By Jim McLean
KHI News Services
Susan Wood, left, Sharon Johnson, middle and Janelle Garrison, right, walk during their lunch time. Promoting daily exercise is one of the goals of the state’s new health and wellness plan. (Thad Allton/KHI)
TOPEKA, April 16
One of every three people covered by the Kansas state employee health plan is overweight or obese. One of four smokes. And one of eight has been diagnosed with high blood pressure.
“It”s staggering, just staggering,” said
LJ Frederickson
of the obesity statistics. “But it”s not surprising.”
The
Kansas Health Policy Authority
has given Frederickson the daunting task of improving those numbers. She is the new director of
state employee health benefits
.
The first step, Frederickson said, will be to compile health risk assessments on the 88,000 people covered by the plan
state workers and their dependents, retirees, and a smattering of non-state government workers.
The assessments will document whether an employee is overweight, whether he or she smokes and other important facts about his or her health. That information will be used to create what Frederickson calls personal health plans.
“The employee will have a copy of everything. They will be totally involved,” she says, anticipating the need to calm fears that the information will be used to target unhealthy workers and justify higher premiums.
“We want to make sure that we”re providing comfort to the employee that we”re not using this information to hurt them in any way,” Frederickson said. “I want to take away that fear.”
Rick Bryant doesn”t need to be convinced.
“I”m not threatened by it. I will gladly participate,” said Bryant, who coordinates the HealthyKansas program for the Kansas Department of Health and Environment.
But Bryant, who has worked for the state for only three years, may not be typical.
“There will be a perception of intrusiveness,” he predicted. “Some people are going to be nervous. It”s going to take a little salesmanship.”
Vendors seeking contracts to help design and implement the health assessment program must submit their bids by the end of April. Frederickson said those proposals will be evaluated in May and contracts awarded by the end of June. She hopes to have the program in place by the end of the year.
Frederickson estimated the cost of the health assessment program will be about $200 per person covered by the state employee plan, or about $17.6 million if all covered workers and their dependants participate.
Improved health the goal
It is well documented that smokers and overweight people are at greater risk for a variety of serious illnesses, from heart disease, diabetes, strokes, even cancer. Borrowing from successful wellness programs at companies such as Proctor and Gamble and Pitney Bowes, Frederickson”s goal is to identify those risk factors employee by employee and create individual plans to reduce those risks by emphasizing preventive care and giving workers incentives to exercise, quit smoking, improve their diets and lose weight.
“You have to have self-leadership, that”s critical,” Frederickson said. “But we want to empower you to make better choices about your health. And we are going to surround you with tools and resources to help get you there.”
Frederickson said workers will be offered reduced premiums and other incentives to participate.
The health and wellness program will require an initial investment, but Frederickson said it will save the state money over time. Though the promise of a financial pay off may be important to legislators who will have to authorize the up-front spending, Fredrickson said the potential savings aren”t the health policy authority”s primary goal.
“I don”t want employees to say we”re doing this because it saves the almighty dollar,” she said. “Really, the point is we”re driving towards better health and that will happen to also save money.”
For 2006, the total cost of state employee health plan was about $319 million with employees covering about $127 million of that through premium payments.
Partnering with providers
For the program to be successful, Frederickson said participating health plans and providers must be enthusiastic partners. Among other things, that means they have to help people quit smoking, lose weight and better manage chronic conditions associated with obesity such as diabetes.
“I said to each vendor, what are you doing about those things because if you”re going to be in business with us you”ve got to be aligned with our goals,” Frederickson said.
Graham Bailey, a spokesman for Blue Cross Blue Shield, said the re-engineering of the state health benefits plan is going to require Blue Cross to change the way it does business with the state. But he said, “It”s certainly something we can accommodate.”
Blue Cross Blue Shield is the largest of three health plans that cover state employees, serving approximately 75,000 of the 88,000 enrollees.
Bailey says that health plans have sometimes been resistant to the wellness strategies being touted by Fredrickson because of their up-front costs.
“In the long-run they may be productive, but in the short term they raise costs,” he said.
Past policies aside, Bailey said Blue Cross supports the direction the state is heading, calling the state employee benefits plan “a kind of Petri dish where it”s safe to experiment.”
In addition to the health assessment program one of the planned changes is for the state to self-insure. That means it will assume the financial risk of the insurance program rather than paying Blue Cross and other health plans to do so.
“We”re going to have to make systems changes and do some things,” Bailey said of the plan, which will reduce the Blue Cross role to an administrative one. “But we”re more than willing to work with them.”
Picking up on the Petri dish theme, Frederickson said the health policy authority hopes to eventually use lessons learned in the state employee health program to improve Medicaid, the $2.2 billion health insurance program for low-income Kansans. That program also is administered by the Kansas Health Policy Authority.
“I think it”s going to be sweet,” she said. “I think it will bring about good things all the way around.”
Bryant at KDHE said he expects good things, too. But not right away.
“This will not be a 100 yard dash,” he said. “It will be a marathon.”
-Jim McLean is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at
jmclean@khi.org
or at 785-233-5443, ext. 110.