Indiana Workplace Wellness Partnership

Transcription

1 Indiana Workplace Wellness Partnership October 14, 2016 Dr. Dexter Shurney, MD, MBA, MPH Chief Medical Director / Executive Director, Global Health and Wellness

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3 WHY CUMMINS CARES ABOUT EMPLOYEE HEALTH & WELLBEING 1. Rising Healthcare Costs (self-insured) 2. Workforce Productivity (Absentism/Presenteeism/Errors & Accidents) 3. Worker Retention 4. The Right Thing to do 3

4 What would Cummins do to optimize health, safety, and performance?

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6 HOW IS HEALTH PRODUCED?

7 Findings: All of these Diseases are Related Obesity Sleep Apnea and Insomnia Gallbladder Disease Type 2 Diabetes and Metabolic Syndrome Kidney Disease Blindness Leg Amputations Coronary Heart Disease, High cholesterol, and Heart Attacks High Blood Pressure and Stroke Osteoporosis Impotence Depression Cancer Lung Cancer Endometrial Cancer Breast Cancer Prostate Cancer Colon Cancer

8 SIXSIGMA APPROACH TO HEALTH Six Sigma tells us to look at root causes The root cause of health is lifestyle To produce good health we must treat the cause, which means addressing lifestyle 8

9 Findings: Traditional Preventive Services often do not address root cause Exception Covered Preventive Care (Adults Years) Height & Weight Prostate-specific antigen (PSA) Pap smear, Cervical cancer screening Mammogram-Breast screening Colonoscopy Bone mineral density screening FOBT Flexible sigmoidoscopy Total blood cholesterol Blood pressure screening for hypertension Sexual practices counseling Osteoporosis prevention counseling Hormone prophylaxis Influenza vaccination Tetanus & diphteria immunization 9

10 Findings: Lifestyle is Imperative to Successful Disease Prevention Harvard: Nurses Health Study 84,941 female nurses ( ) ; 3.4% in low-risk group BMl <25 High fiber and polyunsaturated fat Low trans-fat and glycemic load Moderate-to-vigorous physical activity at least 30 min per day No current smoking 91% of DM2 (95% CI 83-95) could be attributed to habits and behavior not in the low-risk pattern group Public NEJM Sep 13;345:

11 Cummins Diesel Sensor and Fuel System Engineering Goal: Zero Defects

12 Human System Performance Engineering Approach to Create Zero Defects?

13 Current Approach to Health Care Problem? Better Technology Source: CHIP / Hans Diehl

14 Conclusion: 1. We Needed a Game Changing Strategy Lifestyle for Prevention * Treatment * Reversal Lifestyle Medicine clinicians emphasize the use of Lifestyle intervention in the treatment of disease. --American College of Lifestyle Medicine 2. Right Partners with similar mindsets 14

15 FRAMEWORK TO ENABLE LIFESTYLE SUCCESS = MC 2 15

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17 Physician Lifestyle Competencies Average physician receives less than 3 hours of lifestyle training when in medical school

18 Physician Lifestyle Competencies

19 Physician Lifestyle Competencies

20 LiveWell Center - Numbers Exciting time for us we ve seen some really good results starting in 2014 with our LM coaching programs. And now having launched the ACPM/ACLM Curriculum for our physician in June we expect to create a powerful synergy through lifestyle-based shared decision to transform care. Onsite clinics LM approach to care first at our Columbus IN site Which is a 28,000 square feet facility with approximately 46 employees including physicians, nurse practitioners & clinical support personnel. Eligible population of approximately 17,000 (employees & dependents) living within 20 miles of LiveWell site.

