After instituting a series of employee wellness initiatives, Cleveland Clinic has successfully arrested health care cost growth and empowered workers to proactively manage their personal health habits, the Cleveland Plain Dealer reports.
According to the Washington Post's "Wonkblog," Cleveland Clinic employs roughly 40,000 individuals and like other businesses has struggled to contain health care costs. The Clinic's efforts have focused on employee habits—such as smoking, physical inactivity, food choices, or stress—which CDC says account for roughly 70% of all medical costs.
For example, the system banned smoking on campus, began offering cessation classes, and stopped hiring smokers. The Clinic also removed unhealthy foods from its buildings and began offering free fitness and stress management courses to all employees. "We want to make it easy for you to do healthy things and hard for you to do unhealthy things," says Michael Roizen, the system's chief wellness officer.
Establishing a new insurance plan
To encourage employees to use wellness resources, Cleveland Clinic enrolled workers in a self-insured health plan that requires employees to follow a health management program. The Clinic raised premiums for employees enrolled in the plan but then offered them a rebate for program participation.
According to Paul Terpeluk, medical director of the Clinic’s Employee Health Services, nearly 50% of health plan enrollees—who total about 70,000, including dependents—participate in disease management programs, compared with the national average of 15%.
The system also began tracking employees' lipids, blood sugar, weight, blood pressure, and smoking habits. If any of these metrics are deemed "abnormal," the employee must have a physician verify that he or she is taking steps to control the problem to receive the rebate.
Since 2005, Cleveland Clinic workers have lost a collective 250,000 pounds, and in the last three years have lowered their collective blood pressure and decreased smoking rates from 15.4% to 6.8%, the Post reports. As a result, many employees have not paid a premium increase in two years and the Clinic's health care costs have flatlined.
Although Terpeluk says the health plan likely was the biggest driver of health cost containment, he notes that the Clinic's wellness culture also has changed. For example, the system offers regular lectures on healthy eating and wellness and posts signs that encourage employees to use the stairs, the Plain Dealer reports (Tribble, Plain Dealer, 10/19; Klein, "Wonkblog," Post, 10/16).