Finessing the high cost of health care

      Containment of health care costs isn't a new issue. In fact, governments ranging from small town boards to gargantuan federal agencies currently struggle to find ways to alleviate the escalating cost of health coverage at a time when a large, aging population threatens to overwhelm the system.

   The answer, some believe, lies in a uniform system, much like the ones employed by Canada and the United Kingdom but that option has been vastly unpopular with many Americans. Others advocate reining in hospital and pharmacy costs, tort reform and punitive measures aimed at the overweight and smokers. And while no single measure garners unanimous support, everyone agrees it's time to do something.

   The question is, what? And what exactly can law enforcement agencies caught up in local budget crunches do to help bring down the expenses associated with covering their officers and civilian personnel?

   This may seem like a rhetorical question, but it's really not. There are numerous things an agency can do to improve the overall health of agency employees, which results in a lowered use of medical benefits. And while that might not be enough to stem the tide of rising premiums, it can't hurt. Plus, the agency gets the benefit of fitter, healthier employees.

   Turning employees to the bright side isn't rocket fuel science. Mostly, it's investing in wellness and other programs designed to help them change bad habits into good. The real problem most law enforcement administrators face is getting everyone to buy into it. And that takes determination, the ability to ignore the inevitable complaints and most important of all, a plan of attack.

Wellness programs work wonders

   HealthMedia, a private company that provides digital health coaching, says it combines behavioral science with technology. According to company spokeswoman Caren Kenney, a wellness and prevention program must be supported by upper management and address both the individual and the organization as a whole; be comprehensive and address "the full spectrum of need from wellness to behavior health and diseases management," she says.

   Law enforcement officers are suspicious of change and don't like it for the most part. Getting them to willingly participate can be a challenge. She recommends overcoming that challenge by offering appropriate incentives. Privacy is another concern.

   Since HealthMedia uses a Web-based coaching program, which also offers a high degree of privacy to participants; those who take part can do so when it works for them. For individuals whose work days can start at 2 a.m. or 8 p.m. and who often work call duty, rotating or 12-hour shifts, receiving coaching or feedback on their own schedule is a big plus. A personalized program is designed for each participant based on factors such as individual needs, interests and challenges, Kenney says.

   "Health care premiums are expected to swell 8.9 percent in 2009 — well above inflation and salary increases. As organizations examine their budgets, the temptation to reduce or diminish funding for health programs is great. However, most recognize the urgency to promote healthy behaviors through wellness, chronic conditions management and behavioral health programming to reduce both direct and indirect health care costs," she explains.

   Wellness programs work by shifting the focus from treatment to prevention. The evidence strongly suggests wellness programs work and work well when done the right way. According to Kenney and other experts, wellness programs have changed a lot since the days of in-service training when a public health nurse lectured to a mostly tuned-out class of officers on the benefits of 8 hours of sleep (see Page 58 for tips on improving sleep and reducing stress).

   While wellness programs are an integral part of keeping employees healthy, Kenney says it works best when coupled with prevention.

   "Behavior change is the only way to ensure a sustainably healthy organization," Kenney says.

Manage the health care maze

   According to one study, 92 percent of survey respondents said they experience problems understanding their health care benefits. In actuality, probably every government employee has had occasion to puzzle his or her way through the health care maze, and since health care benefits aren't static, they continue to need reinterpretation.

   Figuring out what services are available, what your copayments are, when you can use your benefits and who can provide them are some of the biggest hurdles faced by agency personnel. Trustmark Mutual Holding Co.'s Ron Watt, second vice president of a division of the benefit administration and services business, says that, "given the situations law enforcement workers encounter on a daily basis, it's critical that they operate at peak alertness levels."

   Watt points out that law enforcement personnel are busy. Between training, court and working the demanding hours required of a career in police work, there are often few hours left for a personal life, much less time to devote to the complex language, rules and regulations of health care coverage and benefits. Turning to an outside company to guide officers through the process can result in better and more directed use of benefits, but also aid in keeping costs under control. That's why some agencies — like the Arkansas State Police — have added care management to their benefit packages.

