When diagnosed with a serious chronic or life-threatening health condition, such as cancer, congestive heart failure, or multiple sclerosis, individuals face a critical need for information about the diagnosis, treatment, cost of care, support available, and possible functional limitations due to disease progression or treatment side effects.
As an employee navigates the complex terrain of a serious diagnosis, not to mention health care financing and delivery systems, employers increasingly recognize that the capacity and wherewithal to perform a job depend on guidance and decision support, sometimes provided within the company and most often provided within the family or community. This type of support can make or break a family’s capacity to earn a living and stay insured when they need coverage the most. In particular, self-insured companies have a significant stake in helping employees manage the implications of catastrophic illness, whose costs can make or break the viability of a business.
Many employers are investing considerable resources in strategies to reduce health-related productivity risk.1 According to a 1995 report nearly 95% of US companies reported having wellness programs or planned to incorporate a wellness program into their benefit package.2
Meanwhile, faced with exponential growth in health premiums, employers increasingly shift financial risk to employees in the form of increased cost sharing and high-deductible plans.3 Health market and benefit analysts agree that along with this responsibility must come education to “engage” consumers in their own care.4
Moreover, as for-profit patient advocacy firms spring up across the country,5 innovative models that increase the long-term capacity of employers and consumers to effectively navigate the health care system—-models that teach employees to fish rather than do their fishing for them-—warrant investigation.
Finally, 98% of Wisconsin companies employ less than 500 workers.6 Because of their size, these companies experience immediate implications of a significant employee illness. Small businesses also tend to have less bargaining power with health plans and provide fewer “perks,” such as wellness, smoking cessation, weight loss, or disease management programs.7
The Center for Patient Partnerships at the University of Wisconsin is a non-profit educational center offering free advocacy services to patients facing serious health conditions. A key principal guiding the Center’s approach is to build capacity among consumers and their families to navigate an increasingly complex health care system. This model acknowledges the entrepreneurial and self-sufficient spirit of the majority of Wisconsin workers.
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