Chevron shifts health burden toward workers
April 1, 1999 4 minutes read
Chevron shifts health burden toward workers
Part of strategy is to improve health care quality
An interdisciplinary team at San Francisco-based Chevron Corporation concluded that one of the keys to improving health care quality is to give employees more responsibility for their own health care. In the beginning stages of this initiative, they sought to encourage this shift through a combination of education, information resources, and possible changes in benefit plan structure.
Chevron’s newly revised health and welfare strategy has five key objectives:
1. Manage cost.
2. Maximize participant satisfaction, to the degree that it is compliant with overall corporate objectives.
3. Promote employee/participant accountability.
4. Ensure service partner accountability.
5. Enhance health and productivity among employees.
The last three points are tightly interwoven, explains Bruce S. Smith, senior vendor admini-strator for health and welfare plans. "From my perspective, I have to work with the [health insurance] vendors to ensure their processes operate at an optimal level. Otherwise, the member can’t be self-sufficient," he notes. "If I have trouble getting my claims paid, it’s hard for me to take more accountability. If we can improve processes around referrals and customer service, when my member calls, he or she can take care of these things."
An ongoing process
Chevron formally began the creation of a health care strategy in 1991, then decided to update it in 1996. The multidisciplinary team, headed by adviser Tanya Bednarski, included Smith, D. Ann Whitehead, manager of preventive health services, plan administration staff, and the medical and finance departments.
"We met with an outside consultant several times over a period of more than one year to develop the strategy," recalls Smith. "Now, our health and welfare team meets quarterly at a minimum. And we work together closely on a daily basis."
"We were looking to achieve a couple of things," notes Whitehead, "including having employees assume more accountability around their health and seeing what we could do in the design of our self-insured plan."
At the present time, Chevron has "a contribution policy that is probably more generous than that of other similar employers," notes Smith. "For example, right now there are no premiums. This may create a disincentive on how insurance money is spent; it may not set the stage for employees to be prudent health care shoppers. Should we modify that so a greater amount of financial accountability falls upon the member?"
This is one of the issues that led to the new initiative, he explains. "We’re considering a larger copay."
The Chevron staff is seeking to achieve its objectives through several simultaneous, related activities.
"It all focuses on health, but specifically on wise health care consumerism," says Whitehead. There is a great deal of information available on the company’s Web site, and on its Intranet, as well as plan satisfaction ratings and other reports from HEDIS. "We’ve also communicated our objectives through our company newsletter, linking them back into Chevron’s overall business vision. Employees are fairly knowledgeable about the overall vision," she says.
Participation is encouraged by making it easy, says Whitehead.
"At the work site, everything we do is on company time except for workouts at the fitness center," she notes. "It is also linked heavily to the business needs of a particular group; we help our different operating companies meet their own needs."
"For example," adds Smith, "there’s a location closing in Le Havre [CA]. We’re selling it off, and those employees will either lose their jobs or be relocated. We are providing meditation and yoga classes on company time."
If the activities are linked to specific needs of the business, Smith says, the managers will allow it on company time.
"Then, participation rates jump way up," he says.
Safety is a huge driver for businesses, adds Whitehead. But they also schedule screenings such as health risk appraisals (HRAs) on company time.
Since the initiative is still unfolding, it is far too early to measure results, but Whitehead notes the evaluation process is already well established. "What we’ve really done is have metrics’ created around the initiative," she explains. "We’ll measure participation rates in things like disability management (which focuses on off-the-job injury and illness), participation in a new wellness supplement, and HRAs. This will tell us if people are really taking some responsibility for their health."
The staff will also measure use of the Intranet information resources, and "hits" on the Chevron Web site.
A long-term process
Smith and Whitehead recognize they have begun what will be a long-term process. "Our employees have been relatively passive [about their own health care]," notes Smith. "But if we can turn it around, then we will turn around ongoing cost issues for our company and their health."
"You can sell this to management," adds Whitehead, "because they know they’ll be getting something for the investment."
She’s also convinced health care quality will improve. "Wise consumers will affect clinicians because they demand certain things when they walk in the door," she asserts.
Adds Smith: "I can’t expect my doctor to be solely responsible for my health care and quality of care. He’s inundated with all kinds of stressors and demands. If I can go in and focus with him, he will be a better doctor, and hopefully make changes too."
Smith belongs to an HMO that automatically covers routine, yearly health exams. "My doctor is a good, caring doctor, and I love him dearly, but I don’t have any major medical problems. If I don’t remind him about my physical, he’s likely to forget. And he’s not unusual; he’s the norm. He’s just overwhelmed."
If employees pick up that slack, Smith expects to see positive results over the long term. "This year, all we’ll really be able to do is record and measure how many people have enrolled," he says. "It will take a year or two to get results. I want to look at overall continuing costs for key diagnoses, such as cardiovascular disease, asthma, and diabetes."
[For more information, contact: D. Ann Whitehead, Chevron Corporation, 575 Market St., Room 1628, San Francisco, CA 94105. Telephone: (415) 894-7700.]
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