Health Care Deciphered

Health care reform is not going to reduce health insurance premiums unless we change how we use our health care benefits.  Gone are the days when when eat a $5 dollar copay like candy. Employers are on to the fact that claims utilization = premium.

In order to make a dent in the high cost of health care we need to consume less, exercise more and change our relationship to food. If we all join the fitness train then we all will benefit from rate reductions.

Here are 5 simple ways to reduce health insurance premium besides putting your case on bid:

1. Develop a Wellness Benefit Office.
2. Construct a Human Resource webpage that provides information about the newly minted wellness benefit office.
3. Organize a yearly health fair where medical providers will be available to check: Cholesterol, Glucose, Blood Pressure, Height and Weight (BMI calculation) and provide a personal health report with the results of the screening.
4. Host brown bag lunches on wellness topics such as nutrition, smoking cessation, fitness and stress reduction.
5. Start a walking program.

For further information on how to set up a wellness benefit plan, create wellness benefit webpage and host a wellness fair please call me at 703 402-0059.

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When I think of health care reform I question not just the structure, the cost and taxation but what access to health care means to us as a nation. The United States has always marched to a different drummer. We are a country of immigrants, pilgrims and revolutionist who came to the United States to have a better life.  A better life based on their own definition of success.  In the United States dedicated effort defined standard of living.

The life we live is based on the choices we make.  Choices to spend or not spend, to have children or not have children, to live a healthy life-style or not. Our choices do not require input from the government. 

The basic argument in health care reform is that most Americans do not have access to health care because it is expensive. Health Care is  expensive. Health insurance and medical care costs a lot of money.  The word access has many meanings in this debate.  We cannot have access if we do not have choices.  Not everyone can afford the same health insurance benefit.  Competition is suppose to give us options so we can buy what we can afford. The problem is that we do not have options.

There are not enough health insurance companies to give us choices and therefore we do not have competition to reduce cost. If we cannot reduce cost then not everyone will have access to health care.  According to Market Watch:

“carriers are not only creating monopolies and oligopolies in many regions, they also control the other side of the equation in what is known as monopsony power. That means in addition to having the most enrollees, they’re also the biggest purchasers of heath care and can dictate prices and coverage terms. It also makes it harder for new carriers to emerge as pricing already has been set by the dominant carrier.”   

If they US government becomes the single payor of health care then we will basically have more of the same and the prices will continue to increase. A monopoly does not gives us options nor control health care cost. Only competition can give us options.  Health insurance is already controlled by a few companies. With a lot of demand and limited supply cost prohibits access. If the government sets the prices and establishes the benefits then in essence we will only perpetuate the same system. 

What is lacking in this debate is how to encourage more business to become health insurance companies. Perhaps also allowing foreign insurance companies to compete for a market share. The only way to reduce health care cost is to give people the option to buy what they can afford. 

S. Cecilia Morales

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Vicarious trauma  also called compassion fatigue effects people who are highly empathic and thus susceptible to trauma suffered by others.  These people are most prone to vicarious trauma because they  identify with the pain and suffering of others. In addition their strong sense of responsibility, commitment to their work and well-being of their clients create a strong sense of guilt. They feel guilty that they are not doing enough. These feelings can effect their  relationships with co-workers and family.   

Vicarious trauma can be found in those that provide service to people who have had traumatic events.  People generally affected by vicarious trauma can be non profit workers, counselors, therapist, clergy, humanitarian or a relief worker. However anyone that provides a service and who does not have coping mechanisms can exhibit the symptoms.

In order to help your staff cope with situations and events that may lead them to compassion fatigue the Human Resource office might consider conducting workshops to educate their staff on strategies for prevention. It is also important to help your staff be aware of symptoms of stress that are indicators for vicarious trauma. According to the Denver District Attorney website  ,”vicarious trauma can resemble first hand reaction to traumatic stress in the following ways:

• Sleeping problems;
• nightmares;
• Intrusive thoughts, memories and flashbacks;
• Hyper-vigilance;
• General anxiety and anxiety attacks;
• Isolation and disconnection
• Substance abuse and high risk behaviors;
• Changes in appetite and sex drive;
• Irritability and depression;
• Cynicism, negativity, and apathy about life and the world.”  

