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The Future of Successful Health Care

By Maureen Bisognano | Friday, April 5, 2013

For years now, some of the most innovative work toward the Triple Aim has come from the folks at Bellin Health in Green Bay, Wisconsin. Under the leadership of George Kerwin, Pete Knox, Randy Van Straten, and others, Bellin is a creative, tenacious, and nimble organization.


In our book, Pursuing the Triple Aim, Charlie Kenney and I devoted a chapter to Bellin’s innovative work. We described how George and his team not only reduced the cost of care for Bellin employees, but also measurably improved their health status.


And they didn’t stop there. They took their program to improve employee health while reducing costs to scores of other companies in their area. And in virtually every case, the Bellin team has both improved the measurable quality of health for employees and cut costs for the employer.


I love keeping up with what the folks we wrote about in our book are doing now, and when I checked in with Bellin recently I was not surprised to learn that they have taken even greater steps forward.


George, Pete, Randy, and their colleagues have worked hard during the past several years to reduce the number of the most expensive medical cases among their employee population.

LEARN MORE: Leading Population Health Transformation, Feb. 22-24, 2017, in San Diego, California

Randy explains that they focused on cases where the care’s cost exceeded $50,000. In 2012 alone, Bellin reduced the number of these expensive cases by 24 percent, even as the number of employees they covered increased from 4,289 to 4,523.


How has this worked? Randy explained: “We started this work three and a half years ago. We provide incentives to employees to fill out a health risk evaluation, and we also provide incentives for our employees to get all the age and gender screenings that are appropriate for them. In 2012, 71 percent got all the screenings.”


There is no magic to this work, Randy says – only good planning, providing the right incentives, and persistence.


“We did it through our value-based primary care, where we have created free physician visits and labs for anyone who has one or more of six specific conditions: obesity, smoking, cardio-vascular disease, diabetes, hypertension, or elevated cholesterol. We’ve removed the barriers to getting engaged with your primary care physician. And our expense for the large cases went down from a total of $4.5 million a year to $3.4 million a year. There are fewer cases and we are spending less on each case.’’


Randy points to an individual Bellin employee – Karen Johnson – who perfectly embodies the success of the Bellin program. Watch this video; it’s amazing.


So I took these lessons from Bellin back home to IHI. As we bid out our own employee health insurance plan to vendors this year, we used the Triple Aim as the bid spec, and we had amazing conversations with insurers who we can collaborate with to accomplish the Triple Aim for the entire IHI staff. We offered health risk appraisals for all of our staff and their families. To date, over half of our employees have completed the assessments. I was first in line! The good news for us is that our organizational health score was high – but we are still working hard to make IHI the healthiest workplace around. My hope is that we will produce a bunch of stories like Karen’s here at IHI. This kind of improvement, this kind of change, is the future of successful health care.


-Maureen Bisognano

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