INCORPORATING CORPORATE EMPLOYEE HEALTH (CEH) PROGRAMS INTO

PRIVATE PRACTICE TO CREATE THE TOTAL WORKER WELLNESS MODEL

Russell Certo, PT, OCS
William McCormack MS, PT, CSCS
Tracy Ervin, MPT
Therapists offering traditional Occupational Health Programs are trying to find ways in
which we can expand our relevance/presence within the changing medical delivery
system and grow our own businesses. One method to achieve this goal is to develop a
corporate employee health (CEH) program that focuses on worker wellness. A good
CEH program adds value to the traditional services (FJA, FJD, PWS, ergonomic
analysis, etc.) that we are already providing to our employers, creating a total worker
wellness model in which we can practice.
Center for Physical Rehabilitation (CPR), in an effort to diversify our practice and stay
relevant in the evolving medical delivery system, adopted the M.O.G (Medically
Oriented Gym) in 2015. The M.O.G. at CPR is part of a co-op of national clinics,
providing evidenced based programming that is supported by outcomes. The M.O.G.
offers services to healthy people, as well as individuals that may be medically
compromised (obesity, diabetes, heart disease, arthritis, etc.). Through medically
supervised programs that provide fitness, nutrition, education, and guidance, the
M.O.G. has been able to bridge the gap between medicine and fitness, reducing health
risks and health care costs through risk-reduction programming. The programs and
outcomes demonstrated by the M.O.G. set us apart from other providers in the
community that are offering wellness services.
In addition to serving the general population, the M.O.G. provides specialized programs
to address the needs of employers as they continue to look for innovative means of
improving worker wellness and decrease the costs of health care utilization as well as
workers comp claims/injuries. The M.O.G. includes CEH programs focused on building
and maintaining a healthy/low risk employee population. These programs have
demonstrated cost savings through a reduction in obesity related health conditions,
injury reduction, increased productivity, and reduced absenteeism.
It is our belief that companies that are self-insured for healthcare would benefit greatly
from adopting the M.O.G. model as their employee health and wellness program.
According to the Employee Benefit Research Institute 52 percent of employers are now
self-insured companies.1 Because of certain provisions within the Affordable Care Act,
it is estimated that over the next 5 years, 75 percent of all employees in the private
sector will be covered by self-insured health insurance.2 Currently, the most common
form of wellness programming provided by the employer is an online health risk
assessment (HRA) whereby the employee voluntarily answers a series of questions
online and the software program provides an analysis and simple strategies for

improving health risk markers. In almost all instances, these self-insured employers are
provided some data analysis by their third-party claims administrator or contractors but
are never given appropriate or effective strategies for actually engaging employees in
healthy lifestyles. We believe that therapy following the M.O.G. model can become the
whats next solution for CEH programs.
Consider these Case Studies:

In a study of 102 chronic disease patients following the M.O.G. model, we

were able to reduce the total cost of healthcare on average $4,000 per
participant. This cost savings was measured against what Blue Cross Blue
Shield of WNY had predicted for these patients. Additionally in this study we
were able to show migration from high risk pools to moderate risk pools. 3

In another study, Harvard Pilgrim Health placed 66 pre-diabetic patients into

the M.O.G. and after a 6 month M.O.G. intervention none of these patients
progressed to a diabetes diagnosis. Research has demonstrated that 1/3 of
these patients would have progressed to diabetes, 1/3 would have remained
pre-diabetic and 1/3 would have managed their lifestyle and improved their
health independently. In terms of cost savings, a diabetic patient will cost about
$10,000 more per year than a patient without a chronic disease. In terms of the
Harvard Pilgrim Health study the M.O.G. intervention saved the payer $200,000.
Harvard Pilgrim Health will also obtain downstream cost savings beyond the 6
months of M.O.G. intervention. 4

In 2010, a risk-reduction study was carried out on 252 high risk firefighters
in HowardCounty, Maryland. This study demonstrated a 40% reduction in
recordable injuries during year 1, 60% in year 2 and statistically significant
weight loss with an overall Return on Investment (ROI) of 4.6:1. 5
In the self-insured corporate environment these kinds of cost savings are obtainable
and have proven to work at companies willing to change the culture of healthcare use
and make employee health a strategic initiative. There is enough evidence that proves
that a corporation can incentivize their employees to become responsible for their own
health and to partner with the employer to make smarter cost saving decisions when
the employee is in need of healthcare. It is reasonable to expect that the therapist
embedded in a corporate environment could assist in designing and developing a better
employee health plan. The role of the therapist is not just in terms of workers comp/work
site injury and employee health intervention, the onsite therapist could be seen as the
CEO of the healthcare department. The final step in developing an all-encompassing
employee heath model would be to bring Primary Care Services into the workplace, to
manage and stay ahead of chronic disease.
Self-insured companies are perfectly positioned to take advantage of the M.O.G. model,
however those companies that are not self-insured can also benefit. Working with the
M.O.G. and the insurance company, strategies can be developed to use claims data
that would drive down the total cost of care for employees, reward them with deposits

into Health Savings Accounts and share the savings between the Employer and the
Insurance Company. Risk reduction analyses have demonstrated significant impact of
the health and well-being of employees. If a company is trying to slow the rise of
healthcare costs among their employees, especially for those with moderate to high-risk
preventable diseases like pre-diabetes, diabetes, obesity, cardiovascular disease and
even cancer, the M.O.G. can help.
In addition to the CEH programs, bringing on the M.O.G has allowed for flexibility on the
traditional reactive side of our Therapy practice in regards to the Workers Comp
arena. The M.O.G. has programming that serves workers that are recovering from
injuries. This program, called the REALM (Rehabilitation, Exercise, and Life
Management) program, creates a bridge between skilled therapy and full time return to
work. It allows for continuation of a supervised exercise program once the injured
worker is no longer in need of formal therapy, but is not yet ready for full RTW. It
provides exercise and work conditioning activities specific to the unique medical and
musculoskeletal issues of the individual, to help prepare the injured worker for a safe
return to full time employment. This program can be provided at a fraction of the cost of
continuing traditional therapy and/or work conditioning/hardening. Employers,
physicians, and insurance companies have quickly realized the value of this program as
a tool to help control the overall cost of claims, yet realize successful outcomes.
Through the adoption of the M.O.G., with its innovative programs to assist with
corporate employee wellness and bridge programs for RTW, coupled with our current
traditional occupational health programs and partnerships with WorkWell, CPR can now
offer employers the total worker wellness model. These programs are based on best
practices, are evidence-based, and produce the outcomes needed to set our clinic apart
from a very competitive market in an emerging new healthcare model. We all recognize
that if we do not adapt to changes in health care, we will become irrelevant and our
business will struggle. As a group, we have realized that we can make a difference by
providing appropriate exercise to medically compromised patients who cannot be
served by the neighborhood fitness club and the local YMCA. We are the experts at
delivering these medical fitness prescriptions and we are accepted members of the
health care delivery system. Our growth in private practice for the single entity office
and for the large multisite therapy business is in coordinating lifestyle management
services that drive the cost of care down, flattening the cost curve, and sharing in those
cost savings. These opportunities provide us another chance to serve our communities,
work within the medical delivery system, and maintain our presence, relevance, and
standing within that system.
Russell Certo, PT, OCS, of MOG at Grand Island Physical Therapy PC. He can be
reached at1themog@gmail.com.
William McCormack MS, PT, CSCS, of MOG National. He can be reached
at bill@mainemog.com.
Tracy Ervin, MPT/Owner at CPR (Center for Physical Rehabilitation). She can be
reached atcprtracy@gmail.com.