How Do We Shift Away From Just-In-Time Care?

Our current healthcare system accommodates emergency care, and this creates a domino effect of disruptive side-effects at home, work and beyond. How can we shift the culture?

In case of emergency, report to the E.R.

Hold on. Is this the message we’re sending our employees about how to manage common chronic conditions like diabetes, COPD, hypertension and asthma? Wait until you’re in dire need of care, then rush to the nearest urgent care or emergency department. Wait longer to get admitted, receive just-in-time care along with referrals to other specialists, and then wait even more for more appointments. Repeat the cycle. 

Unfortunately, this is a pattern of care in a healthcare system that increasingly supports patients in the moment, during emergencies, rather than the proactive preventive care approach we emphasize to our employees. We encourage establishing a relationship with a primary care provider, regular wellness checks, and adopting lifestyle behaviors that can produce the best outcome: avoiding healthcare all together. 

But a healthcare system that is stressed by a physician shortage, increased demand for services, and the complexities of insurance—they have to keep the lights on, too—has evolved over the years to more of an emergency care model. And this can significantly reduce quality of life on many levels as we get rattled around the system. 

Perhaps you’re caring for an older adult in the family but need care for yourself immediately—and this requires finding someone to help. It’s not that easy. Or maybe you are due to pick up a child from daycare, but the waiting room is showing no signs of letting up. This bleeds into work productivity, a healthy home life, and creates stress and perhaps triggers other health issues. There’s a domino effect of just-in-time care. 

According to a Health Psychology Research study, “Quality of Life in Chronic Disease Patients,” while these diseases are slow in progression and long in duration, the majority hold the potential to worsen overall health by “limiting their capacity to live well, limit the functional status, productivity and HRQoL [health-related quality of life] are a major contributor to health care costs.” The study lists diseases including cancer, heart diseases, stroke, diabetes, HIV, bowel diseases, renal disease and diseases of the central nervous system. 

Data from the 2018 National Health Interview Survey (NHIS) estimated 52.8% of adults had at least one of 10 selected chronic conditions and 27.2% had multiple chronic conditions. 

If we know our employees are dealing with chronic conditions—and our claims reports prove it—how can we support preventive health? If the best way to “fix” the healthcare system is to not need it at all, a culture shift is in order. The good news is, there are resources and tools you can access and implement to positively influence healthcare usage and the overall lifestyle of your employees. Here are some ideas. 

Identify vulnerabilities. Start with consumers of your healthcare plan and their needs, then work into the financials. Review claims reports and summaries to understand the percentage of your population that is impacted by chronic disease. How does your messaging align with the data? The reality is, once an employee is diagnosed with a chronic condition, the resulting health issues, doctors’ appointments, and stressors are disruptive. The first step to changing the conversation is gaining insight on what exactly your people need in a health plan to optimize wellbeing and reduce the burden of disease so they can improve their lifestyles. 

Set the example. Cleveland Clinic reports that 80% of chronic diseases are driven by lifestyle factors like diet and exercise. As employers, we can make a big impact on helping our people adopt healthy habits, and you don’t have to do this alone. For example, the Health Action Council Fall Step It Up Challenge is a free four-week step program that allows you to register teams. One participant told us, “This challenge helped me get motivated to get out and start exercising again.” The 2023 In-Value-Able Conference & Expo kicks off in January for two months of strategic thinking, tactical solutions, and idea sharing that you can put into action in your organization. As employers, if we want our employees to adopt healthy habits, the example starts at the top. Are you taking a 15-minute walk at lunchtime or offering healthy snacks at staff meetings? Small changes create noticeable traction.

Develop partnerships. As employers, how can you get involved and engage more deeply in the conversation about our current healthcare model, gaps in care, and what role we can play together to change the trajectory? Do we need to “edit” the messaging we deliver to our employees who are the consumers? Consider playing an active role, whether that’s volunteering or serving on a governing board within your community. Bring your metrics and feedback about how your employees are using their benefits. 

Start the discussion: “We want to give our employees the support they need. This lifestyle disruption takes a toll. How can we make changes?” Share your stories. And be a part of the solution as a voice focused on helping individuals stay healthier. Awareness is crucial. By developing partnerships with thought leaders in our communities, we can work across sectors to gather perspectives and address the healthcare and wellness gaps that are driving up costs and deteriorating quality of life

About Health Action Council 
Health Action Council is a not-for-profit 501(c)(6) organization representing mid-and large-size employers that enhance human and economic health through thought leadership, innovative services, and collaboration. It provides value to its members by facilitating projects that improve the quality and moderate the cost of healthcare purchased by its members for their employees, dependents, and retirees. Health Action Council also collaborates with key stakeholders – health plans, physicians, hospitals, and the pharmaceutical industry – to improve the quality and efficiency of healthcare in the community.