Preventative Wellness: A Mid- and Post-Pandemic Workforce Priority

Yuri Teshler couldn’t look away. Instead of taking in a movie with his wife and five kids, he was fixated on a seemingly endless stream of theater patrons with oversized popcorn and sodas. Many of them, Teshler noted sadly, were children.

“We as a culture have just accepted that [this] is the way it is,” said Teshler, practice lead for Healthcare at Moore Strategy & Insights. “And there's no plan that I see that says, ‘this is not good. This is not right.’”

Changing that thinking became a focus for Teshler’s career as he turned to technology to improve an inefficient healthcare system. He and other experts believe that innovative thinking and new approaches, with a focus on preventative wellness, are crucial as corporate America grapples with the effects of COVID-19. That is the theme of the fifth chapter of Work, Wellness & Space.

Wellness as a Top Priority

In-office screening options – think phones that take your temperature – will become common in the workplace. And many companies will ask employees to fill out questionnaires about their health before coming to work, in what is being called “attestation.” Simultaneously, a new mindset is emerging. Reporting to work sick will no longer be a sign of flagging dedication, said Bobby Benson, design principal at Cannon Design. “Now, you will work from home the moment you are sick – and that will be looked at as a good thing,” he said.

From there, thinking collectively, and continually, about limiting threats of ailments is no longer so big a leap. Whereas today, the CDC reports that 90 percent of the $3.5 trillion of annual U.S. healthcare expenditures goes to chronic and mental health conditions, the dangers of COVID-19 have emboldened advocates of what Eden Health CEO Matt McCambridge calls a “health-forward” approach.

This approach will require adoption by the corporate world of new thinking in the healthcare space, away from traditional fee-for-service models and toward holistic, preventative, value-based care.

Ron Barshop, CEO and founder of NeWay Care, points to VillageMD as a sign of where we’re headed: The company recently announced a $1 billion investment from Walgreens Boots Alliance to open up to 700 physician-staffed clinics inside Walgreens drugstores in more than 30 U.S. markets by 2025. He also lauds Chicago-based Oak Street Health, which operates 54 primary care centers across eight states and serves Medicare patients. The company filed preliminary paperwork in July for an IPO.

Their model centers around relationship-based clinics and focuses on building a primary care delivery platform that addresses rising costs and poor outcomes. Patients who need it receive transportation to appointments and are invited to participate in family-centric events. The company shares in the risk for its patients’ healthcare costs, which has equated to a 51 percent reduction in hospital admissions and a 42 percent reduction in readmission rates.

For corporate America, value-based care with a preventative focus is as relevant to mid-career workers as it is for older demographics, particularly in a post-pandemic world. And the good news is that business leaders are taking note: Willis Towers Watson’s 2019 Best Practices in Health Care Survey found that an increasing number of employers are incorporating value-based approaches into their health plans, and 2019 research from the New England Journal of Medicine strongly supported this finding, asserting that value-based care can help solve some of the cost and quality problems that plague the U.S. healthcare system.

“As businesses work to reopen after and amid COVID-19, decision-makers should take a page from innovators and embrace preventative wellness,” said Elizabeth C. Nelson, Ph.D. candidate and author of The Healthy Office Revolution. “Preventative steps are key to improving not only individual health but also the capabilities of doctors and medical offices. After all, much of the human experience is counterintuitive to basic human health. Brain chemistry alone is more aligned with someone in distress or danger than not for the average working adult. Healthcare must holistically shift to preventative health, going way beyond ‘eat healthy and exercise.’”

“This will not only make us more resilient,” she added, “but allow medical professionals to do the work our preventative measures cannot."

A Corporate Mentality Needed in Healthcare?

Traditional healthcare players, typically large organizations that struggle to innovate, are investing in startups to help. The Blue Venture Fund initiative by Blue Cross Blue Shield is one example; another is Humana’s $100 million investment in an at-home primary care startup called Heal, where the two companies will offer value-based primary care to elderly patients through a combination of house calls and telemedicine – essentially bringing preventative wellness to patients’ doorsteps.

Barshop, in his podcast, Primary Care Cures, frequently explores where and how the traditional healthcare model is ripe for change. New technologies and outside viewpoints – particularly individuals with more corporate backgrounds -- are increasingly part of the primary care conversation.

Barshop came to healthcare from finance. McCambridge had a similar path, moving from venture capital to start Eden Health, which features a virtual primary care and navigation platform centered on care teams. The company helps employees across the country navigate the healthcare landscape across insurance, primary care and mental healthcare, and its model has integrated specialties such as behavioral health and physical therapy.

“When you design something around the user, you come to understand what their needs are,” McCambridge said. “It’s the human-centered design approach.”

As CEO of Atlanta-based Ascend Medical, Jason Madsen, who made his name in private equity, has positioned his organization as a virtual primary care platform with mobile diagnostics and imaging. Set to launch in late 2020, the company aims to operate 20 clinics by 2024, focusing on evidence-based medicine, technology, compliance and metrics that deliver optimal outcomes through primarily telehealth and, when needed, in-person visits – declaring that the pandemic has made physical presences less vital and is creating a “land grab that is virtual.”

“There is a reset among patients who have existing relationships with primary care, urgent care and even through retail,” he said. “These patients are going to look for new relationships with provider groups who understand their situations on a long-term basis.”

Putting Preventative Wellness in Individuals’ Hands

Teshler and Barshop are working together on a tool that uses biometric feedback to measure sleep, diet, mental health triggers and other data to provide customized guidance on health and wellness. Only about 10 percent of the process needs clinician oversight, and each individual is responsible for implementing much of the guidance.

The guidance could mean individualized plans for things like weight loss or marathon training, but Teshler and Barshop believe their business model will appeal to employers looking to create healthier workforces, too – particularly now. The tool is poised to fill a growing demand that experts believe has only accelerated as a result of COVID-19, one in which employees and employers use data-driven science to achieve wellness goals and maintain healthy organizations over the long term.

“COVID has shown us that the U.S. healthcare system cannot serve the entire population,” Barshop said. “We need to simplify a user experience that makes healthcare simple and frictionless for every individual to be involved, yet supervised, by a doctor.”

The Conflicts Around Managing Preventative Wellness

As is our practice with Work, Wellness & Space, we identify social conflicts surrounding each chapter’s theme. Regarding the focus on preventative wellness as a result of COVID-19, conflicts include:

·        Remember Going to Work Sick? Even before the pandemic, walking into offices during the cold and flu season was like walking into a petri dish – because of social norms that dictated that workers play “hurt.”  But a player who comes in sick jeopardizes the health and wellness of the entire team – especially now. Can business leaders enforce evolved thinking and stay focused on providing safe and healthy environments? Can individuals self-regulate?

·        Short-Term Thinking to Preventative Care: Organizations will be challenged to overhaul workplaces while simultaneously revamping healthcare and wellness plans. But surviving the pandemic and navigating future health crises depend on committing to collective, preventative wellness. Can we expect traditional or upstart healthcare providers to proactively ease the burden of choice that many organizations feel they must make? How will organizations stress preventative wellness given the office/work-from-home combinations that are likely in the coming months and years?

·        Embracing Value-Based Models: Value-based care provides cost-savings and better outcomes for corporate health plan participants. But can busy business leaders, who are juggling even more responsibilities because of the pandemic, take a page from healthcare outsiders and move toward a model that pays for results – similar to what is taking place in the primary care space?