Any company would be deliriously happy with an in-house health-care program that saves nearly $1 million a year and offers lower insurance premiums, fewer workdays lost to illness and doctor’s appointments, and high-quality employee care for less money. But SRA International, Inc., a Fairfax, Virginia-based provider of information technology services to government and corporate clients, values its Nurse Advocacy Program for another reason. The company’s innovative system for monitoring and managing medical problems has helped employees who otherwise might have become too ill to work at all. Instead, it has enabled them to have successful, productive careers.
There was the SRA employee with Parkinson’s disease who suffered from chronic, incapacitating dizziness–until the company’s nurse advocates analyzed his case and discovered that he was taking an overdose of medication. Another employee’s diagnosis of kidney failure might have forced him to retire on disability. Instead, SRA nurses devised a flextime schedule that allowed him to reduce his workload on days when he was fatigued from dialysis treatments. Another employee’s job performance was hindered by bouts of severe back pain, which vanished after an SRA nurse convinced her to try a regimen of stretching and exercises, and then monitored her to make sure she followed the prescription.
“We started the program with the intention of saving money on health care,” says Ted Legasey, SRA’s chief operating officer. “We figured that if 20 percent of your cases result in 80 percent of the insurance cost, the trick is to manage the heck out of those cases. And it worked. For the last four years, for example, we’ve had single-digit increases in our insurance premiums, compared to 20 percent for the rest of our industry. But we also discovered that there were plenty of other pluses that we hadn’t anticipated. We could really make a big difference in employees’ lives. That’s really paid off in terms of loyalty and job satisfaction.” For the past four years in a row, Fortune magazine has rated SRA one of the best 100 companies to work for in America, an assessment based in part on confidential surveys of the workforce.
Many large companies, from automotive giant Nissan to aerospace and electronics manufacturer Honeywell International, have some kind of on-site medical program for workers–often through contractors such as Whole Health Services in Cleveland, which operates clinics for 40 U.S. companies. But according to health-care experts, it’s unusual for a company of SRA’s modest size–2,100 employees, located mostly at the Virginia headquarters and 10 other sites in the Washington, D.C., area–to offer such a program.
SRA goes far beyond the conventional occupational-medicine focus in treating work-related injuries and illnesses. “The traditional approach is sort of like the school nurse, taking care of anyone who gets sick,” says Kay Curling, SRA’s director of work/life solutions, who runs the Nurse Advocacy Program. “We do that, too, but afterward, we keep working with people to help them stay well.”
SRA, which operates a clinic at its headquarters and sends its three-nurse staff to visit other sites, strives to proactively manage the cases of employees who seek care. In addition to checking the blood pressure of employees with hypertension and monitoring asthma sufferers’ lung function, SRA’s nurses will suggest diet, exercise and other lifestyle changes, and then monitor the patients to make sure they’re following directions and benefiting from the recommendations.
“Health costs are increasing because health care isn’t getting to the root of the problem,” Curling says. “You can’t just treat symptoms. You’ve got to coach people and help them to change underlying behavior that contributes to the problem. Their regular doctors don’t have time to do that, but we can.”
SRA’s nurses also help employees cope with one of the most stressful health-related problems–the difficulty of caring for a sick family member, whether it’s a child with cancer or an elderly parent who is frail. “If mom and dad are in another state, and they’re having a lot of problems, you may spend a lot of your workday calling around and trying to find help for them,” Curling says. “Here, you can bring in their medication list and have our nurses look at it, to be sure they’re getting what they need.”
SRA also does its own aggregate analysis of employee health cases–with the identifying data stripped out, for privacy protection–in an effort to spot patterns of health concerns in its workforce that the company can remedy. “Our data showed a correlation between the birth of new babies and emergency-room visits,” Curling says. “As a result, we saw that our people could benefit from a new-baby coaching program. We teach them some basic skills, so that if it’s 4 a.m. and the kid is crying, they have other options besides rushing off to the ER.”
Because SRA puts so much effort into managing employees’ health, it also is able to keep a tight rein on costs. The company often has been able to reduce the financial reserve required by the insurance underwriters by showing them that cost projections for disability benefits are unnecessarily high.
SRA’s health-care ingenuity often does get employees back at their desks with startling speed. For example, when one employee suffered a serious fracture of her wrist, Curling recalls, the workers’ compensation insurer proposed keeping the woman at home for 10 weeks to heal. “One of our nurses, Karen Amato, started working with the employee to analyze the problem,” Curling says. The answer was voice-activated computer software, which would allow her to work and let the wrist heal, without taxing her other arm. “Instead of 10 weeks, the person was back at work in nine days, and she was a lot happier.”
Workforce, July 2003, pp. 41-42 — Subscribe Now!
