HCSC Fosters Sustainable Health Care for Their Employees and Community
Health Care Service Corporation (HCSC), a customer-owned health benefits company that operates the Blue Cross and Blue Shield plans in Illinois, New Mexico, Oklahoma and Texas, has focused on improving the health and wellness of its plan members and communities for more than 75 years. The health care industry is complex and constantly evolving and, therefore, new ways and channels of communication are necessary to respond appropriately to new challenges. HCSC is prepared for the evolution of the marketplace and has developed and implemented innovative approaches that deliver valued health products and solutions to all plan members—in any environment.
While targeting issues and creating innovative projects to tackle specific health problems across HCSC’s four states is important, a shift in thinking around how the organization approaches all opportunities is imperative to overall success. Autonomous work to improve health outcomes is no longer appropriate as HCSC strives to incorporate partnership, collaboration, and innovation to find reasonable solutions to these challenges. Involving and leveraging expertise, experience, products, services, and many other assets from both the public and private sector, the communities in which HCSC operates, in addition to their own employees, serves to create an environment that fosters sustainable models of change. HCSC approaches these opportunities with the goal of creating a system of change that can be replicated in other circumstances, environments, and communities.
Two key examples of these models of change are highlighted.
Knee osteoarthritis (OA) is a major cause of arthritis-related disability in the United States. Difficulty doing activities, such as walking, climbing stairs, or rising from a chair may be due to knee OA and, as a result of the obesity epidemic in this country, has led to growing numbers of adults with this condition. As a health insurer, HCSC became aware of OA’s impact on the health and wellness of their members, communities, and its own employees. In response to this, HCSC partnered with Northwestern University’s (NU’s) arthritis prevention research group to support JointADventure, a pilot program intended to address knee symptoms and improve the quality of life. NU has found that knee OA is already a major cause of work disability and work absenteeism, and it is responsible for approximately 400,000 total knee replacements annually. Through this partnership, HCSC will leverage one of its greatest assets—its own employees—to participate in this research program.
Employees voluntarily participate in a six-month workplace intensive intervention program focusing on diet and exercise lead by a dietitian and occupational therapist. The program goals of JointADventure are to enhance scientific knowledge related to behavior change and to improve clinical practice pertaining to OA. However, the long term intended outcome of this program is to determine the most impactful approaches to the way lifestyle interventions are delivered to large employed populations. The pilot phase with HCSC’s employees began in June 2012 and the intention is to replicate this program and offer it to employer groups, consisting of HCSC’s plan members,
to make it available to their employees. The potential reach of this program is significant as HCSC plans serves more than 13 million members across its four states. Additionally, there is opportunity to replicate this program for a much larger audience and make an even more significant impact on reducing the incidence of OA caused by lifestyle choices.
Lawndale Diabetes Project
Individuals and families who are uninsured or lack access to health care providers generally utilize emergency departments and urgent care clinics as their primary means of receiving care. Low-income communities, where this is most typical, have a higher prevalence of chronic disease and as a result they collectively face significant health issues. This affects not only those individuals, but entire families and the overall health of the community as well. The Sinai Health System (SHS) has found this to be true with regard to the North and South Lawndale communities on Chicago’s west side, which face a disproportionately high prevalence of Type 2 diabetes. While a national epidemic of diabetes has been identified with 9% of the U.S. population now diabetic, North and South Lawndale’s prevalence rate hovers between 25-28%. As a result, HCSC
is partnering with SHS, to implement an innovative model that utilizes community health workers and navigators to address the diabetes epidemic in these two communities.
The Lawndale Diabetes Project has three primary goals: 1) to reduce the burden of diabetes and childhood obesity in the communities of North and South Lawndale, 2) to orient resources in the community so that sustainable change takes place and remains after the two-year program concludes, and 3) to learn how to best treat chronic diseases in underserved urban populations, which will help guide best practices ahead of the implementation of state health insurance exchanges. Community Health Workers (CHW) go door-to-door in the predominantly African American North Lawndale as well as in the Latino South Lawndale communities. They conduct
interviews and survey and screen families for diabetes and pediatric obesity and offer interventions that include free first-time primary care physician visits. Those identified as
candidates are referred to a community health navigator (CHN) to assist in accessing follow-up care and provide education about managing their conditions. The model’s
potential for lowering the cost of care and reducing chronic disease is promising. It’s hoped that such cost-effective interventions can be replicated in other communities facing
similar health issues. Linking these residents to the health care system is critical to lowering chronic disease rates like diabetes, and the CHWs and CHNs work to build the
community’s trust and ensure that sustainable change continues well after the program has ended.
[Editor's note: Article orignially appeared in The Role of Business in Health and Wellness Innovation.]