21 Service Offerings Lifestyle Approach to Care Covered lives include all active employees & dependents, including children (2 yrs. old & above) Primary Care / Preventive Care / Urgent Care / ER Hand-offs Occupational Health Services Disease Management / Medication Therapy Management Visiting Specialists & Tele-Health Radiology Lab Services Health & Lifestyle Coaching Diet / Exercise / Behavioral Seminars & Classes Lifestyle / Cooking demonstrations / Exercise Physical Medicine Chiropractic / Acupuncture / Massage / Physical Therapy Optometry - exams & prescriptions Nutrition/Education Kitchen

22 Photos - Exterior

23 Photos - Interior

24 Photos Interior, con t

25 Lifestyle in Context: Our Approach to Health & Health Care Anthem Network High Performance Network Policies LiveWell Center LifeStyle Programs Benefits Community 25

26 From 2012 to 2020, spending on specialty drugs is expected to increase by 361% 26

27 Early Results Cummins CHIP Pilot Results Initial Total Cholesterol 200 mg/dl Initial LDL > 110 mg/dl (% of total) (44%) (% of total) (56.4%) AVG % Reduction 15.7% AVG % Reduction 19.7% Best Ind. % Reduction 53.8% Best Ind. % Reduction 66.2% % Participants Improved 98% % Participants Improved 91.8% PCSK9 Inhibitors: Praluent and Repatha approved by the FDA in 2015

28 Net Promoter Score (NPS) Survey Results Detractors Passives Promoters % 2.0% 2.0% 0.0% 0.0% 0.0% 0.0% 0.0% 8.2% 14.3% 71.4% 6.1% 8.2% 85.7% NPS Formula Promoters 85.7% Detractors 6.1% Polarized score (nothing between 3-7) Average Score = 9.1 CHIP NPS 79.6% 86 out of 100 people are promoters NPS Comparisons iphone 70% Amazon 69% Marriott 62% Netflix 50% 28

29 CHIP Adherence 80% Improvement in healthy lifestyle (3.0 to 5.4) 78% maintained improvement after 1 year Studies show diet adherence after 6 months is between 25% and 45%, CHIP is double that after 1 year! 29

30 IOM: What Does a Healthy and Productive Workforce Look Like? Perspective Current State Desired State Function Absenteeism Performance Cost Metrics Medical Costs Economic Outcomes Care Model Treatment Focused Prevention & Behavior Change- Focused Medical Model Individual Population Health Metrics Disease Status Health Status Interventions Single-Risk Focused Multiple-Risk Focused Health Framework Employer, Condition, and Program Centric Employee Centric Management Systems Segregated Programs Integrated Systems

31 Scor e Scor e Scor e Scor e Lifestyle Medicine Index (LMI) Category Scoring Example Patient A Patient B Patient C Patient D Measurement Measurement Measurement Measurement BMI 35 0 pts 27 1 pt 23 1 pt 32 0 pts Cholesterol pt pt pts pts Glucose pts pt pt pts Systolic BP pt pt pt pts Total Score 2 (Low Risk in 2 categories) 4 (Low Risk in all 4 categories) 3 (Low Risk in 3 categories) 0 (Low Risk in no categories) Insert Data Classification 31

32 Control Charts with Annual Changes 32

33 Additional LWC Metric (Program Year Beginning 2017) % Disease Reversal "The term 'reversal' is used when people can go off diabetes medication but still must engage in a lifestyle program in order to stay off " Ann Albright, PhD, RD., Director of Diabetes Translation, CDC

34 10 Yr Survival Probability 95.9% Charlson Comorbidity Index (CCI) Forumula = 0.983^ (e ^(Score*0.9)) Category Response Scores Age MI CHF PVD CVD Demen tia COPD CTD PUD DM CKD CVA Leukem ia Lympho ma Solid Tumor LD AIDS Yes see below Insert Data Classification see below see see below below 6 No < End Organ Damage 2 Uncomplicated Diabetes 1 Metastatic Tumor 6 Non-metastatic 2 Mod. to Severe 3 Mild 1 34

35 Cummins Game Changing Strategy Lifestyle for Prevention * Treatment * Reversal Different Expectations Provider Education Expanded Metrics 35

36 MAKING PEOPLE S LIVES BETTER BY UNLEASHING THE POWER OF CUMMINS QUESTIONS? Internal Use Only 36