Pacific Bell’s Health Promotion continues providing the programs described in the 1995 award application on a voluntary, no-change basis. The program’s objectives were expanded to include ergonomics, return-to-work, Work Hardening program expansion, flu shot trial, advance directives, prevention capabilities study of healthcare providers and pharmacy efficacy analysis.
Program Description
Narrative Description of Program
Pacific Bell’s Health Promotion continues providing the programs described in the 1995 award application on a voluntary, no-change basis. The program’s objectives were expanded to include ergonomics, return-to-work, Work Hardening program expansion, flu shot trial, advance directives, prevention capabilities study of healthcare providers and pharmacy efficacy analysis.
The program’s mission targets improved employee capability, reduced absenteeism, and health care cost containment through:
- Development of an integrated health promotion approach involving educational, organizational and environmental changes. This approach targets active and retired employees as well as dependents. Programs are staffed by skilled health professionals including occupational health nurses, exercise physiologists, social workers, safety and administrative experts.
- Delivery of ongoing programs which inform and motivate employees and families to adopt positive health behaviors and sustain changes. Examples of modes used to accomplish this include:
- One-on-one delivery: Ergonomic workstation evaluations, coronary risk management, return-to-work and weight management.
- Educational: Back care, breast health, smoking cessation and prenatal.
Employee-initiated: Health Information Program (toll-free hotline) and Health and Safety Video Library. - Analyses and improvement of programs to ensure contribution to shareholders, business and client expectations. Programs are designed to meet the Human Resources strategies of reduced absenteeism and health care costs containment.
Contact Summary
| General Information | |
|---|---|
| Program Name | FitWorks |
| Company Name and Address | Pacific Bell2600 Camino Ramon, Rm. 2W050San Ramon, CA 94583 |
| Contact Person | Susan Blair |
| Program Information | |
| Program Category | Worksite, High-risk, Chronic Disease, Integrated Systems of Care |
| Year begun | 1988 |
| Total number of individual participants | 12,972 |
| Number of currently actively enrolled | 8,336 |
| Cost per participant per year | $97 |
| Estimated cost savings per participant per year | $215 |
| Program targeted at Healthy People 2000 goals |
Yes |
| Program goals (in priority order) | (1) Improve Employee Health & Capability(2) Promote/Sustain Positive Health Behaviors(3) Analyze & Improve Programs Offered |
Evaluation Summary
Pacific Bell’s Health Promotion programs (FitWorks) continue to demonstrate "actual" economic contributions to the Company, based on analyses conducted by the Medstat Group. In 1994 and 1995, the return-on-investment (ROI) was 3.1 and 2.22 respectively which translates to $8.5 million and $6 million in savings.
The greatest contribution to the savings is from reduced disability costs. Specific disability conditions related to a sedentary lifestyle yielded 11 fewer disability days for the FitWorks participant. A tiered analyses, based on total check-ins for 1995 was added to the program evaluation. Participants with 43 check-ins annually experienced one less absence day than non-participants.
Pacific Bell’s prenatal program, Step in Time (SIT) was evaluated this year for financial savings to the Company and program effectiveness. Birth outcomes of SIT participants to non-participants for Health Care Network (HCN) and Health Maintenance Organization (HMO) enrollees were compared separately. Pacific Bell average-length-of-stay (ALOS) and C-section rates were also compared to Kaiser HMO and Cigna Point of Service (POS) California-wide averages. Findings indicate the older SIT participants (ages 35-49) had lower ALOS than non-participants (2.83 vs. 3.1 days). Older SIT participant cost/case was $6,500 compared to $7,060 for older non-participants.
A new strategy was to integrate workplace programs with benefit program offerings. A survey of the providers identified primary, secondary and tertiary prevention activities available to Pacific Bell employees, dependents and retirees. These findings were validated through a randomized sampling of 2500 employees on their perceptions of and experience with provider’s prevention programs. The reported survey data was compared with Pacific Bell’s prevention priorities and performance targets were established for the health plans.
An additional benefit analysis to identify and address the health-related risk of potential drug-to-drug interactions (DDI) was conducted. Pacific Telesis Group employees with prescriptions with at least one potential DDI within a two-month rolling "window" were identified. Over a 13-month period, nearly 7,300 patients had at least one potential Level 1 interaction. The ratio of emergency room visits for employees receiving potential DDI prescriptions, to employees who did not, was also reviewed.
The retiree program cited in the 1995 application has been evaluated internally via pre- and post-enrollment measurements and a quality of life survey. Since using FitWorks, 56 percent of survey respondents indicated an improvement in overall health. Twenty-two experienced a decrease in body pain severity. The retirees’ pattern of prescription drug use has been integrated into the DDI study.
Evaluation Documentation
Critique
These programs include prenatal, flu shot, prevention, ergonomics, and Return-to-Work components. The Step-in-Time prenatal program enhances birth outcomes while saving an average of $560 dollars per delivery, and the ergonomics and Return-to-Work programs reduced disability days by 11 per participant. All-in-all, the programs have generated savings of $2.22 for every $1 dollar invested, and yearly savings have escalated from $6 million to $8.5 million dollars.
Specific Comments Included: A comprehensive program which has been in operation for a long time and involves a previously recognized Koop Award winning program. Health and cost outcomes are documented and there is an overall strong commitment to evaluation. There is an innovative "Drug Interaction" program which may be unique among corporate programs. There is a good working relationship with MEDSTAT regarding outcomes research. About one-half of the 22,000 member workforce have participated. An external economic evaluation of the overall program provided evidence of cost savings. Effectiveness is shown over a range of indicators. The program has a stated link to human resources strategy particularly as it relates to impacting absence and health care costs. There is outreach to families and retirees and the staffing is multi-disciplinary. Educational strategies are imbedded rather than programmatic. There is integration with benefits and there are prevention performance targets for the health plans. This continues to be an excellent program and it is getting better; the focus on high risk employees and problems is commendable. The drug interaction analysis is an excellent non-traditional service especially for a retired population.
A few concerns were expressed: the participant versus non-participant design is weaker than desirable, but trends tend to counterbalance this bias. The sub-grouped pregnancy results are not entirely convincing. The actual evaluation design methodology and analyses could have been described more completely. There is potential concern for the stability of the program after the Pacific Bell merger with Southwestern Bell Corporation.