   Although care management may not be for everyone, such services combined with a strong wellness program can help contain costs, use benefits wisely and provide long-term results that will impact your health care bottom line.

   A 12-year veteran of police work, Carole Moore has served in many law enforcement disciplines. She welcomes comments at

Take 8 (hours) and call me in the morning

   If wellness programs or care management are out of the question, there are still things you can do to promote better health and fewer trips to the hospital.

   You know that smoking is bad for you; so is not getting enough sleep. Eating lots of fast foods, not recognizing the importance of essential vitamins and minerals a body needs to maintain itself, and lack of exercise all contribute to obesity, poor health and possible serious illness in the future. And stress — well, some is inevitable in this profession, but that doesn't mean you can't reduce it. Remember a little stress goes a long way since it acts as a catalyst for blood pressure issues, leads to other bad habits like alcohol and cigarette usage and interferes with sleep cycles.

   Departments can many times obtain assistance with wellness through their local health departments at little or no cost, or through their insurance carriers. But even if you have outside help addressing wellness issues, it doesn't mean you shouldn't also look for solutions inside your department.

   Working around the clock, sitting in court after a full night's work, rotating shifts, following hot leads, making busts just as the shift ends, holding down extra jobs, attending training — all of these can factor into poor sleep. Getting a full 8 hours is vital to peak performance and something that can give your officers an almost-free energy boost.

Avoiding sleep deprivation

   While a solid sleep won't solve every problem, studies have shown sleep deprivation is a major player in poor health, stress and substance abuse. Here are a few techniques to help level the sleep playing field:

  • Permanent shifts can help alleviate some of the problems associated with shift work.
  • Black-out curtains or even black plastic trash bags taped to windows give the sleeper a nice, dark room conducive to rest.
  • Sleep masks help block the light in even the brightest room.
  • Earplugs can reduce noise. Soft, pliable plugs work best.
  • A "white noise" machine or even an air purifier on the night stand or next to the bed can screen outside sounds.
  • Avoid calling an officer during sleep time.
  • Reduce or eliminate caffeine on the job, at least toward the shift's end.
  • Although many agencies have already banned smoking, officers who haven't quit often benefit from group efforts. Reach out to your local health department or American Cancer Society.

Reducing stress...

   ... can change behavior. Strategies include:

  • Have supervisors watch for signs of stress and regularly meet one-on-one with officers under their command.
  • Have counseling available. An online service is ideal for privacy concerns.
  • High-stress assignments should not be forever. Change things around on occasion.
  • Listen to gossip: Yes, it's odious, but locker room talk can sometimes point you to an officer undergoing unusual personal stress.
  • Look for signs of alcohol abuse. Profuse sweating, the odor of alcohol on the breath, constant use of breath mints or gum, drinking heavily after going off duty, erratic behavior — all may be signs an officer needs help.
  • Invest in blood pressure cuffs — the automatic kind — and make them available for officers to privately check their blood pressure.
  • Look into stress-busting techniques like yoga and meditation.
  • Invest in a good set of scales so officers can monitor their weight — privately.
  • Be aware of your body and what is normal. Seeking help when something's out of whack before it gets worse helps tamp down expenses and keep officers healthy and working.

Lower the junk quotient

   Keeping costs down is all about prevention. And prevention is all about education and taking small steps:

  • Although banishing snack machines filled with empty calories and sugary drinks sounds like a good idea, it may not be practical when many must grab a bite on the go. But do encourage vendors to offer a few healthier alternatives, like low-calorie packs of microwave popcorn and no-sugar-added juices.
  • Encourage officers to get a move on. Sponsor a departmental softball team, field a recreational league basketball team, promote running or taking walks — the possibilities are endless.
  • Have supervisors send officers who are clearly sick home to recuperate, especially when colds and flu are rampant. Better to operate short one officer than have a whole platoon down.

   Lifestyle changes backed by administration can combine with wellness programs and care management to reduce the extent of illness and disease plaguing agency personnel. The key to holding costs down can be as simple as putting officer health first.