Program Description 

Pitney Bowes is a Fortune 125 company with 23,000 employees nationwide. An analysis of health care expenditures in 1991 revealed that escalation of health care costs would eclipse growth in corporate profits by the year 2000 if Pitney Bowes did not intervene. Health Care University (HCU) was piloted to approximately 5,000 employees under the Medical/Wellness program umbrella in 1993 in response to this challenge.

The strategy is multi-dimensional and highly integrated. The model is conceptualized as a bridge-like trapezoid that allows Pitney Bowes to "bridge" the gap from prior benefit practices to a more efficient, health care management approach. Its building blocks are:

• Education of health care consumers; 
• Efficient in utilization and purchasing practices; and 
• Employer Design - providing resources to achieve objectives

The program is funded via the corporate operations budget. Savings offsetting costs are noted in specific budget areas (e.g., disability savings, etc).

Program Mission

To optimize organizational and employee health and productivity.

Program Objectives

• Manage costs to 0 percent increase through 1997; 
• Enhance health outcomes, and 
• Avoid cost shifting/reward healthy behaviors; 
• Measure impact; 
• Enhance benefits;

Pitney Bowes supports good health by emphasizing prevention, early detection, wise consumerism, and appropriate, timely care for individuals at all levels of health. Integration of health initiatives creates simplicity, efficient resource use, and consistency for participants. Preventive care is fully integrated with on-site medical and fitness facilities, ergonomic programs, EAP, work/family, and disability and benefit areas. Resources, referral, and data ,analysis link these to create a unified, coordinated, "Total Health" approach. Convenient access is assured through use of technology such as kiosks equipped with health monitoring equipment, and on-site resources.

The HCU program motivates employees by providing credits for participation in selected activities. If an employee earns six credits during the term (September-June), they are awarded $25 toward future benefit purchase. Many activities are provided on-site for convenience, and/or are fully covered under the medical plan if a physician's office visit is required. Programs include: 

• Cardiovascular and cancer screenings 
• Smoking cessation 
• Vaccinations 
• Exercise 
• Self-care and consumerism education 
• Nutrition counseling 
• Seminars (lunchtime and multi-day)

The in-house medical clinics are an integral component of the preventive care process, providing employees with convenient access to primary care, in-house disability management, health screening and diagnostics, on-site asthma management, and health counseling for at-risk individuals. Clinicians also serve as patient advocates to assist participants to select and maintain appropriate care. These centers experience high utilization, logging 20,000 visits per year, and are staffed by primary care doctors, nurse practitioners, physician assistants, certified occupational health nurse, and educators/counselors.

Fitness Centers are staffed by exercise physiologists who provide fitness screening exercise guidance and supervision. HCU coordinators are also active at each site where there is high concentration of employees.

Health Care University-Fact Sheet

The Pitney Bowes Health Care University is a highly integrated total health care approach. It allows employees the opportunity to earn credits for healthy activities. HCU is instrumental in pulling together many of the components offered through the Pitney Bowes Medical and Wellness program such as health screening, educational seminars, self-care education, ergonomics, exercise and nutrition counseling.

On-site Medical Centers

Staffed by highly qualified clinicians including wellness coordinators who advocate services available through HCU, the on-site medical centers offer:

• Primary care 
• Patient advocacy 
• Diagnosis and Treatment of Illness 
• Disease management assistance-asthma monitoring 
• Health screening services 
• Disease management - depression in the workplace 
• Health counseling/treatment compliance assistance 
• In-house Disability Management

On-Site Fitness Centers

Staffed by exercise physiologists, the on-site centers offer:

• Fitness assessment 
• Exercise guidance and monitoring 
• Convenient access

These 45 minute talks are provided to employees by local experts. At least one per month is offered at sites with high concentrations of employees:

• Self Care 
• Skin Cancer 
• Heart Disease 
• Lyme Disease 
• Ergonomics 
• Exercise 
• Arthritis 
• Colon Cancer 
• Diabetes 
• Stress Management 
• Glaucoma 
• Nutrition

Seminars run 5-8 weeks with periodic follow-up:

• Weight Management 
• CPR/First Aid 
• Stress Management 
• Asthma Management 
• Smoking Cessation

Many screenings are offered at the worksite including: 

• Mammography 
• Vision 
• Diabetes 
• Hypertension 
• Glaucoma 
• Cholesterol 
• PSA 
• Skin Cancer 
• Colorectal Cancer

Ergonomics

The ergonomics program includes:

• Worksite assessment 
• Education 
• Change in workstation 
• Prevention

Pitney Bowes partners with providers to offer a comprehensive Employee Assistance Program for employees and dependents. The program uses a counseling and referral model. Program assessment includes measures such as utilization, demographics, referral types, primary diagnosis/reason for visit, and risk status.

Disease Management

Disease Management initiatives are supported through self-care assistance, on-site clinics, and through a provider who assists with identification of candidates, asthma education, and a toll-free hotline. Disease state management programs being phased in this year include: depression in the workplace, diabetes, and migraines.

Wise Consumerism/Self Care

Wise health consumerism and self-care initiatives are integrated with seminars, and are supplemented through a patient "ombudsperson" program staffed by clinicians from the on-site clinics.

Other Initiatives

• Interactive kiosks with self-monitoring observance of national health events 
• Public awareness campaigns 
• Community involvement; 
• Screening coverage through the medical plan (employees and dependents) 
• Smoke-free facilities 
• Seat belt use promotion through benefit design

Pitney Bowes has developed an integrated health care strategy that consists of three major building blocks: Education, Efficiency, and Employer design. Pitney Bowes goal is to Educate the health care consumers to effect more Efficient utilization and purchasing. It will provide Employer support and guidance for these objectives internally and externally through plan design, programming and support of internal and community health care resources. This concept is illustrated as a trapezoid that uses the three building blocks to create a stable structure that "bridges" the gap between old paradigms and new benefit and health care approaches.

Pitney Bowes has expanded this strategy into three dimensions that are interlinked to further increase the stability of the structure. These are:

• Demand Management, or a focus on application of health benefits, using education, consumerism, and timely use of appropriate care when necessary. 
• Disability Management, or productivity management focused on reestablished or maintaining employees productive employment through the most efficient mix of resources. 
• Disease Management/Prevention, or care management that focuses on prevention of disease or slowing of disease progression, efficient treatment as needed, better compliance with care, and promotion of healthy behaviors. Health Care University falls under the Disease Management/prevention umbrella.