The International Critical Incident Stress Foundation, Inc (www. icisf.org) offers education and training . In addition they have conferences and workshops on crisis intervention.

Understanding the symptoms and ways to prevent vicarious trauma  can help in staff turnover and improve the morale of your staff. Sadness can be contagious. Those who provide emotional care and support to others can also become victim to the same trauma.  A healthy staff is one that understands that vicarious trauma or compassion fatigue is something that can be managed.  

For more resources on vicarious trauma please email me at cecilia@healthcaredeciphered.com

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Sometimes creating a corporate wellness culture can be a challenge.   I just attended the 25th annual Interaction Forum.  Interaction is a membership organization of humanitarian and development professionals. The forum was for three days in Crystal City, Virginia and featured workshops on humanitarian policy, development, fundraising  and climate change among other things.  There is no greater challenge for a human resource officer than trying to keep humanitarian relief workers healthy.  

Humanitarian workers are faced with compassion fatigue, lay-offs, kidnap, environmental disasters, separation from family and basic project management  stress.  Caring for the health and well-being of humanitarian relief worker is challenging. Creating a wellness culture for the relief workers who are working with famine and hunger is not a easy task, yet the staff at non-profits and other non-government organizations (NGO’s) like CARE and World Vision  are not only faced with crisis care management but also on finding ways to improve the health and boost the morale of the relief worker.

Creating a culture of wellness takes dedication and creativity. It also means that you are willing to commit human resource staff to the development, perception and maintance of the wellness culture. Creating a wellness culture takes patience.  Not everyone is going to jump on the wellness bandwagon. In order to succeed in creating a wellness culture the following should be considered:

1. Define what wellness means to your organization and what is the goal. Is it cutting insurance claims, managing stress/burn-out or motivating staff ?

2.  Develop educational programs that support your needs and make them accessible, for example on-line seminars, coaching and roundtable luncheons on health topics, work-site lectures from community resources. 

3. Give out incentives for participating in wellness benefits plan, e.g. awards and recognition

4.  Encourage family participation with fitness competitions against other departments in your organization, e.g. basketball, soccer or tennis.

To summarize creating a culture of wellness takes resources, dedication and patience from the human resources team. People are not going to change their behavior over night and stress is not going to suddenly disappear. 

For further information or for a list of staff care resources please call me at 703 402-0059 or cecilia@barrosinternational.com.

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Wellness programs and insurance companies are forming tight partnerships that are transforming the term disease management. I was on the phone this morning with a wellness vendor that sells as part of their wellness program biometric screenings, health education and coaching.  The difference between this vendor and other vendors is that they come to the employer’s office to perform the biometric screening.  The benefit of this is that they can give the employees a analysis of the test results which can then be taken to the employees primary care physician.  This vendor also bills the insurance company so the member pays for the service with their copay. This is just an example of how insurance companies and health care providers are teaming up to provide workable solutions to the health care crisis.

The solution to the crisis is wellness.  To achieve wellness people need to be part of the process by understanding how unhealthy behaviors affect their health. In order to feel part of the process the employer should engage the employee by soliciting their opinion based on individual need.  This can be done in many ways, for example conducting a survey that will identify needs e.g. hiring a personnel coach or nutritionist.  Another option is using the data from a health risk assessment.  A health risk assessment can provide employees information on diseases they may be a candidate for based on either family history or unhealthy behaviors.  

For further information on wellness programs please call me at 703 402-0059 or email at cecilia@healthcaredeciphered.com

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The wellness team is essential in promoting the wellness benefits plan. After selecting and assembling the wellness team the next step is determining how to tailor a wellness benefits plan that is representative of the employee needs. To do this you should set goals with the following agenda:

1. Determine the objective of the wellness benefits plan: For example reducing health care costs and increasing productivity.

