As our nation struggles to find an affordable, effective future for health care, some answers may come from an experiment at a midsize employer in Montevideo, Minn.
Friendship Homes, with 180 employees, is one of the largest employers in the town of 5,400 about 130 miles west of the Twin Cities. The company builds prefabricated homes. And like many in construction and related industries, it has struggled to help its employees with back and muscle pain and other injuries caused by strain and overuse.
Each year, those injuries cost U.S. employers and employees real dollars in lost worker time on the job as well as higher health care, health-insurance and workers' compensation expenses. But for the past year, Friendship Homes, teamed with Northwestern Health Sciences University, where I work, has operated an on-site health clinic and education program with a goal of preventing these and similar injuries, which are among the most frequently occurring patient conditions in the United States.
Friendship Homes' new program has been heavy on injury-prevention and wellness. Workers learn how to avoid activities that may result in them straining their backs and muscles and otherwise hurting themselves at work. The program also allows employees to receive regular checkups and treatments for any injuries right away at work from a local chiropractor whose skills are an ideal fit for the needs of the people working at this company.
A year into the project, workers report that they are feeling better and like having health care services at their job. Statistics show that they are incurring injuries at much lower rates. They are also recovering quicker when they do get hurt.
And when it comes to the bottom line, the results have been better than Friendship Homes and Northwestern expected. For every $1 that the company has invested in the program, it is saving $8 by avoiding more-costly and less-effective treatments, spending less on insurance payments and keeping more workers on the job in the first place, which generates savings through less lost tine for workers and less overtime to compensate for absences.
These savings don't take into account the higher productivity and work satisfaction that employees and managers both have reported since the company started the program.
The program is simple. But it shows the significant benefits that can accrue to any company or organization that has the gumption to think differently about health care and to take what is still too often seen as the dramatic step of using the workplace and work time to provide health care education and treatment.
In the case of Friendship Homes, those services have come from a local chiropractor who also is trained in therapeutic massage and acupuncture. But it's a good bet that other firms across our country could see similar results from the same approach — on-site education, checkups and treatment — using these or other health providers. The bottom line is that a focus on wellness pays off, and fairly dramatically.
Friendship Homes and Northwestern expected good results. But nobody predicted an eight-for-one return on the company's investment. The outcomes have been so significant that Friendship Homes' corporate parent has asked us to partner with the firm in rolling out similar on-site health programs at their other manufacturing sites.
What are the lessons here and the implications for American health care in general?
First, medical diagnoses related to neck and back pain — the kind of health problems that are a major concern to manufacturers such as Friendship Homes — are now costing us more than $1 billion annually in the U.S.
Second, common treatments often involve prescribing drugs, including addictive opiate narcotics, and ordering patients to undergo expensive but frequently ineffective surgeries. In short, how we have been responding to a real and debilitating medical issue hasn't been working and has been causing other problems.
Third, after more than a year of work at Friendship Homes, it's clear that outcomes and health expenses turn dramatically positive when employers, employees and health professionals work together, focus on prevention, start with conservative treatments and make health care convenient and affordable.
It's important to note that no one piece of this program is the secret ingredient. It takes all parts working together and working consistently over time. In addition, providing all health options, including chiropractic care and other alternative treatments, ensures effective and cost-effective care.
At Northwestern, a nonprofit, research-based health sciences university, part of our mission is to find solutions to health care issues and concerns. We think we've found something at Friendship Homes, a midsize manufacturer in central Minnesota. It just might be part of the future for effective health care for our nation.
Christopher Cassirer is president and CEO of Northwestern Health Sciences University in Bloomington.