Just what the doctor ordered Featured

9:58am EDT July 22, 2002

In the early 1990s, the health care situation at Sanese Services faced a grim diagnosis.

An aging work force with health problems—many caused by smoking—was sending the company’s medical claims through the roof.

“Here it is 1991, health care costs are rising, profit margins are reducing. We’ve got to get a handle on our health care costs like any other costs we would have,” remembers President Ralph Sanese Jr.

In fact, by 1993, those medical claims were on pace to top $3 million. To avert financial troubles at the company—and avoid the risk of having to halt benefits for employees—Sanese took drastic measures. By prohibiting smoking at the company, instituting wellness programs and bringing a doctor on site every week, he’s managed to reduce health care claims by nearly 50 percent—even while his work force grows.

Assessing the patient

Growing up in the family business, Sanese remembers huge ashtrays on desks and smoke-filled conference rooms.

“It was common to walk out of there and I could hardly breathe,” he says.

In 1993, the company took the first step toward a healthier work force by prohibiting smoking—but only after telling employees why. At company meetings, he showed them how nearly 80 percent of the company’s health care dollar—money that could have been returned to employees as profits—was used to treat circulatory problems.

“We had to change a whole culture of people who were unhealthy,” he says, pointing out that the vending and catering company got its start in 1946 by selling cigarettes.

Sanese also began working with Dr. Stephanie Cook, medical director for the Ohio State University Department of Emergency Medicine’s Tailored Health Care program, recently renamed Prompt Care Plus.

Her first move was to survey employees and develop programs to help resolve the leading problems, such as hypertension, inactivity and high cholesterol.

In one year alone, she referred 88 patients to primary care physicians for various problems, found 20 new hypertension patients, one of whom had an inflammation of the heart lining, and diagnosed five new diabetics. Of 16 people found to have high cholesterol, 12 were brought within normal limits simply by following her advice regarding changes in lifestyle habits, while four required medication to correct the problem.

Cook now visits Sanese’s North Columbus headquarters weekly, wandering among employees in every department, including office, warehouse, kitchen, distribution, customer service and accounting, to talk to them about their medical needs. She and nurse Ruth O’Brien-McMullen provide tetanus and flu shots, diagnose and treat existing problems such as colds or coughs, refer employees to specialists and test cholesterol and blood pressure.

Included in Sanese Services’ wellness programs are exercise classes and smoking cessation courses, immunizations, mammographies, hearing tests and a once-a-month massage therapy day. Most programs are free to employees.

Julie Russell, a dining service specialist at the company, found out first hand the benefits of having a doctor at the company.

One morning before work, she became paralyzed with pain and could barely lift her arms. By the time she got to work, she was nearly crying. The massage therapist, Ritah Clark, was in that day and helped Russell recover—and stay at work.

“I never considered going straight to my doctor,” Russell says. “I knew Dr. Cook could help me right here and I knew I wouldn’t have to miss work and didn’t have to pay my $20 co-pay.”

“We are not to take the place of primary care physicians,” Cook points out. “The problem is, employees can’t get to them. We provide a bridge to care—we deal with things that can be dealt with quickly, but get people into the system as well.”

On the road to recovery

Sanese knows he’ll have to continue the wellness programs to keep reaping the benefits. Of his 1,100 associates, nearly 60 percent are older than 40. He’s also seen how the program has paid off as nearly two-thirds of his work force actively participates.

He also believes he, himself, must help employees understand the reasoning behind the changes and lead by example. For instance, he watches what he eats since Cook suggested he take a cholesterol-lowering medication, and he often meets with managers off-site in a location where they can exercise.

Sanese invests approximately $3,000 a month in programs provided by Cook and has brought the company’s annual medical claims down to $1.6 million. According to a study Cook conducted of the 1996 program, the direct costs of her services—had employees sought them elsewhere—would have amounted to more than $80,000 a year for Sanese, and lost wages would have exceeded $39,000. Sanese provides incentives, in the form of health care benefit discounts, to employees who commit to healthier lifestyles through, for example, smoking cessation or regular exercise.

“We can’t force this on employees,” says human resources director Judy Elliott, “but we can get information in front of them so they can make the right decisions themselves.” For more information, contact Dr. Stephanie Cook of Prompt Care Plus at 293-2054.

Joan Slattery Wall is a reporter for SBN.