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Mediocre Massachusetts Health Report Card: No A’s, Some D’s And F’s

Massachusetts may be a medical hub, but when it comes to what we do to encourage good health rather than good health care, we’re looking resoundingly mediocre. That’s the conclusion of a first-time “health report card” for the state put out by the Boston Foundation and the health policy foundation NEHI. From Nick King, vice president of NEHI:

The “Healthy People/Healthy Economy Report Card” grades policies on 14 different health indicators in four key areas: physical activity, access to healthy foods, investments in health and wellness, and citizen education and engagement. The grades were mixed – no As, five Bs, two Cs, four Ds, and two Fs.

The innovative report card is the first in the nation to focus on the effectiveness of public policies that encourage healthy living and controlling and preventing obesity and other chronic illnesses. This first annual report card should serve as a template for other communities and states across the country seeking to hold public officials accountable for the effectiveness and direction of their wellness policies.

Below is the report card in “at-a-glance” form. Here’s the Globe’s Chelsea Conaboy’s story on it and here’s the WBUR news story. My central takeaway: We can fiddle with health care reform all we want, but the best way to save money is actually to keep people healthier in the first place, using measures like those graded below.

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Tufts Health Plan Workers’ Premiums Rise Only Slightly!! The Message: ‘Wellness’ Works

What most hit me at this State House press conference yesterday was the contrast between what two leaders said about health costs. Paul Grogan, head of The Boston Foundation, commented that the rising price of health care had just been brought home to him very personally, when his office manager informed him that health care premiums at the foundation would be going up 14 percent next year. Ouch.

Then a few speakers later, Tufts Health Plan chief Jim Roosevelt offered a dose of hope that perhaps that rising cost curve really can be bent. Tufts Health Plan, he said, has 1600 employees, and in 2009, it paid $12 million for health care, with the employees paying $3 million out of pocket. This year, he said, “We kept our own health care cost increases to employees to 2%, when the average is 9%. There is a correlation between health care investing and health care costs.”

It’s a sad commentary on the state of health care, but a company raising its employee premiums only 2% struck me as significant news. How did they do it? Here’s what he said: The company has been subsidizing salads and fruits in the company cafeteria; it provides one-on-one nutritional counseling, and an on-site gym that one-third of employees belong to; it’s a smoke-free workplace.

Tufts Health Plan chief Jim Roosevelt

I followed up with Tufts Health Plan spokeswoman Patti Embry-Tautenhan. Did the Tufts employer contribution to premiums go up, perhaps? I asked. No, she said, adding in an email:

Jim would say that the fundamental change begins with changing a culture, which takes time.

For example, six years ago, most employees thought of the Tufts Health Plan 10K for Women as a marketing effort. Today, employees really embrace it as a signature event for the company, which expresses our brand, “No One Does More To Keep You Healthy.”

Employees, men and women, are encouraged to walk or run the 10K. This year, 360 employees ran/walked the course. There were more than 20 employees who cheered on the sidelines. The hope is that by encouraging employees to participate, even on the sidelines, maybe next year they will be inspired to walk it. Participation has increased year over year.

In addition, we have an annual “Team Lean” challenge modeled on TV’s Biggest Loser, which has occurred for three years. Teams of people participate for 12 weeks and win prizes at the end. To date, more than 4,027 pounds (two tons) have been lost by the participants or an average of six pounds/person/year. We promote it with the goal of healthy weight loss, which is 2% of the starting weight.

From Farmers’ Markets To Soda Tax, Coalition Aims To Make State National Wellness Leader

This graph says it all: We spend too much money on sickness and not enough on staying healthy. To parse it: 50% of how healthy you are depends on your own behavior. But only 4% of health care spending goes toward “healthy behaviors;” the system sits back while you gain weight or smoke or fail to exercise, then pours money into treating the chronic illnesses that may result.

A new coalition is taking aim at those numbers. Just announced at the Massachusetts State House, it is called “Healthy People/Healthy Economy,” and includes a broad, anybody-who’s-anybody swath of players, from legislators to health insurers to business leaders to public health officials to The Boston Foundation, which is spearheading the project with the New England Healthcare Institute. The coalition’s Website is here.

The state is already the national leader in medical care and also the national leader in access to that care, said Boston Foundation head Paul Grogan. “It is now time to assume a similar leadership position with regard to health and wellness,” he said.

How? The coalition laid out a plan of action that included measures anyone would be hard-pressed to argue with: increased physical activity for students; increased access to healthy foods; financial incentives to reward healthy behaviors.

And then there’s the potentially more controversial one: repealing the sales tax exemption on candy and soda, which would generate an estimated $52 million that could be used to help promote wellness.

Even without controversy, the coalition faces a battle against deep cultural norms. Chatting after the State House press conference, Rep. Jeffrey Sanchez, chair of the Joint Committee on Public Health, described the Puerto Rican habit of fried pork in the morning, fried pork in the evening. Changing that will come hard, he said.

P.S. Conflict of interest disclosure: I did gratefully accept one of the little pedometers that the coalition handed out at the event, and also a free sample of local, gluten-free Heartbreak Sauce, from