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October 15, 2012
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Wellness Programs Going Viral

Dr. Bill Frist prescribes investing in employee health; 3-to-1 ROIs proving to be financially infectious

By Mark Green

Businesses are realizing they can count on a $3 return for every dollar they put into employee wellness programs, and the financial benefits go much further with targeted prevention efforts.

“Since 2009, there is a tenfold increase in wellness programs,” one well-informed healthcare expert said, “by not small business but mid- to large business.”

A tight-belt business environment the past few years probably is helping push the trend among HR directors, CFOs and CEOs looking at all options to improve the financial health of their companies. But increasingly, it’s just considered basic sound business practice as well as a healthy trend for the nation.

“No question in my mind, if we are to invest a dollar to have the greatest value in terms of outcome and results, we should put that dollar in prevention and wellness,” said healthcare practitioner, policy specialist and venture capital investor Dr. William Frist, who also served as U.S. Senate majority leader from 2002 to 2007. Frist is a strong advocate of wellness – as a business practice to adopt and a business sector to be in.

Individual doctors, hospitals and the entire healthcare industry need to get involved, he said. Public policy, too.

Frist well knows whereof he speaks.

His father and brother founded Hospital Corporation of America in 1968. Frist earned a Princeton healthcare policy degree and Harvard medical degree, trained at top hospitals in Boston and England, and was chief resident at Massachusetts General Hospital and then Stanford University Medical School before he launched Vanderbilt University Medical Center’s heart-lung transplant program.

He has performed more than 150 heart, lung, and heart-and-lung transplants. In 1991, he operated on CIA Director David Petraeus after the then-lieutenant colonel was shot in a Fort Campbell, Ky., training accident.

In 1994 and 2000, Frist won election to the U.S. Senate. After heading the 2002 midterm National Republican Senatorial Committee when his party regained Senate control, he was voted majority leader. He left public office in 2007 after two terms, as he’d promised in 1994.

For the past five years, Frist said, he has spent all his time on healthcare and education issues: one-third teaching and speaking; one-third with the Chicago-based Cressey and Co. healthcare investment firm, and one-third on global health issues.

He teaches now at Vanderbilt’s medical school and previously at its school of management, and has been a Princeton international economic policy professor. Frist debates healthcare policy publicly with Democrats Tom Daschle and Howard Dean, and meets with officials in Washington. He’s edited and written books on healthcare and politics.

Since 1998, Frist has made annual medical mission trips to Africa and began doing the same for Haiti following the devastating 2010 earthquake there. He’s on the Clinton Bush Haiti Fund board, has headed Nashville-based international health and education nonprofit Hope Through Healing Hands, and founded the Tennessee K-12 education reform initiative SCORE (State Collaborative on Reforming Education).

He co-leads the Health Project at the Bipartisan Policy Center founded by four other former Senate majority leaders and is a board member on Michelle Obama’s “Partnership for a Healthier America” campaign to eliminate childhood obesity and the Robert Wood Johnson Foundation.

Walking his talk, Frist has run multiple marathons and half-marathons.

While he states unequivocally that his personal political career is over, Frist recruits and supports others and was in Lexington in September to back the legislative candidacy of healthcare lawyer Robert Benvenuti in state House District 88. He gave an exclusive interview to The Lane Report during that visit.

Numbers clear on best bang for the buck

Heart-lung transplant surgeon and former Senate Majority Leader Dr. Bill Frist during one of the yearly medical mission trips he leads to Africa.

Frist knows healthcare’s component parts well, such as what factors most determine how long someone lives: “The numbers break down 30 percent genetic, 5 percent environmental, 15 percent socioeconomic, which is surprising to a lot of people, and then 40 percent behavioral: wellness, prevention. And then what is left (10 percent) is who your doctor is, what hospital you go to, what your emergency room is.”

Those numbers instruct, Frist said. To best impact longevity – the most basic measure of good outcome – and healthcare spending over time, the public and private focus and resources should be on the 40-percent sector: behavior, wellness and prevention. Some key behaviors are pretty basic: smoking, obesity, seatbelt use.

National policy instead focuses on hospitals, insurance and universal healthcare.

Though he prefers its central point were cost containment rather than insurance access, Frist is a public supporter of the Obamacare healthcare reform law, and has been since before its passage. The ideas and concepts it contains are “not just Republican but conservative in origin,” he said. Frist is a fan especially of the state healthcare exchanges that Kentucky and 16 other states are in the early stages of creating, an option of the Healthcare Affordability and Accountability Act that a majority of states are opting against to date on the basis of political opposition to Obamacare.

President Obama and Senate Majority Leader Harry Reid’s decision to use the reconciliation process was a big strategic mistake that politicized healthcare reform.

Regardless of political allegiance, care providers, institutions and insurers all “need to link that to the 40 percent impact that behavior has on outcomes.

“That’s a new way of thinking. That means that hospitals get involved in prevention and wellness, that doctors get involved in prevention and wellness. It means that public policy is very much shaped in part around obesity issues, issues of urban planning, parks, different places to exercise, educating people about choices.”

And the private sector should fill much of this need, according to Frist. Small companies can provide wellness programs for employees or individuals, health coaches, or expert and efficient navigation of the healthcare system such as helping choose a doctor or determine whether a situation merits your primary care physician, a clinic or the ER.

Better profits, entrepreneurial opportunity

“There’s huge amounts of opportunity to make money, to create jobs, to innovate in this 40 percent impact that behavior and prevention has on the total outcome,” he said.

Meanwhile, Frist said, employer-sponsored wellness programs concentrating on prevention and wellness are achieving 70 percent decreases in hospital and insurance claims. That’s based on 15 years of data compiled by a South African wellness services company, Vitality, in which Cressey and Co. has taken a stake. Frist serves on Vitality’s advisory board.

(Humana in 2011 launched HumanaVitality, which the Kentucky Personnel Cabinet made available to Kentucky Employee Health Plan participants in September.)

The three-to-one returns on business wellness investments come, Frist said, from lower claims rates, decreased absenteeism and increased “presenteeism.” The latter, he said, is a new business metric for the increases in worker productivity derived from better healthcare. “It’s a big concept.”

There is further opportunity in focused “management of the sick, the 5 percent of all patients, one in 20, who account for 50 percent of all healthcare spending,” Frist explained. “If you target within the overall population those 5 percent of patients, and you concentrate on wellness before they get sick, it fits right into chronic disease management – so, plenty of opportunity there.”

As for the essential elements of an effective wellness program? The component parts are simple, Frist said: nutrition and exercise. But the key to an effective program is twofold: education and implementation. And the predominant role must rest with the private sector.

“Individual companies have to choose for themselves about which to emphasize,” and then truly implement the program. Executing wellness to an extent that actually affects the health of employees, he explains, absolutely pays off.

“Good health leads to higher profits,” Frist said. “It’s a link that is not intuitive necessarily because a lot of people think just better health is good. Not only do you save money (with lower health benefits and absenteeism costs), but actually higher profit.”

Mark Green is editorial director of The Lane Report. He can be reached at markgreen@lanereport.com.

 

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Dr. Bill Frist prescribes investing in employee health; 3-to-1 ROIs proving to be financially infectious

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One-On-One

Spotlight on the Arts

The Lane List