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September 19, 2014

Hello Houston Were Working on the Problem

Do you remember the scene in Apollo 13 where Mission Control is in bedlam over the rising carbon monoxide levels in the space capsule? The lead flight director shouts for quiet and says, “We have a problem. Let’s work the problem.”

By Dean Gruner, MD

Do you remember the scene in Apollo 13 where Mission Control is in bedlam over the rising carbon monoxide levels in the space capsule? The lead flight director shouts for quiet and says, “We have a problem. Let’s work the problem.”

About seven years ago, we said the same thing at ThedaCare. We were looking at consecutive years of double-digit rate increases for our employer-sponsored health plan. We were on pace to double our costs within five years! That trajectory was not sustainable. What’s more, the trend pointed to something equally concerning. If we were generating significant rate increases, our employees had to be experiencing greater sickness and more health problems.

I know from talking with many business leaders that companies care deeply about employee health. They’re like us. Employee health is a key part of our relationship and life together. At ThedaCare, helping our employees live healthier, more productive lives fits right in with our mission to improve the health of the communities we serve.

Buying health insurance does not improve health. It’s important, to be sure, but insurance matters most when someone gets sick. That’s changing, as more plans support preventive care and wellness, but the point remains that while health insurance is an important employee benefit, and good plan design matters, no health plan will make someone healthy.

It breaks my heart to see people suffer from health issues. Employees, neighbors, friends, family and patients are in misery because of poor health. For me, and for ThedaCare, managing the dollars attached to health care is only part of the solution. We also want to avoid the human cost of heartache, pain, missed work, low productivity and reduced job satisfaction associated with chronic conditions and serious illness.

That’s why we addressed our problem by taking the long view (it’s taken us eight years to move the needle) and going “all in” on changing our culture (more than just incentivizing one or two steps). It’s taken time and commitment, but we’re seeing real results.

In the last four years, our health risk appraisal (HRA) scores show steady improvement, so we know people are actually healthier.

  • In the last four years, we’ve decreased our obesity rate by 2%, defying national trends.

  • Our verified smoking rate is down to 6%, which is far below the national average of 18% (CDC benchmark).

  • We’ve held our annual per member per month cost increases to an average of 2% over the last four years.

  • I’m writing fewer “get well” and “I’m sorry for your loss” notes to employees and their families.

How are we doing it? Fundamentally, we developed a multifaceted strategy to create a cultural shift focused on improving the health of our employees and reducing the trend increases. Our senior vice president of talent development and human resources, Maureen Pistone, will tell you our effort came from the hearts of an HR leadership team that wanted to create a better work environment where it is easy, convenient and desirable to be healthy. She’s right. By focusing on people first, educating senior leadership, developing effective programs, setting achievable targets, and partnering with internal experts like our own ThedaCare At Work team, we cast a vision for better health for everyone at ThedaCare.

One result of our approach is the Platinum award we received in 2013 from WELCOA, the Wellness Council of America. More than 36 area employers representing 33,000 employees in the Fox Cities received WELCOA awards in 2013 as well. And the momentum continues. Through the Weight of the Fox Valley initiative, local healthcare systems and employers are talking regularly about proactively engaging workplace wellness. These are exciting, positive steps that demonstrate many business leaders in our community are serious about supporting employee health.

It’s hard to be healthy, on both the personal and public levels. But, in addition to our improving health and cost benchmarks, we’re learning that people can and do embrace change that makes them feel and function better. Our employees tell us they like knowing the personal power of changing poor lifestyle habits. They appreciate a work environment that creates a bit of positive pressure to eat better and move more (after all, they’re here 40-50 hours a week). And importantly for me, they feel cared about.

Houston, like you, we’re working on the problem – and we’re making tremendous progress.

— Dr. Dean Gruner is president and CEO of Appleton-based ThedaCare. To send your thoughts to Gruner, email