Not healing thyself

Hospital workers spend more time and money on healthcare than other American workers, a Thomson Reuters study revealed.

These employees use hospital care 8.6% more than average for the treatment of chronic illnesses, including asthma, diabetes, congestive heart failure and mental illness. The cost of employee healthcare for hospitals soars when the statistic is coupled with the study's other findings showing that hospital workers visit the doctor and use ambulatory care less, said Dr. Raymond Fabius, chief medical officer of healthcare business for Thomson Reuters. Hospital employees visit the emergency room 22% more than average.

“It's pretty clear that we have a terrific opportunity to do better here,” he said.

The gap between hospital employees and the rest of the American workforce widens when the data includes employee families. Overall, hospital employees and their dependents are spending $4,662 a year compared with the average U.S. worker at $4,124, a 13% gap.

“The average healthcare worker, the average nurse or doctor, when given a choice between taking care of somebody or family, sometimes they feel compelled because of their commitment to their profession to take care of their patients first,” Fabius said.

For Fabius, it's simple: A working environment can either support a healthy lifestyle for its employees or it doesn't. Hospitals are failing and care for employees must change. Administrators assumed that employees received the proper care because of their expertise in healthcare and access to resources. Hospital leadership long ignored employee needs with the belief that their workforce didn't require special care or additional programs, he said. In truth, long hours and a stressful workplace help factor into a “significant illness burden” for hospital workers.

Many hospitals do offer employees wellness programs to aid with weight control, smoking cessation and mental illness, among other health concerns. But with revenue streams drying out, reducing costs by all means has become paramount for hospitals. Keeping employees healthy is an alternative to reducing healthcare costs for hospitals—layoffs.

The study calculates that a hospital with 16,000 employees could save about $1.5 million each year in medical and pharmaceutical costs for each 1% reduction of employee health risk. The research sorted through 1.1 million hospital workers and their dependents, comparing them with 17.8 million health plan members from all work types for the year ending with the third quarter of 2010.

Employee health has caught the attention of American Hospital Association Chairman John Bluford. He cited a popular statistic the AHA computed this year: For every dollar an employer spends on wellness programs, healthcare costs drop about $3.27, while the cost of absenteeism falls by $2.73. The AHA released its own report in January, which was quoted in the Thomson Reuters study.

That underscores the importance of employee health, but there's also a question of credibility, said Bluford, who's also the president and CEO of Truman Medical Centers in Kansas City, Mo. It's a hospital's responsibility to keep its employees healthy, as they serve as a community role model.

“It's most appropriate given the Accountable Care Act, and its emphasis on accountability,” he said. “Who needs to be more accountable than the employees of America's hospitals?” But it's not easy, Bluford acknowledged. Given the proliferation of wellness programs, hospitals must demonstrate patience, he said, and he has seen hospitals “throw in the towel” too early. It takes about three years after implementation to see major results, Bluford said.

Fabius said it would take even longer for results: seven to 10 years. Improving the health of their own employees, though, would give hospitals a jump-start developing accountable care organizations.

One healthcare system testing its ACO by enrolling its employees is Norton Healthcare, a four-hospital system based in Louisville, Ky. Norton implemented a wellness program in 2008 and has seen gains, particularly with its smoking cessation program, said Dr. Sandra Brooks, Norton's system vice president of research and prevention, who oversees the program. Kentucky residents rank near the top 50 states when it comes to smokers. The system has been smoke-free since 2007, with other Kentucky hospitals following suit. Norton also installed walking paths and made other tweaks to the environment.

“I don't think we have enough data to say (hospital employees) are at a greater risk,” Brooks said. “We believe our employees are similar to the general population, but given healthcare is such a demanding field, we feel very strongly we have to do whatever (it takes) to optimize our health so we can continue to provide healthcare to others.”

One way Norton is expanding its program is to set up a Web-based portal so employees can download and print forms to bring to their doctor. That launches in January and they hope to have all 11,500 employees registered next year. Smartphone applications also are part of the process.

Bluford said hospitals need to find innovative ways to reach at-risk employees. “The gym rats are going to take care of themselves.”