Upstream health care: What’s your health plan doing to reduce employee hospitalizations?

The doctors who see your people would rather proactively treat disease than wait for symptoms to cause an ER visit. The term for it is upstream health care.

Because this approach can decrease hospital admissions and re-admissions and healthcare costs, look for health plans to launch and explore more upstream health care initiatives that motivate patients to get engaged with their wellness and address various root causes of poor health in order to improve long-term health outcomes and keep care affordable.

Upstream health care in action

During the Thomson Reuters “Total Health” event in Chicago, Dr. Jaewon Ryu, president and CEO of Geisinger, a regional health system and health plan based in Danville, PA, provided some specific examples that have produced results.

One takes on healthy eating, which can have an impact on productivity. A “Fresh Food Farmacy” program designed for patients with diabetes, congestive heart failure and chronic kidney disease provides access to produce and lean meats, coupled with services like dietician coaching and “Recipes of the Week.”

As a result, he said:

• Successful healthy hemoglobin A1C management among program participants is double that of the health plan’s patients who are just using medication, and
• Primary health care use has increased 19%, indicating patients are taking a more active role in their overall health.

Another initiative that’s made an impact is a comprehensive home care program that coordinates primary care and ongoing clinical services to cut the costs of care. According to Ryu:

• Emergency department use among Geisinger’s 10 hospitals decreased 15%-20%, and
• Geisinger hospitalization rates decreased 25%-30%.

Now may be a good time to check in with the administrators of your company health plan to ask what its future plans are for ensuring your employees stay out of the hospital and on the job. Does your plan have any active special programs that fit the description of upstream health care that you should be promoting to your employees?

Include this in your ‘Did you know …’ email

When letting your people know about that cool new program that keeps them healthier and saves them money, don’t forget to remind them you can connect them to resources for answering their health insurance coverage questions.

“The insurance side of the world for most patients is very poorly understood. And I think it’s because (the American healthcare system has) set up a fragmented, complicated system,” Ryu commented. “As a result of that, people don’t understand (things like) ‘Where do my benefits start?’ ‘What is a deductible?’ ‘How does this apply?'”