2. Structure a plan based on your employee culture:  For example, blood screening, personal health coach, workshops and telephonic health education.

3.  Develop methods for assessment and evaluation: For example create reports that can quantify the percentage of people who have stopped smoking, are losing weight and calling in sick.   

4. Create newsletter: Communication is not just key but it can motivate the employees with success stories.

5. Establish time-lines for plan success: Wellnessintheworkplace.net says that a time frame of success helps clarify goals. For example, “by 2010 you would like to decrease tobacco use 20%.”   

For this and further information on how to set goals for your wellness plan please contact me at cecilia@barrosinternational.com or 703 402-0059.

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Healthcare costs and trends have been increasing past the employers ability to offer health insurance.  The increases are due in part to our unhealthy lifestyle that leads to chronic illness which increases medical claims.  A wellness program can educate and inspire a person to change their habits.  A wellness program can introduce another way to handle stress besides eating. In addition a wellness program can also increase productivity at work.

Employees are consumed with daily deadlines, meetings and unscheduled interruptions so crafting a wellness program that encourages employee participation and more importantly sparks interest is the key to success. This involves a vision. In the next few days I will be presenting key elements of a successful wellness benefits plan.     

Vision begins with commitment from the executive team. This  means that the executive team should understand the objective and goals of the benefit plan. This is presented with data and facts from the medical claims utilization reports. If the executive cannot see the parallel in claims, utilization and chronic diseasethe wellness benefit plan will not be successful.

Once the executive team understands the goals of the wellness plan the next step is developing the wellness team that will supervise the implementation of the wellness benefits plan. The team should be made up of employees and managers but also be diverse. They should represent people that not just healthy and fit but also people that are not.  People, for example, who understand the obstacles and barriers to wellness based on their own poor lifestyle and habits might be able to encourage participation.  If the vast majority of the team members are young and fit they may inadvertedly foster frustration through subtle expectations and thus discourage people from participating or achieving their wellness goals.  Also the people in the team should be just as busy with job and family responsibilities. Remember the purpose of the team is to be the representation of the challanges that lead people to the unhealthy lifestyle.

Tomorrow I will give ideas on how to set goals for the wellness benefits plan. As usual for ideas and help in constructing a plan or how to find the best vendor for wellness benefits plans please call me as 703 402-0059 or cecilia@healthcaredeciphered.com

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Stress keeps us from making connections with our-self and others. Stress numbs our awareness and is the messenger of sadness, depression and loss of joy. When we are stressed our world becomes smaller and our complaints a tidal wave of frustration. In a office complaints challenge the  team to excel.  To increase morale and bolster the spirit of team work stress has to be addressed in the work place.  

Work-site wellness programs should have workshops on how to relieve stress because according to Mind, Body, Soul  website on Corporate Wellness depression does the following:

•  Minor depression, which affects more people each year, may account for 51% more spent disability days than major depression.
• Over 50% of work days lost annually in the US are stress-related.
• Stress costs employers $150 billions annually in lost productivity, absenteeism, poor-decision making, stress related mental illness and substance abuse.
• Over 46% of all employees are stressed to the point of burn-out.
• One out of four American workers suffers a mental health problem rooted in stress.
• Anxiety and depression are among the six most common conditions seen in family practise.
• Fifty percent to 70% or routine visits to primary care physicians are for medical complaints that stem from psychological factors.

Based on the above information from Mind, Body, Soul  the effects of stress should be addressed by employers as a way to reduce disability claims and medical claims.  Stress reduces profit. Introducing monthly brown bag lunches that demonstrate stress reducing  techniques such as meditation, yoga and other forms of energy medicine like qigong, reiki and Emotional Freedom Technique (EFT) increases productivity.

Since stress blocks our well-being it is important to develop a wellness benefits program that introduces staff to the techniques that help reduce  the effects of stress. In addition, creating a calm and relaxing room where people can meditate can encourage well-being.  Hiring a yoga instructor to teach weekly yoga classes is another technique to build inner and calming endurance.

