Productivity Plus

Sherman shares the wealth

A program that looks beyond medical needs rewards both employer and employee. The Wellness Councils of America highlights Sherman Health Systems.

By Chad Abresch MEd, Craig Johnson and Bo Abresch

Sherman Health Systems planted its roots more than 100 years ago in Elgin, Ill., 38 miles west of Chicago. Since then it has branched out and become a premier health care provider for the greater Chicago area, widely recognized for its excellence in cardiology, cancer, diabetes, women's services and orthopedics. Each year nearly 40,000 patients are treated in Sherman's emergency department, 11,000 surgical procedures occur, and some 2,000 babies enter the world. For its own employees, this major medical system also runs one of the most progressive and results-oriented wellness programs in the nation.

It all started in the early 1990s. Like many organizations, Sherman was spurred to action by employee benefit costs that were rising at unprecedented rates. Management made a commitment to establishing a "personal responsibility partnership" with employees concerning their future health and to building a fully integrated, risk management oriented, advocacy model of benefits. The linchpin would come to be known as the Integrated Health Advocacy Program (IHAP).

Sherman worked with Benefit Performance Associates to develop IHAP, emphasizing preventive and educational programs, nutrition screenings, informational seminars, exercise programs and a host of other activities. More so than most programs, IHAP provides comprehensive holistic care and rewards participants financially for their involvement. It also produces measurable bottom-line results.

The inner workings

When IHAP began, 5 percent of employees were responsible for 55 percent of Sherman's health care costs. IHAP targets these most-at-risk individuals—defined as employees who have generated $100,000 in medical claims in one year or $10,000 annually for three or more years—and encourages them through incentives to change their behaviors.

They are invited to participate in a whole person, clinical advocacy trial designed to help them regain control of their lives and health. This program, however, offers more than the usual medical resources.

That's because Sherman believes people who are challenged with complex conditions will typically struggle to develop productive life management skills. Some of their multiple chronic conditions stem from psychosocial, family and even financial difficulties.

IHAP strives to create enhanced personal physician care and helps to coordinate multiple providers. The process begins with comprehensive medical screenings, a general physical and an interview with a behavioral health professional. It can also include a home visit. All available medical records are assembled, and a multidisciplinary team reviews the findings and drafts a transition plan for long-term health risk management. Specific components might include individual and family counseling, personalized diet and exercise plans and targeted education programs. It spells out participation requirements, health goals, time frames and estimated costs. The final step: review and input by employee and physician.

When plans become action, IHAP is ready to provide almost any needed resource to enhance overall health and well-being. That includes both standard medical services and complementary treatments like massage, chiropractic and acupuncture. Social services range from legal and secretarial help with Social Security applications and appeals to financial advice to head off bankruptcies and meal deliveries for the homebound.

The payoffs

Employees who complete the program double their lifetime cap on total medical benefits from $500,000 to $1 million, a significant boost to financial security for people with chronic disease.

From the management side, Sherman reports that visits to the emergency room have been cut in half. In the first five months of fiscal year 2000, total benefit plan costs equaled 17 percent of payroll compared to an average 21 percent at Chicago suburban hospitals. Annual per-employee health claim costs have fallen from $4,750 in 1994 to $3,116 in 1999—a 34 percent reduction. With roughly 1,250 insured employees, that's an annual savings of over $2 million.

Not all of it drops to the bottom line, because Sherman has shared the wealth with employees in the form of two special contributions to 401(k) accounts totaling $3 million. (These are in addition to the $1.7 million normally contributed to 401(k) accounts annually.) Sherman has also been enhancing overall benefits, reinvesting $500,000 a year in preventive care and planning to raise that soon to $1 million annually.

With all this have come numerous awards, including the 1999 National Best Practice Award given by the American Society for Healthcare Human Resources Administrators. Sherman also received the American College of Occupational and Environmental Medicine Corporate Health Achievement Award in May of 2000 and the Gold Well Workplace Award given by the Wellness Councils of America.

All of these honors were earned one person at a time by attending to the full range of the individual's needs. One of those individuals who'd been through IHAP said, "I learned how to talk to my doctor." A simple statement, but one that is profound in its implication of a once passive patient's full participation in health care. It is also emblematic of the personal empowerment that Sherman has actively encouraged and been amply rewarded for.

Chad Abresch is WELCOA's senior staff writer for consumer and organizational publications. Craig Johnson, a health promotion specialist and staff writer, also manages the national Well Workplace Awards Initiative. Bo Abresch is the communications specialist for WELCOA.

 

Chad Abresch. Sherman shares the wealth. Business and Health 2001;1:53.