1. Ingram’s H e a l t h + W e l l n e s R e p o r t 49
Winds of Change Swirl Around
Health-Care Interests
Winds of Change Swirl Around
Health-Care Interests
Participants (from left)
Joe Sweeney, Ingram’s
Jill Monroe, City of
Kansas City, Missouri
Scott Hall, Greater Kansas City
Chamber of Commerce
Adam Rossbach, Mosaic Life Care
CiCi Rojas, The Central Exchange
Jaren Pippitt, Mosaic Life Care
Polly Thomas, CBIZ
Matt Benge, Assured SRA
Bill Redinger, Park Hill School Dist.
Gregg Laiben, Blue Cross Blue
Shield of Kansas City
Jim Fight, Kansas City Area
Transportation Authority
The current challenges facing the U.S. health care
system seem to be as varied as the 318 million
Americans that system serves: individual customers
with unique health and wellness issues, insurance
companies adjusting business models in the post-
Affordable Care Act world, insurance brokers trying
to help clients navigate waterways that are changing
routes daily (sometimes hourly), employers trying
to figure out ways to cope with dramatic increases
in insurance premiums, and employees who may—
or may not—be doing what they can on a personal
level to help their employers win that fight.
Those are just for starters.
Each of those stakeholders will view the current
and emerging challenges of the health-care sector
from different perspectives. And a dozen of those
perspectives on issues that are key to the quality
of life in the Kansas City area, broadly, and to
the region’s sprawling Northland, in particular,
convened on Dec. 10 for a unique roundtable
sponsored by Mosaic Life Care and hosted at the
company’s extraordinary Shoal Creek clinic.
Mosaic Life Care’s Adam Rossbach, director of
business solutions, and Jaren Pippitt, home-centric
administrator, served as co-chairs for a fast-paced
two-hour conversation that covered strategies
to bend the cost curve for health care, effective
employer wellness programming, technical advan-
ces in care and record-keeping, evolution of care
settings and other vital topics.
Current Challenges
Around the table, participants sounded com-
mon themes about the need for more education
and engagement, at multiple levels.
In addition to rising drug costs, for example,
Jaren Pippitt of Mosaic Life Care and Matt Benge
of Assured SRA both identified need to engage and
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HEALTH + WELLNESS
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incentivize employees in ways that get them both involved
and excited around improving their own well being.
Scott Hall, who’s involved with the Greater Kansas City
Chamber of Commerce’s Healthy KC initiative, saw the need
for engagement at the business ownership level. “There’s still
a reluctance to drive to workplace wellness, because in the
short term, it can cost money,” and getting past that initial
gut reaction is a huge challenge for many chamber members.
It’s also important, said Bill Redinger, assistant super-
intendent, human resources for the Park Hill School District,
for employees to understand “that we are all in the fight together,
specifically around costs. Employees can’t have the impression
that it’s merely a matter for their bosses; they have to step up, too.
Barriers, said Polly Thomas, director of clinical consulting
services for CBIZ, must fall, particularly those that keep
employees from doing a better job of managing health, such
as time constraints for working parents, or those caught in a
sandwich generation. Employees also need better tools, she said,
to determine where to receive quality care, and to understand
the cost implications of their own choices about care providers.
For some employers, said Jill Monroe, wellness manger for the
city of Kansas City, the challenge is one of location: Companies
with multiple offices have a harder time keeping employees on the
same page. “We have more than 100 locations,” she said, “so how
do we engage those employees and keep wellness in the forefront?”
What Works
Cici Rojas, CEO of The Central Exchange and a former
Truman Medical Center executive, said incentives play a
huge role in getting employees on board—and keeping them
there—because “we have to change the behavior of people
taking care of well-being.”
Matt Benge cited the benefits of customizing a strategy
to the work force. Technology, he said, can help, but wellness
“is not a one-time-in-a-year, open-enrollment thing. You’ve got
to build your strategy year to year, and leaders have to go all-
in on it, or else it’s not going
to work.”
Committee-driven cha-
nge, with broad input, is
effective, said Polly Thomas.
“That’s the most successful
way to build a sustainable
effort,” she said. “It takes on
a life of its own and becomes
self-driven.”
Gregg Laiben of Blue
Cross Blue Shield of Kansas
City said a multi-pronged
approach is vital. “The more
you can touch folks, the better
chance you’ll have of getting
them engaged and keeping
them engaged,” he said.
For Jaren Pippitt, more
than a decade of concentration
on obesity and tobacco use,
for example, hasn’t had the
impact we might like for
reducing the effects of those
conditions, which, ultimately,
require long-term lifestyle
changes. “How do we align
incentives for a payoff that’s
immediate and tangible, but
is still a motivator?” she said.