For more information on community resources for meditation or to learn more on energy medicine please call me 703 402-0059 or email me at cecilia@healthcaredeciphered.com

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The purpose of a wellness program is to reduce those health insurance claims that contribute to the increase in premium. In order to reduce health insurance claims a wellness program has to identify conditions like obesity, smoking and stress that lead to heart attack, lung cancer and depression.  Wellness programs are varied in their approach but most offer the following:

1. Health Assessment.

2. Online Health Coach.

3. Telephone-based Health Coach.

Some insurance companies provide cash incentives to complete the health assessment. The incentives range from $75.00 to $150.00.  In addition some health insurance companiess provide cash incentives like $25.00 to participate in the online health coaching program and $75.00 for the telephone-based health coaching program.   If the insurance company provides the incentive the cost can 1% or slightly less to your health insurance premium. 

The benefit of using the insurance company to provide the wellness program is technology, ability to run reports and disease management programs.  Typically these reports will tell you the number of people who are participating in the wellness program and what are the top conditions. The report is important because many wellness programs provide on-site educational workshops based on those top conditions.  An example of educational workshops are nutrition and smoking cessation classes. 

Also the reports generated by the insurance company can compare your health conditions to other organizations. This baseline is useful in providing further incentives to your employees for participation in the wellness program. This information can also be communicated to your employees so they are involved in the process.

The importance of collecting targeted and appropriate data on health conditions is that the Human Resource Director can work with the wellness benefits coordinator to structure a health insurance plan that provides incentives while cutting cost. Examples of this is:

1. Offer a 100% employer paid base-line plan with a $1,000 deductible.

2. Offer another plan with $750.00 to $500 deductible to employees who are enrolled in disease management programs.

3. Offer a plan with zero dollar deductible for employees that have measurable results in the disease management plan, eg they are in the diabetic program and are hitting their targeted goals for weight loss.    

For further information on wellness programs please call me at 703 402-0059 or email me at cecilia@barrosinternational.com.

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Health insurance companies normally do not pay for acupuncture, massage therapy, energy medicine , nutritional consultation, homeopathic medicine or naturopathic medicine, yet these health care modalities are called Complementary and Alternative Medicine (CAM) have positive effects on life-style and behavior changes.  CAM can enhance your worksite wellness program by incorporating yoga, meditation or weight management classes.

The National Institute of Medicine (NIH) has been investigating the different CAM modalities under a department called National Center for Complementary and Alternative Medicine (NCCAM). The purpose of NCCAM is to provide information and research on health care systems that are not part of conventional medicine.

Complementary and alternative medicine has been gaining in popularity as people are looking for therapies that can alleviate the effects of pain and depression. According to NIH the therapies that have been gaining in popularity since 2002 are: Deep Breathing, Meditation, Massage and Yoga.

In addition, to the increase in CAM therapies the NIH has a reported a increase  CAM products, “such as echinacea, fishoil/omega 3 and Flax seed.”  There is growing evidence that Omega 3 and flax seed  have positive effects on breast and colon cancer.  In addition flax seed is high in fiber and thus effective for for weight loss.

Health insurance companies do not pay for alternative medicine however some insurance companies provide discounts to CAM practitioners, such at Reiki, aromatherapy and meditation classes.  Some of the CAM therapies like acupuncture can also be paid under the Flexible Saving Account.   Employees can benefit by the therapies in CAM by including  CAM in the wellness programs.

CAM included in a work-site wellness programs can help in stress reduction through yoga and meditation.  A example of this is the wellness program of Vermont Automobile Dealers Association (VADA), “Jump Start to Better Health.”   The program was designed and implemented by Bernie Noe, ND.  Bernie Noe is a naturopathic doctor. According to Naturopathic.org,” In the 2 years of the program VADA saved an average of $8.20 in health care cost for every $1.00 invested in the program.”  

For more information on wellness programs please call me at 703 402-0059 or email me at cecilia@healthcaredeciphered.com

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