How the Cleveland Clinic Controls Health Care Costs
Of its own employees, that is:
The clinic, however, didn’t give employees a choice. “First thing we said was we had to make our institution toxin free,” Roizen said. “The biggest toxin we have in the U.S. is tobacco. So we began offering free tobacco-cessation programs to our employees. Then we banned smoking on campus. You can’t even smoke in the parking lot in your car. The first offense you get a warning, and the second you get fired. We fired two high- profile physicians who refused to quit. Then they knew we were serious.” ….The clinic no longer hires smokers.
Food came next. The clinic took out almost every deep-fryer in the building. They removed sugared soda from every beverage case. They eliminated trans fats. On a tour of the campus, I noticed a long line outside a McDonald’s. My guide sighed. McDonald’s, he explained, had a long-term contract that predated Cosgrove’s wellness initiative. The clinic couldn’t throw them out — yet.
The clinic tracks its employees’ blood pressure, lipids, blood sugar, weight and smoking habits. If any of these are what the clinic calls “abnormal,” a doctor must certify that the employee is taking steps to get them under control. Otherwise, no insurance rebate. The idea is to force employees to have regular conversations with their doctors about wellness. If they participate, they can lock in the rates they were paying two years ago. The savings amount to many thousands of dollars.
See full Ezra Klein article.
The wrong people will learn the wrong lessons from this story. First: It’s a health-care facility, so it’s kind of obvious that they will be motivated to want healthy people working there. To think that the executives at other facilities will be as interested is delusional. (Especially because they have track employees’ blood pressure, lipids, etc. at almost zero marginal cost, which would not be true for Joe’s Plumbing.)
Also, they fired two doctors who kept smoking. I’ll bet a lot of other smokers, obese people, etc. quit (or soon will, after they close McDonald’s). Of course, the remaining population will be healthier. You can’t do that to the Medicare population.
Wow! That seems rather draconian. Given that it takes years for a unhealthy lifestyles to result in high health expenditures; and considering employees can do what they want at home, I don’t believe this will be effective in reducing health costs. Of course, maybe it will run off all the unhealthy employees!
However, I don’t have a problem with the idea of requiring people to take responsibility for their health and pay higher insurance rates if they refuse to at least take steps to control their blood pressure, cholesterol or weight for that matter. At conferences all the policy wonks seemingly agrees this is probably a good idea. But it never quite makes it into the policy briefs they go home and write.
In other news, the Cleveland Clinic is raising health care costs by spending money on faddish wellness initiatives unlikely to have any connection with employee health expenditures.
“Toxin free?” Sounds like an ad for a full body toxin cleanse. One hopes they’ve managed to eliminate C. difficle, which produces some nasty toxin all by iteslf.
@ Linda,
As suggested above, maybe the real purpose of this wellness initiative is to run off all the unhealthy employees!
He who writes the checks makes the rules. Given how many Americans now have chronic diseases, I’m guessing you’d see at least some difference in costs in a healthy vs. unhealthy population, even if they’re relatively young.
If CC employees don’t like it, they can always go work elsewhere.