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Care New England’s commitment to wellness begins at the top.
Dennis Keefe, the president and CEO, as part of a weekly letter to employees soon after he began the job, shared his story about having Type 2 diabetes and how through diet and exercise, he was eventually able to take control of managing his chronic condition.
This proactive commitment to good health flows through everything the company does. In describing its wellness initiatives, Care New England says that it isn’t so much a program but a culture: “It is not only what we do, it is what we are.”
“Our CEO is hugely supportive,” said Domenic F. Delmonico, senior vice president of managed care at Care New England, Rhode Island’s second-largest hospital network, which includes Butler Hospital, Kent Hospital, Women & Infants Hospital, VNA of Care New England and the Care New England Wellness Center. “Dennis is personally involved and engaged, and totally onboard.”
As a self-funded insurance employer, Care New England’s wellness program, Flex for Life, falls under Delmonico’s domain. “Keeping employees healthy and at work is a good business plan,” he said. “As a business model, we’re increasingly moving into that area under health care reform. Frankly, we make money when people aren’t healthy [under the current model],” he said. “The new mantra is keeping people healthy and out of hospitals.”
Care New England has been a self-funded employer for its health insurance for the last nine years, since 2003, with Blue Cross & Blue Shield of Rhode Island as the administrator. The hospital system runs its wellness initiatives by itself, according to Delmonico.
Care New England uses its self-insured status for maximum effect on health-plan management. The Flex for Life program is a core strategy for health care cost containment and to provide a supportive environment in which employees and their dependants can pursue better health with resources to do so.
Flex for Life efforts are branded with a logo showing a little person doing a gymnastics pose. The program includes offering a daily tip that is shared with employees online, describing ways they can improve their eating habits, exercise routine and overall health. Each year, Care New England asks its employees and their family members to complete health-risk appraisals, conducted by an outside consultant to preserve confidentiality. About one-third of the hospital system’s employees participate; it’s a number Delmonico would like to see increase, but that goal has its logistical challenges, he said.
One of the reasons for the lower rate of participation is that Care New England has 14,000 health-plan members, but 9,000 of those are family members and spouses who don’t work for the hospital network. “We have a very large population who are not our employees,” Delmonico said. Another factor, according to a marketing study now under way, is the work schedule. “For people working the third shift, it’s very challenging for them to participate,” Delmonico said.
Simple as it may seem, Delmonico called the health-risk assessment and biometric-screening program “a very, very important opportunity to help people understand some basic information about themselves and their own health – for blood pressure and glucose levels.” Care New England has had employees participate in a screening - and be immediately sent to the emergency room for care, because their blood pressure was dangerously high, he said. “We also really try to get people to go to their primary care doctor, and if they don’t have one, encourage them to get one, so that the wellness plan is done in conjunction with their doctor,” he said.
The activities that have the most employee engagement under the Flex for Life wellness initiative often revolve around fitness – programs that get them moving – and nutrition.
The most popular Flex for Life programs are the Healthy Steps nutrition-and-weight management program, the Small Step, Big Rewards diabetes-prevention program, and the telephonic coaching program. All of these programs have consistently high participation and produce excellent feedback from employees, in addition to demonstrable outcomes for change in knowledge, skills and behaviors.
Another popular program is a creative stress-relief activity, a workplace gardening program that is run at each of Care New England’s hospitals. The idea was “borrowed” from Amica Insurance, according to Delmonico. About 60 employees participate at each session, planting gardens in containers and then watering and tending as needed.
Care New England is also working on creating healthy opportunities and choices for both employees and patients. “At Kent Hospital, we have taken soda off the menu we give to patients. And, as a way of promoting healthier choices, we are exploring ways of making soda more expensive in vending machines and water less expensive,” Delmonico said.
The biggest challenge, he continued, is changing long-held habits and realizing that often people are not ready to make the changes they need to make. “If people aren’t ready to change, you can’t make them stop eating unhealthy foods,” he said. In conjunction with this effort, Care New England is working with James O. Prochaska, director of the Cancer Prevention Research Center and professor of clinical and health psychology at the University of Rhode Island.
Delmonico called the Flex for Life program “an example of comprehensive, innovative, result-driven wellness programming.” The organizational commitment of Care New England to the health and well-being of its employees and their dependants supports and drives the efforts of the Flex for Life wellness team to continue to grow the program, targeting both low-risk and high-risk employees and their dependants. •