Heller quickly acknowledged a deficit that has frustrated many health policy thinkers: that there is little to no solid evidence that aggressively working with employees to improve health will save money. And this was no clinical trial or laboratory test environment.
But intuitively, he says, it should. It makes sense.
In South Florida, statistics show a higher percentage of people with diabetes than many other large metropolitan areas, and at Baptist, there are 1,000 workers already diagnosed, Heller said.
In the Miami-Dade County area, a patient with diabetes costs $20,000 more per year than a patient who does not have diabetes. "If we can prevent one diabetic form becoming a full blown diabetic the program will pay for itself."
After year one, the program actually increased costs by 4%, because more of their employees saw doctors and took more prescription medications. The second year health costs stayed level. But in the third year, the last one measured, "we saw a 30% reduction in overall spending. And that's pretty significant."
That strategy may be working for the time being for Baptist, which has still offers its employees a choice of health plans with no deductible, yet still manages to pay 80% of healthcare costs.
The discussion among the audience moved toward the possibility that employers might be able to require their employees to fill out such questionnaires and agree to such interventions as a condition of employment. For example, some organizations now require their workers to receive annual influenza vaccinations, or else wear a mask while on the premises.