Some mega-employers manage clinics on their own while others outsource to clinic vendors or healthcare systems. Many provide clinics within their own facilities, but some offer near-site locations and even share a near-site clinic with other companies. Regardless of which model is preferred, more organizations with 5,000 or more employees are deciding that on-site or near-site clinics can make primary care more convenient and affordable for everyone.
Some of these clinics offer pharmacy services and many have expanded to offer services such as physical therapy, telehealth and even behavioral health. One benefit that clinic operators often emphasize is that by making primary care convenient to employees, and in many cases their family members, fewer employees will neglect primary care because of cost or the inability to take time off to see a doctor.
Worldwide, 226,000 people have signed up with the British charity Veganuary, agreeing to try a vegan diet free of all animal products. While some try vegan for one or two meals per day, others have gone full scale. Some are doing it for environmental reasons while others are concerned about animal welfare and, of course, their health.
Investment bank Morgan Stanley recently hired a Chief Medical Officer. General Motors made the Detroit-based Henry Ford Health System the only in-network option for 24,000 salaried employees in southeast Michigan. And, Apple joined many other large employers in using on-site clinics to provide more personalized care. These tactics are being used to address a combination of risk factors contributing to costly chronic conditions like diabetes, heart disease and obesity.
Filling Voids in Wellness Programs
We all know how hard it is to change lifestyle habits. While traditional wellness programs can offer great tools and improved access, more and more employers are realizing that to boost engagement and keep it from fading over time, you must tailor a program to the needs of each individual.
This level of involvement, sometimes referred to as condition management, includes more personal involvement and communication. Providing guidance and support on nutrition, exercise, stress management and other concerns can help at-risk employees overcome the challenges that have kept them from enjoying their best life.
Walmart is requiring employees to use certain hospitals for costly procedures, such as spine surgeries. Requirements like this are typically accompanied by an assurance that the plan will cover the full cost of the procedure, including travel, when applicable. In an effort to make sure plan members receive high quality, cost-efficient care and weed out unnecessary costly procedures, Ford struck a single-hospital deal earlier in 2018 and the State of North Carolina recently announced its intention to take similar cost-cutting measures for its 727,000 members.
In order to address a sleep shortage that is hurting productivity for U.S. businesses, the American Academy of Sleep Medicine has introduced an online wellness program to help employees track the quantity and quality of their sleep. Employees log their time online or upload data from a fitness tracker such as a Fitbit. With the CDC linking sleep to chronic illnesses such as Type 2 diabetes, heart disease and depression, researchers hope to help employees set a goal and improve the quality of their sleep.
Technology giant Apple reported recently that thousands of hip and knee replacement patients are using Apple Watches and a new health app, MyMobility from Zimmer Biomet, to share health data with their surgeons during treatment and recovery. The app is being used to provide physicians with data about the patient’s heart rate, number of steps taken and time spent standing continuously, rather than having to rely on traditional in-person visits.
With behavioral health conditions impacting one in five Americans, it’s no wonder we’re seeing more employers search for ways to provide members with better access to behavioral healthcare benefits.
Statistics show that many employees, including some that are insured, fail to get the mental healthcare they need. Because self-funded health plans provide plan design flexibility, some plans are taking bold steps to address this growing need. While many are using telemedicine to improve access and lower costs, some employers are treating out-of-network behavioral health treatment as in-network, enabling employees to pay the same amount for treatment regardless of which provider they use. Others are covering out-of-network behavioral healthcare services even when their plan doesn’t cover out-of-network services for other types of care.
When you consider that mental illness has become the greatest cause of disability claims in the U.S., it is not surprising that employers are looking for ways to help employees obtain the care they need.
Significant Action is Warranted
There is plenty of research to show that Americans are not getting the mental healthcare they need. According to Mental Health America, despite having health insurance, 56.5% of adults with mental illness received no treatment in the past year.
Another problem is that behavioral health treatments are rarely classified as primary care, and are regarded instead as specialty treatment. This makes people find an in-network provider, go out-of-network, pay higher out-of-pocket costs or avoid treatment altogether. Claims data from Collective Health shows that more than 40% of the 2017 behavioral health spend was out-of-network, which is many times the amount spent on primary or preventative care.
Have you tried to monitor your health by counting carbs, calories or protein? While health can feel like a game of numbers, it can help to know measurements that matter most. Here are a few numbers that may help:
50%. That’s the proportion of your plate that should contain vegetables. The rest of your plate should include 25% whole grain, such as brown rice and 25% of protein rich food, such as fish, beans or chicken. Using a plate model can be much easier than counting calories.
25-35 grams. Aim to take in 25 to 35 grams of fiber a day. Most Americans only take in 16 and low fiber can cause issues with high cholesterol and blood sugar levels, increased risk of certain cancers and digestion problems.
7-8 hours. Sleep is necessary for a healthy lifestyle, so try to get 7 to 8 hours. A lack of sleep can increase risk of Type 2 diabetes and obesity, and lead to complications such as loss of focus, impaired memory retention and irritability.
150 minutes. Aim for 150 minutes of activity per week, spread throughout each day, with a minimum of 10 minutes per session. Activities you enjoy are the ones you’re more likely to do regularly.
120/80. Blood pressure is called the “silent killer,” as it can often be present without any symptoms. Unchecked or untreated, high blood pressure can increase the risk of heart attack or stroke. Monitoring is key, as well as frequent exercise and a healthy diet.
The time to think about diabetes is not when it’s diagnosed. It’s important to take steps to prevent diabetes and prediabetes before they ever develop. While more than 100 million American adults live with diabetes or prediabetes, there are easy, proven ways to prevent it. Here are just a few:
Eating better: the breakdown. Though we often hear that we should “eat better” it’s not always clear what that means. Whole, fiber-rich foods are what you should be consuming. Fill your plate with vibrant foods, having natural color and fiber, such as quinoa, brown-rice, blueberries and garbanzo beans. These foods are slow-burning, providing longer term energy and maintaining sugar levels more steadily. When eating a meal containing slow and fast burning foods, eating slower-burning foods first will slow the absorption rate of faster-burning foods.
Water is your best friend. While the call of sugary drinks such as juice, packaged iced tea and soft drinks can be hard to resist, water is always the best choice. Even diet or low calorie drinks can increase the risk of diabetes, potentially causing changes in gut bacteria that affect metabolism. Water eliminates stripped carbs and provides the hydration your body needs.
Keep moving. Exercising regularly, doing both cardio and resistance activities, not only lowers your blood sugar but makes your cells more sensitive to insulin. That’s really a two-for-one diabetes prevention action! Choosing activities that you and your family enjoy makes exercise fun.
States are moving toward telemedicine to help students access mental health services. Minnesota and Utah have proposed telemental services in order to reach students with underserved mental health needs. Students with unmet mental health needs experience many obstacles, with conditions such as depression and anxiety negatively impacting their attendance and performance.
Telemental health is being utilized to reach those in areas without child therapists or in other “healthcare deserts”. Texas has successfully implemented telemental health programs since 2012, connecting thousands of students with much needed care and treatment. One proposed Minnesota bill suggests launching four telemedicine projects aimed at improving access to telemental health services for students. Proposed grants would help provide dedicated space in schools and the technology needed for students to access telemental health services. A bill in Utah would enable the Division of Substance Abuse and Mental Health to create a two-year program using a telemedicine platform to facilitate remote consults between children and child psychiatrists.
Legislators and school officials in a number of states see many benefits to pursuing a telemental health platform, including the potential to identify young people contemplating suicidal or homicidal actions.