Pfizer - Premier Employer Program  Evaluation Summary

Highlights of Program Results

Methodology

Significant investment in integrated data systems and analyses enables Pfizer to effectively monitor and evaluate the impact of existing initiatives, and identify areas for continued improvement so health care resources can be used to their greatest potential. Analyses that support the health care strategy include:

• Data to evaluate program effectiveness are collected by on-site clinics and fitness centers including biophysiological measures, self-reported data, and other methods to allow ecological, before and after, and control comparisons.
• Hewitt Associates’ Integrated Health Information System (IHIS) to maintain on-line three years of individual-level medical claim and enrollment data for the Pfizer indemnity population. Analyses are performed using a total episode of care approach that account for inpatient, outpatient, laboratory, x-ray, and pharmacy services. All data are adjusted for demographic factors.
• For the managed care population, health claims are evaluated for plans that have data available, facilitating longitudinal and comparative analyses. These comparisons involve commercial populations only, therefore adjusting for a healthy-worker effects.
• Hewitt Health Value Initiative (HHVI) utilizes information collected annually from employers (including Pfizer), and hundreds of health plans. This data facilitates longitudinal evaluation of clinical indicators of quality health care. A Pfizer-specific request for information supplements this process and adds more in-depth information regarding quality indicators.

In 1997, Pfizer piloted an ergonomics program for employees in their Manhattan, NY location. The program consisted of group educational sessions and individual workplace evaluations. Participants were asked to respond to a baseline and post-program survey to determine if the ergonomic program resulted in reduction in symptom intensity, increased productivity, and functional status. Standard measures including the SF36 questionnaire were used to compare pre/post values as well as to provide comparisons to national standards for functional status. Program participants reported reductions in symptoms while non-participants reported increased severity. Participants also had increases in SF36 scores, especially in vitality and role/physical areas suggesting increases in productivity post-program.

Participants reported a 1.5% increase in productivity post-program, which translates into savings or ROI of 3.51:1 and net savings of $1,153,206 for participants.

Physical Therapy Program

Since 1992 Pfizer has offered physical therapy services on-site to employees in its Manhattan, NY location. These services are offered to ensure that employees can conveniently access quality therapeutic services, and to reduce the amount of lost work time for these employees. Approximately 210 patients participated in over 3,000 physical therapy sessions on-site from 1994 to 1997. In 1998, a study was performed to evaluate the cost effectiveness of the on-site services. Results include quantitative measures including a reduction in claim costs related to musculoskeletal and physical therapy services and qualitative measures including pain reduction scores and satisfaction with the program. This program generated an average ROI of 2.38:1 over the study time period (1994–1997), and produced over $590,000 in savings related to employee lost time avoided by on-site access to services.

Fitness Centers

On-site centers have been in existence for over 10 years and are staffed by exercise physiologists who assist employees in reaching their fitness and weight loss goals via education, counseling and assistance with regimen compliance by incentive programs and relationship building. In 1998, the ROI for this program was 4.29:1. This was based on average savings per participant when compared to non-participants and reflects saving from absenteeism, turnover, performance, and productivity.

Disease Management Programs

These are administered on-site and include design features such as before and after comparisons and prospective cohort follow-up. Programs have been selected based on high prevalence diseases in a working population and include osteoporosis, hypertension, lipid, and weight management. Interventions include patient monitoring and compliance education, health risk reduction, and provider education.

Result highlights of disease management programs include statistically significant reductions in lipid levels for Lipid Management program participants. Baseline information for the osteoporosis and weight management programs indicate that the risk screening and outreach successfully identified and recruited individuals who are significantly at-risk for illnesses related to these conditions. Baseline measures also have been obtained for the Hypertension Intervention Program and preliminary results suggest that participants achieved reductions in mean systolic and diastolic blood pressure.

Medical Clinics

Pfizer has on-site clinics in several locations. These services are available in Groton (Connecticut), Brooklyn and Manhattan (New York), and Parsippany (New Jersey), Terre Haute (Indiana), and Puerto Rico. They have been in existence in some locations for more than 10 years, and include finite primary care for acute conditions (upper respiratory/urinary tract infections, dermatological, musculoskeletal conditions), case management of chronic health conditions (asthma, diabetes, cardiovascular disease), disability case management, and health counseling. The clinics are staffed by primary care physicians, physician extenders, and occupational health nurses /associates. To enhance coordination with the health plan, the clinics are participating providers in health plans that Pfizer offers in several of these locations.

By improving access to health care, clinic providers are able to treat and manage health conditions earlier in the disease process resulting in better outcomes for the patient and improved demand and cost management for Pfizer. In addition, clinic providers are involved in driving behavioral change in patients. These changes are often driven by the trusting relationships that are established between the provider and patient. The resultant ownership that takes place improves medication compliance and results in dietary changes, smoking cessation and other lifestyle changes that lead to primary, secondary, and tertiary prevention.

Wellness and Health Education Programs

Wellness programs are implemented through the clinics and fitness centers and include breast, prostate, colon, and skin cancer screening and awareness, nutrition education addressing a broad spectrum of health issues (e.g., diabetes, osteoporosis, pregnancy, and weight control), cardiovascular risk screening/reduction, eye care updates, pediatric health, and stress management. Lyme disease prevention education has been targeted to regions where this disease is endemic, in particular for Connecticut employees and dependents. Appropriately credentialed personnel and outside resources including physicians, nurses, and psychologists present programs. Programs can include on-site screenings and 30–60 minute lectures, and individuals in need of additional assistance are referred to targeted disease management programs following the group sessions.

Welfare Benefit Design Initiatives

Pfizer offers to its employees a broad choice of health coverage options including multiple indemnity and managed care options.

• The Pfizer Quality Assessment Initiative has been in existence for three years and is an effort to identify areas for health care quality improvement through assessment of Pfizer’s managed care data collected annually by a survey, then reviewed by follow-up health plan audits. Health care delivery areas assessed include primary prevention (Healthy People 2000 goals for mammography, pap smears, childhood immunizations), disease management, utilization review, and case management, and customer service. This information is then reported to employees as part of Pfizer’s benefits enrollment process to provide assistance in making informed health care coverage decisions.
• The Pfizer Health Plan (indemnity) population claim data are reviewed annually through Hewitt’s IHIS. Primary prevention, disease management, and case management are focused areas for continuous improvement initiatives.

Pfizer is fully committed to creating and maintaining the best health and well-being programs for its population. Future directions for the Pfizer premiere employer initiative include:

• Use of Health Risk Appraisal data as a diagnostic tool to target risk reduction, screening, and educational programming. The HRA will be repeated periodically to provide comparison and to redirect health management efforts.
• Continued thorough assessment of health returns and ROI to ensure efficient and judicious use of health care resources.
• Leverage of leading-edge technology applications (e.g., Internet, intranet, voice response) to ensure convenient access for the entire population, regardless of work location or situation.
• Implementation of all programs to spouses and dependents (some are currently available for employees only).