principal, says that by getting the coalitions to work in a coordinated manner, he hopes to make meaningful inroads in the delivery of health services and reform of the nation’s health care system.

Innovation

Advancements in the medical delivery system are happening so rapidly it’s difficult for organizations to know what they are, let alone how effective each is. It’s an area where a coordinated effort can allow the coalitions to more easily reveal the strategies that are working best.

“One of the weaknesses in the system today is too often people will tell you what their ROI is, but it’s all self-reported based on their own analysis,” Thompson said. “We need a system that’s more accountable and leads to independent evaluation so we can share that and accelerate the success of those delivering results and cause others to look seriously about making improvements.”

“There’s a lot of movement underway to start to change the way we pay for and deliver and even the way we organize around health care and provide value based care.” — Michael Thompson, president and CEO, National Business Coalition on Health

Such a system would allow the coalitions to support those organizations and strategies that are most effective, and it would help people to become healthier. “What could be healthier to the system than a system that’s accountable?” Thompson said. “We need to develop accountability and improvement that will help us turn the corner in health care.”

Reform of the health care delivery system involves many players, including employers. One of the most pressing issues involved is the affordability of health care — or lack thereof.

“There’s a lot of movement underway to start to change the way we pay for and deliver and even the way we organize around health care and provide value based care,” Thompson said.

“It’s incumbent upon us to figure out how to get the multiple players on the same page. It won’t happen overnight, but you’re already seeing a lot of activity around bundle payments, accountable care organizations in both the public and private sectors. Coalitions become very important to engage stakeholders to rationalize that in the community and NBCH needs to keep that broader picture in mind and facilitate and support the development of that.”

Wellness and Integration

The idea of wellness is being challenged and criticized within the health care industry, Thompson says. He believes the coalitions can help by integrating them into local communities.

“Wellness and population health is a local issue, it’s not limited to the four walls of work,” Thompson said. “Many employers are in multiple communities. We must find a way to help them connect in the communities.”

Along with wellness, Thompson supports what he says is the emerging issue of well-being. Where wellness refers to encouraging people to develop better habits, well-being is a broader concept.

“Well-being is enabling people to be the best they can be so they can thrive in their lives and perform optimally in their chosen work,” Thompson explained. “Well-being is a much higher order conversation, and it doesn’t start and stop with a health risk assessment.”

It also does not necessarily start and stop within the U.S. but can involve any areas of the world. Companies that are global should focus on well-being and integrate it into their cultures, Thompson said.

He endorses the idea of integration overall, including occupational and nonoccupational injuries and illnesses.

“Good health is good health. Good safety is good safety. How do you separate where work ends and life starts? The two are very much intertwined,” Thompson said. “The laws around workers’ compensation are certainly siloed and the processes are siloed, but companies, when they step back, have to deal with the administrative arm on a silo basis but more holistically if they are looking to enhance wellness or health.”

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One area that deserves a more holistic approach is mental health. Beyond providing care to people who have mental illnesses are issues related to the stigma associated with it. Increased access to mental health care could help improve employees’ overall health and cut costs for payers.

“What’s even more concerning is in many ways it’s getting worse because we are getting used to the idea that if people want [mental health] services they should go out of network … that’s not sustainable or legal,” Thompson said. “If we can create a system with a more holistic view on treating the whole person, everybody wins, including those paying the bills … it’s one of the areas I’d describe as low hanging fruit.”

Nancy Grover is the president of NMG Consulting and the Editor of Workers' Compensation Report, a publication of our parent company, LRP Publications. She can be reached at [email protected]

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.

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That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.

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Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]