In October 2000, Blue Ridge Paper Products Inc (BRPP) hired Jessica Ellis. By Christmas of that year, she was playing a major role in implementing a program that would not only serve to control health care costs for the company but would change the lives of many of its employees.
Headquartered in Canton, NC, BRPP operates another mill in Waynesville, NC, as well as DairyPak plants in Georgia, Iowa, Ohio, and Virginia. With more than 2000 employees, health and safety for this self-insured organization is no small affair. Due to the dangers associated with milling paper, emergency medical technicians (EMTs) are on-site 24 hours a day at the organization?s Canton facility.
Back in 2000, these same EMTs noted a remarkable incidence of diabetes among Canton employees, and benefits personnel decided that a disease management program was the best way to respond. When Ellis arrived at her new post, her superior, Bonnie Blackley, instructed her to research ways in which BRPP could establish its own version of the Asheville Project.
The initiative was launched in the Canton facility in January 2001. At first, BRPP did not work with pharmacists, opting instead to use the medical expertise of its in-house EMTs. Soon after, the model established in Canton was rolled out across the entire organization to provide a full population health management program, with the participation of pharmacists and other medical professionals. ?I don?t think there is any type of health condition that we don?t have a program for,? Ellis notes. She serves as the company?s corporate manager of disability programs.
Participants must fulfill several conditions: for example, diabetes patients must attend a diabetes education seminar, monitor hemoglobin A1C and cholesterol levels regularly, and attend scheduled appointments with their monitoring specialists. Annual dental and eye exams also are part of the program, and all medications must be obtained through specified pharmacies. ?We have always required that they get their medications at specific places,? Ellis explains. ?At first, a lot of pharmacies didn?t understand when someone came in to get his or her medication. The pharmacy would try to charge the patient, who would say, ?No, I?m in the diabetes program, so I don?t have to pay.??
In Canton, employees enjoy the added benefit of using the company?s own dedicated facility, the Blue Ridge Paper Products Inc. Family Medical Center & Pharmacy, which only serves those covered under the manufacturer?s insurance.
Pamela Garrett, BRPP?s benefits service center supervisor, notes that the diabetes education seminars offer employees a networking vehicle through which they can compare notes with other people suffering from the same disease. The dedicated pharmacy in Canton also provides a sense of community. ?One of the big boosts to our program locally is that we have our own clinic and pharmacy,? she says. ?Our diabetic patients are being seen here by the nurse in our clinic in conjunction with the pharmacy over there.?
In modifying the Asheville model for BRPP, Blackley and Ellis drew up a program that was in line with BRPP?s specific capacities and restrictions. ?We decided that we would give them a free meter, free supplies for the meter, and the medications,? Ellis relays. ?We couldn?t do dermal medical equipment, such as insulin pumps.? Determining which medications to cover was also a challenge. ?People would say, ?You need to pay for my heart medication, or my kidney medication, because I wouldn?t be on that if I didn?t have diabetes.?? Eventually, it was decided that BRPP could not cover these auxiliary medications.
Ellis notes that by 2004, benefits personnel began noticing the model?s effect on BRPP?s medical costs. ?When most every company that offers group medical is seeing double-digit increases, we are staying relatively flat,? she says. ?We fully believe that it has to be our health population program.?
Before being diagnosed as a type 2 diabetic with high blood pressure, Mike Rhinehart admits he paid little attention to his health. Thanks to his employer?s implementation of a health management program? based on the project pioneered by the City of Asheville?Rhinehart is not only health conscious, he feels great.
?My A1C was 7.1 when I started, and it?s 5.7 now,? he recounts, adding that his blood pressure levels are now back to normal. ?I have gone from 256 pounds down to 216 pounds. I have stopped smoking. I am 60 years old, and I am more flexible than I have been in about 10 years because I exercise once or twice a week. I feel better just generally.? A swing shift worker, Rhinehart adds that it is now easier for him to get through the night shifts, and work in general is less taxing.
These changes took place gradually, and Rhinehart recounts that because of this, they were not that difficult to make. ?I worked with the program, my coach, and one of the paramedics down in the mill who monitors my glucose levels. He reads my meter and then puts out a report for me to give to my doctor,? he says. ?I didn?t lose 40 pounds overnight.?
Rhinehart notes that the mandatory diabetes education program served as a strong motivator for him to turn things around. ?The program works,? he says. ?They teach you to read labels. I didn?t pay any attention to labels on food; whatever was there and cheap, I bought.? Now, Rhinehart shops for quality over price. ?If I have to pay a little more for it because it suits my needs, I will do that, because it?s my health. I care about my health now probably more than I ever have. The program that I went to at the hospital really opened my eyes about what diabetes can do, and what it can lead to.?