Monday, January 31, 2011

Improve Without Data?

One of the maxims I use wth any organization is: If you don't tell me what's wrong, I can't fix it.  I'm not afraid of questions, comments or complaints.I'm afraid of silence. With regard to wellness improvements, we followed the maxim, letting the data tell us what steps we needed to take.

1) One of the steps that was important when trying to reduce our health insurance costs, which has become the highest expense category in many companies, is to determine where we were at. Namely, we had to know which risk factors to address. We contracted with a medical provider to conduct a confidential health risk assessment, including blood tests, biometrics, and a behavioral survey.

2) We communicated the importance of the assessment--and the privacy involved, compliant to HIPAA. We talked some about the insurance costs. However, we stressed the necessity of knowing their own health risks. We had heard many stories about people discovering critically dangerous high results of their blood pressure, cholesterol or blood sugar as a result of the assessment. Over the next few years, we had our own stories: people who had their own discoveries and took action, and feeling much better than they have in years; people who ignored the warnings from those who reviewed the results and ended up in the hospital with very acute, severe conditions. With good communication and small monetary incentives, we had over 70 percent of our employees and spouses participate each year.

3) We reviewed the corporate report that showed us the overall condition of our group. We learned that we were worse than average, with 40 percent of our company classified as fair, poor or very poor in terms of the number of risk factors. We learned which were our top 5 health risks.

4) Health education materials targeted those top 5 risks. Likewise, we designed some participatory programs to help people reduce those risks. During the third year, we established premium reductions based on improvents in four key areas.

5) Re-assessment and repition of the information is also mandatory. As we repeated steps 1-4 and monitored the health insurance claim statistics, we were pleased to learn that risk factors decreased by at least 10% each year, and costly claim categories--like prescription use, emergency department visits and acute care physician visits--were also going down.

Every continuous improvement program needs data, and also requires evaluation of the results after actions have been taken. No matter what, you cannot make any improvements without some data.

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