Tag Archives: Employee Health

This Weeks Covid-19 Update – Apollo 11, NASA and Lessons Learned Relative to the COVID Pandemic

This week, on the 51st anniversary of the Apollo 11 landing on the moon, Dr. Nick van Terheyden and Fred Goldstein discussed the success, failures, and lessons learned and their relevance to solving the Covid-19 Pandemic.

 

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What the Walmart Decision to Send all Spine Surgeries to Centers of Excellence Really Says

Walmart announced this past year that they were modifying their Centers of Excellence (COE) program and requiring employees to travel to one of their eight approved COEs for Spine Surgery. That raised a lot of eyebrows and interest among other self-insured employers, benefits consultants and of course the healthcare system itself. Walmart did this after finding that perhaps 40 percent of those referred to a COE after having a recommendation for surgery by their local physicians, were not recommended for surgery by the COE.

There are 650,000 to 700,000 spine surgeries performed per year, with around 280,000 to 300,000 being done in an outpatient setting and (https://www.beckersasc.com/outpatient-spine/10-things-to-know-about-spine-surgery-in-ascs.html) spine surgery is the most highly reimbursed subspecialty within orthopedics. (https://www.beckersspine.com/lists-and-statistics/item/739-11-statistics-and-facts-about-orthopedics-and-orthopedic-practices).

Amazingly, 90% of Americans live within 10 miles of a Walmart and they employ about 1.5 million people in the United States (https://corporate.walmart.com/newsroom/company-facts). Think about that! I would assume that somewhere close to 90% of the spine surgeons also live within 10 miles of those Walmart’s’, many of whom Walmart has deemed were potentially doing unnecessary surgeries on 40% of the employees they referred to the COEs with spine issues. BTW the hospitals I’m sure were doing well by these referrals too.Becker’s said they did this to save money (https://www.beckershospitalreview.com/finance/walmart-will-require-workers-to-travel-for-surgery-in-effort-to-cut-healthcare-costs.html), not mentioning that 40% of the cases were reviewed by the COE and determined to not need the surgery that had been recommended by the local doctor, sure that saved money, but what about quality of life for the patients, and quality in general . Should they just go ahead and let those surgeries be done?

Here are some other outcomes as reported by Beckers Spine Review

1. About 2,300 employees — around half of the Walmart employees who underwent spine surgery or evaluation without surgery from 2015 to 2018 — utilized a center of excellence. During that time, 46 percent of patients underwent surgery and 54 percent received other forms of treatment.

2. The employees who underwent care at center of excellence sites reported shorter hospital stays; the COE employees stayed in the hospital for 2.5 days, compared to 2.9 days for the non-COE employees. Then, 0.6 percent of the COE patients were discharged to skilled nursing facilities, far lower than 4.9 percent of the non-COE patients.

3. Over the past three years, the readmission rate per 1,000 patients in the program was three for COE patients, compared to 65 for non-COE patients.

4. On average, patients who received care at a center of excellence returned to work after 10.6 weeks, which was 2.6 weeks sooner than the non-COE patients.

5. Cost for care was 8 percent higher at the center of excellence — $32,177 on average — compared to $29,770 at the non-COE, but the lower readmission rates, earlier discharge and lower skilled nursing facility use was a “payoff” of the COE model.

So now getting back to something I have seen little attention paid to, what does that say about the state of spine surgery around the United States? Its not as if Walmart has a little footprint around the country.

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Tom Chamberlain, CEO of EdLogics on PopHealth Week

In attempting to control healthcare costs, improve health and seek better utilization of healthcare services by their employees,  one key area of focus by employers needs to be health literacy. It’s clear that poor health literacy is a strong indicator of health care costs. Here are some statistics:

Health Literacy Stats

 

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Tom Chamberlain, PharmD, the Founder and CEO of EdLogics joined Gregg Masters  and me on PopHealth Week  to discuss their platform and how it works to improve Health Literacy and engagement.

 

From their marketing materials:

EdLogics is an education-based consumer engagement company that provides innovative health education and learning management solutions to employers, health plans, healthcare providers, and government entities. Through interactive game-based learning, multimedia educational programs, innovative gamification strategies, and rewards for educational achievement, EdLogics is transforming the way consumers learn about health. The EdLogics Platform makes learning fun and engaging, measures learning comprehension, improves health literacy, and empowers consumers to take greater responsibility for managing their health.

You can learn more about their platform via this video (http://www.edlogics.com/overview/)and listen to the interview on PopHealth Week below:

 

 

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For full disclosure, I am an advisor to EdLogics.

PopHealth Week is Produced by Health Innovation Media

 

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Ray Fabius, MD, a Discussion about Employee Health and a Whole Lot More

Ray FabiusAt the Population Health Alliance Forum last fall, covered by Health Innovation Media, I had the chance to chat with Ray Fabius, MD, CEO and Founder of HealthNext. We discussed a lot of ground including Culture of Health, the impact of creating a culture of health on productivity and company performance, HealthNext and the second Edition of Population Health: Creating a Culture of Wellness which he co-authored with David Nash, MD.   Ray brings his incredible experience and intellect to this insightful session, have a listen.

 

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Thanks to Gregg Masters the Producer and Co-host of PopHealth Week.

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The Validation Institute and Certification – Stand out from the Crowd

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As many of you know, I am on the advisory board of the Care Innovations Validation Institute.  This is an important organization for the Population Health and Wellness industry. The advisory board is chaired by Dr. David Nash, Dean of the Jefferson College of Population Health.

Our industry is facing some questions; one need only look at the multitude of population health and wellness vendors and their reports of amazing outcomes to know that something is not right.  RAND has published some very good studies (here, here and here)  that showed limited to negative returns from various wellness and employe health improvement programs and Al Lewis has published many examples in his books (here and here)  and on his website.  While on the other side, Ron Goetzel at the Institute for Health and Productivity Studies within Johns Hopkins Bloomberg School of Public Health,  has a whole section devoted to programs that do work.

Last year the Population Health Alliance held a debate between Ron and Al. The event was standing room only and came to the conclusion that many of the programs do not work, while a few very well designed and implemented programs do.

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