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Wellness Partners
As more employees seek help managing their health, Healthy@Hopkins steps up.

Harry Koffenberger, vice president of Corporate Security, in the department's command center. At work in the background are protective services officers Darlene Fairley (left) and Tanaya Hitt.
Necole Jarrett, right, “breaks” her habit, with help from Marlana Neumann, left. Says Jarrett, “I feel wonderful—I can take deep breaths now—but my husband’s a smoker, so it’s always tempting.”

Because she only considered herself a social smoker, Necole Jarrett never took her habit too seriously. Yet within a few years, Jarrett, a quality assurance analyst at Johns Hopkins HealthCare, got concerned when she became short of breath.

Jarrett, 39, had tried to kick the habit on her own several times and even succeeded during her two pregnancies, but resumed after her children were born. “I knew it was bad for me, and I hated the taste in my mouth,” she says, “but I just couldn’t stop.” Then, one day last January, she heard about a smoking cessation class offered by JH HealthCare health educator Marlana Neumann. Jarrett decided to try again—but this time with support. “It made all the difference,” she observes.

Jarrett hasn’t lit up since. And she’s not alone. Two-thirds of those who signed up for the class have given up smoking. There was never a requirement to quit, explains Neumann, just to try. Cheering them on was JH HealthCare President Patty Brown, who organized the class. “We want to help employees help themselves,” she says, “in a nonthreatening, nonjudgmental way.”

Over the past few years, Brown and colleagues in managed care have been studying health care cost trends. Among their findings: 11.5 percent of Hopkins’ Employer Health Plan members account for 70 percent of EHP dollars. Mirroring national statistics—in most large companies, 20 percent of the workforce accounts for 75 percent or more of health care costs—these medical expenses are usually tied to chronic illnesses like asthma, diabetes and cardiovascular disease. And these conditions are almost always traced to smoking, obesity and stress.

Acknowledging that employers have difficulty controlling the rising costs of medical care, they can at least try to curb them by encouraging employees to practice healthier lifestyles, explains Brown. The idea is catching on. According to the Hay Group, a consulting firm that surveyed 435 U.S. employers in 2007, 75 percent now offer wellness incentives, from nutrition education, weight management and smoking cessation to discounted gym memberships. Some have even gone to the expense of opening elaborate in-house fitness centers.

Increasingly, this strategy is succeeding. According to a February 2007 article in Business Week, some large companies have seen a 3-to-1 return on investment in their wellness programs.

Enter Healthy@Hopkins. Since it debuted a year ago, the system-wide collaboration between the University, The Health System, its hospitals, Johns Hopkins HealthCare and EHP has helped employees take charge of their health through free care management and preventive programs. The road to better health, says Brown, requires employee engagement, ideally beginning with the completion of a health risk assessment (HRA) form, noting medical conditions and lifestyle habits, like how often you eat breakfast and if you’ve ever smoked. Based on those responses, a confidential personal wellness profile is created and provided to the employee.

Last fall, during open enrollment, the Human Resources departments of  the various JH employers announced incentives for completing the HRA; e.g., JHU offered 100 extra benefit dollars for 2008. The response was overwhelming. More than 67 percent of Johns Hopkins Hospital and Health System and Hopkins Bayview Medical Center employees, and 60 percent of University employees completed HRAs during open enrollment. (Compare with a 5 percent University participation rate the previous year.)

Many employees were surprised by the results of their HRAs, says Heidi Conway, the University’s senior director of benefits and shared services. “We left the door open for feedback, and it was mostly positive. People who thought they were in good health learned that they needed to address particular concerns with their doctors.”

More than a few employees credit the HRA for unveiling a chronic condition. And thousands noted on their HRAs an interest in getting help with weight control and smoking cessation.

Still, some questioned the confidentiality of the program, fearing that the information could get into the wrong hands. That’s a misconception, says Conway.  Like health care claims data, the HRA data is subject to HIPAA requirements and cannot be shared with the employer.  Conway explains: “We are only provided aggregate, unidentified data to help us understand the needs of our employees and plan for additional programs.” Further, Brown notes, “the goal of the HRA campaign is not only to identify health risks, but to collect data on problem areas for employees so Hopkins can provide appropriate support and invest its resources wisely. It is a very powerful tool
in that regard.” 

Meanwhile, wellness programs across the institutions are booming. Since 2003, Wellnet—a network of preventive health services throughout Hopkins Hospital and the Health System—has provided free wellness profiles and classes, like cardiovascular risk reduction, weight management and yoga, as well as walking groups.

Wellnet coordinator Patti Moninghoff, who clocks about 100 hours of health education programming a month, offers classes on nutrition, stress management, and women’s and men’s health, to name a few. “They’re always full,” she says, as are cholesterol, glucose and blood pressure screenings. Lately, Moninghoff has had more requests for on-site visits to affiliates, like White Marsh.

The heightened focus on wellness hasn’t escaped notice. Recently Hopkins Hospital, Johns Hopkins HealthCare, Home Care, Community Physicians, Bayview Medical Center and Howard County General Hospital all received the American Heart Association Fit Friendly Company Award, recognizing sustained efforts to promote a culture of well-being among employees.

Still, with a huge enterprise like Hopkins, the effort can be daunting. The key, says Brown, is to be supportive to the employees in their quest to improve health. On several occasions during the smoking cessation class, for example, Brown, whose father died of lung cancer, conference-called the group to see how they were doing. “My message to them was simple, and sincere:  I care about you and hope you’re successful.  And many, like Necole, were.” 

—Judy Minkove



Johns Hopkins Medicine

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