Tangible tools that work,
said Polly Thomas, show
employees what’s in it for them, not just for their employer’s
bottom line, but “many employers aren’t willing to put the time
and the cost into it” to demonstrate that return.
Others, said Matt Benge, court failure if they throw too
much at employees, too soon: “You have to do it incrementally,
with a stair-step approach,” he said.
One-time classes on issues as complex as diabetes man-
agement, said Jill Monroe, are a bust. “That’s not going to
change behavior,” she said. Effective instruction “has to be
over a long period of time. … Changing behavior takes time.”
Scott Hall said things as basic as a basket of apples in the
break room can have an impact, as well as more intense efforts
like fitness competitions. “Not everyone is motivated by that,”
he said, “but creating friendly ways to compete, to gamify this,
really drives people to change behaviors.”
Delivery Innovation
From clinics that may be on site or mobile, from the patient-
centered medical home structure to satellite facilities built
around holistic approaches to health and wellness, participants
explored the changes in the way services are delivered.
Bigger companies, Polly Thomas noted, can justify their
investment and succeed with on-site facilities—clinics, medical
staff and fitness facilities—but mid-size and smaller organiza-
tions are starting to succeed with near-site and shared models.
“These seem to be most successful when they integrate with a
benefit plan and other resources an employer has,” she said.”
Adam Rossbach noted that Mosaic Life Care itself was
committed to innovative, low-cost approaches to wellness,
including, he said, “on-site care at a fraction of the cost including
on-site telemedicine, which utilizes remote family-medicine
physicians” at sites like the
Shoal Creek facility.
“We see the growth extend-
ing the doctors into places
they’ve never been able to be,”
said Laiben. “But even that is
just a stopgap measure, because
the real clinic we’re after, you’re
all carrying in your pocket” is
thesmartphone.Thedisruptive
power of new technology, he
said,couldcuthealth-careprem-
iums by 30 percent if we lever-
age that technology correctly.
As Jill Monroe and CiCi
Rojas noted, confidentiality of
individual health records, and
potential employer liability for
inadvertent release of that
information, are large issues.
But with new methods of
“seeing” a doctor, “employees
needtounderstandwho’sonthe
other end, and what are their
credentials?”saidPollyThomas.
“More are apt to use it if they
know they’re seeing the same
provider every time, or the
same group of providers, vs a
random person who rotates in.”
Changes to Come
That ties in with the next generational tsunami of health-
care patients: Millennials entering the work force, already in
numbers that exceed the dwindling cohort of Baby Boomers
and the subsequent Generation X.
“Millennials want to do everything on their iPhone,” said
Adam Rossbach, and that will include health-care delivery.
“People are busy, they’re working, they have kids,” said Jaren
Pippitt. “Our goal is to meet them where they are.” Mosaic, she
said, is “preparing for that shift to on-demand health-care, and
smart phone, telemedicine and e-consultations are going to boom.
Changes in the efficacy of health-care delivery and
wellness programs are vital, said Scott Hall, because “any
organism that is healthy will grow faster and grow stronger
and thrive more if it’s healthy. That can be a person,
a company or a community.”
Most agreed that there will be an increasing emphasis
on other dimensions of health and wellness besides
physical well-being, including financial, mental and
behavioral health, spiritual health, and the health of one’s
relationships.
To that extent, employers should provide incentives,
said Polly Thomas, that “are not just focused on physical
health, but other dimensions. There’s a lot of evidence on the
power that volunteerism has.” So a paid day off to work for a
charitable cause has a place in a company’s overall strategy,
or allowing employees to direct any financial incentives due
them toward a particular charity.
“In describing the pillars of wellness, from a human
capital perspective, that gives us the opportunity to have a
dialog with employees, and shows that, as an organization,
we value our people,” said Jim Fight, human resources
officer for the Kansas City Area Transportation
Authority. “We’re looking to be impactful in people’s
lives beyond services they provide to us to improve our
bottom line.” I
HEALTH + WELLNESS
REPORT
1. Jaren Pippitt, left, and Adam Rossbach, right, served as co-chairs for the Health and
Wellness Assembly, steering a two-hour discussion that touched on a wide range of topics.
2. Smaller companies, said Polly Thomas, are beginning to see success with alternative
models of medical care for employees. | 3. Gregg Laiben said broad advances in mobile
health-related technologies, properly leveraged, could sharply reduce insurance premiums.
1. Employees, said Bill Redinger, can’t be left to think of health-care costs as an administrative
concern alone. | 2. Jill Monroe expressed the concerns felt by employers operating from many
locations, and the challenge of consistent employee communications . | 3. Scott Hall wondered
how long huge increases in insurance costs could continue. | 4. CiCi Rojas cited the innovative
strategies like using accrued paid time off to be used for employees’ health-related expenses.