GOOD NEWS IN HEALTH CARE?

With comp and group health in meltdown,
wellness programs offer mitigation

By George "Rusty" Capulet


Prevention Services, Inc., staff at the Carlisle, Pennsylvania, Roadway terminal. From left: Gene McGuire, Vice President of Business Development; Steven M. Chevarria, Injury Prevention Specialist; Matthew R. Pearson, Injury Prevention Specialist; Bob Zeigler, Mid-Atlantic Area Manager; and Jeremy Kauffman, Injury Prevention Specialist.

It certainly comes as no surprise to anyone that both the workers compensation and health insurance markets are in turmoil. Both have been buffeted by double-digit health care inflation that shows no sign of abating. But a proactive approach to the situation can reap benefits in the form of lower costs and a very grateful client. A strong wellness program can reduce costs over the long term and improve morale in the process.

But how do you find a program that will grab the hearts and minds of employees and get them to make lifestyle changes that will ultimately result in their being healthier and safer?

"The best way to get the attention of employees is face-to-face meetings," says Scott Addis, CPCU, president of The Addis Group, an agency based in King of Prussia, Pennsylvania. Addis explains one instance where a company executive was complaining that his workers comp costs were putting his business at risk. Scott obtained permission to go into the company and talk directly to the employees about workers comp. He explained the workers compensation system and how much the company actually spent on workers comp--in terms the employees could understand. He pointed out that the company was spending $11 for every $100 in payroll. With an experience modification factor of 2.0, Scott went on to explain that the real cost was $22 for every $100 in payroll based on the company's own experience. For the first time, the employees understood that it was their own medical costs and lost-time accidents that caused the company's rate to be so high. It really hit home.

"I then asked them who their main competitor was and what they thought that company's rate was for comp," Scott continues, noting that he had done his research and already knew the answer to the question. "They assumed that their competitor was paying about the same amount and were shocked to find out that it was about one-third of their cost as a result of better claims experience. A light bulb went off when the employees realized that overutilization of workers comp was hurting their company competitively and, ultimately, the employees themselves."

After that initial meeting, a number of employees came up to Scott and asked what they could do to help lower the costs. It became their idea to begin to use peer pressure to stop malingerers who were taking advantage of the system. They watched out for each other and began operating more safely. It became a total company effort once the employees understood how their safety behavior and claims experience impacted them. There was an immediate and long-lasting culture change.

PSI Injury Prevention Specialist Matthew Pearson (right) gives a newsletter to a Roadway dock worker in a daily trip around the facility.

Not long after that meeting, Scott heard about Prevention Services, Inc. (PSI), headquartered in Blue Bell, Pennsylvania. While the company shared his philosophy on the importance of face-to-face meetings, what really intrigued him was the company's concept of deploying its health care professionals to the workplace to deliver an integrated injury prevention and health promo-tion program directly, personally and regularly to employees.

"When I saw what Prevention Services was doing in the wellness arena," Scott says, "I recognized kindred spirits who used a similar approach to get employees to think about wellness. I immediately identified with the program. PSI changes behavior. The Addis Group is in the process of introducing PSI to all of our clients. The PSI model results in employee participation levels that I haven't seen anywhere else. Their participation rate is around 99% at most companies with which they work, compared with levels of around 25% for most wellness companies."

PSI Injury Prevention Specialist Steven Chevarria (right) discusses the "three points of contact" rule with a Roadway mechanic in an effort to minimize workplace accidents.

Gene McGuire, vice president of business development for PSI, explains the impressive participation rate: "We place a health care professional (our trainer) in the workplace as a wellness trainer on a full-time or part-time basis, depending on the size of the company, to engage employees and management in a program to improve safety and health behavior. The key word here is behavior."

Gene points out that statistics show that changes in behavior can have a significant impact on injuries and illness. "Ninety-four percent of injuries and 50% of illnesses are the result of unsafe and unhealthy behavior. An improvement in these behaviors will produce a substantial return on investment for companies."

Gene notes that PSI's typical program includes a number of components. The first steps in the process are analysis and planning to determine each client's objectives and his or her occupational health needs. Next, PSI offers a series of meetings to introduce the program to management, and a series of seminars to motivate employees to address improvement in their safety and health behaviors. During this process PSI also administers confidential health risk assessments for any employee who wants one. The purpose of these assessments is to drive self awareness, provide employees with a plan for personal improvement, and provide content for targeted program development.

Stressing the importance of good diet choices, PSI Injury Prevention Specialist Jeremy Kauffman hands out fruit in the Roadway drivers' lounge.

Gene says the next component--the employee counseling process--is the most important. "This process is the core of our program," he says. "It's the component which drives the program's success through regular, systematic, consistent personal interactions between PSI's trainers and employees. In essence, PSI trainers become personal counselors for employees, available to help them improve their health, safety and quality of life."

Because these personal interactions are at the heart of PSI's programs, PSI supports its trainers' efforts with an array of wellness and safety resources and activities, including workplace risk analyses, stretch regimes, newsletters, metric health testing, hotlines, guide books, online education and advice, and a continuous flow of health promotion programming.

"Life on the Road" educational materials were developed by PSI to help drivers keep a healthy lifestyle while traveling.

Gene explains that PSI's employee counseling includes a set of work injury interactions (including early intervention to prevent injuries from worsening and turning into full blown reportable injuries), MSD (musculoskeletal disorder) consulta-tions to help employees mitigate musculoskeletal conditions and symptoms before they worsen, and personal wellness consultations dealing with a host of health issues, from disease to diet to fitness (for employees and their families). In addition, PSI trainers participate on their clients' safety, health and workers compensation committees.

A case study of a distribution company that used PSI dramatically shows the benefits of this process. The case study encompasses more than. five years of historical data. For this company, PSI provides services to about 3,000 employees.

The results for the distribution company are startling. The number of new injuries fell 54%, compared with an increase of 20% for a company of similar size and characteristics that did not utilize PSI. The average annual medical expense fell 65%, compared with an increase of 2%. New claim costs dropped 55% vs. an increase of 14%. The average cost per claim fell 62%, compared with a drop of 16% at the company that did not use PSI; and lost work days fell 67% compared with a drop of 19% at the non-PSI company.

PSI's programs are available through a special program for insurance agents, brokers and consultants. Gene concludes: "The best part is we're affecting people's lives positively and helping employers keep health costs down. It's been extremely satisfying." *

For more information:
Prevention Services, Inc.
Web site: www.preventionservicesinc.com
Phone: (866) 894-1300