Academic journal article Health and Social Work

Evaluation of a Corporate-Sponsored Health Care Program for Retired Employees

Academic journal article Health and Social Work

Evaluation of a Corporate-Sponsored Health Care Program for Retired Employees

Article excerpt

Health status in later life is determined not only by one's medical condition, but also by a variety of psychosocial factors, including health habits, coping strategies, social support, economic condition, access to health care, and other environmental influences (Broadhead et al., 1983; Catalano, 1991; Essex & Klein, 1989; Mailick, 1986). Modification of psychosocial factors such as these can be expected to maintain or improve physical well-being and reduce or delay the development of some acute illnesses (Fortman, Winkleby, Flora, Haskell, & Taylor, 1990; Rimer, Jones, Wilson, Bennett, & Engstrom, 1983; Smith, Smith, & Gilligan, 1988). This approach is based on a proactive model of health care that emphasizes health promotion and early intervention, in contrast to a reactive model that is concerned primarily with the treatment or amelioration of illness and disability.

Social workers are uniquely qualified to help older adults address the psychosocial conditions that can affect health promotion and maintenance. Studies have found that geriatric health care teams that include social workers can be more effective than traditional physician-only care for elderly patients (for example, Schmitt, Farrell, & Heinemann, 1988). Such multidisciplinary teams can help reduce hospital and nursing home admissions, decrease the use of prescription medications, protect functional health, lower mortality rates, and reduce overall health care costs (Rubenstein, Josephson, Wiseland, English, & Kane, 1984; Schmitt et al., 1988; Williams, Williams, Zimmer, Hall, & Podgorski, 1987; Yeo, Ingram, Skurnick, & Crapo, 1987).

Social workers, more than any other members of the health care team, are trained to assess and monitor the interacting effects of health, lifestyle, and psychosocial conditions. Social workers can help ensure that a health care plan adequately reflects the older person's ever-changing social, cultural, familial, economic, and environmental conditions and that it includes optimal use of available community resources. This monitoring can result in a more proactive approach to geriatric health care, including provisions for fostering and maintaining behaviors that help prevent disease and maintain good health.

This article evaluates a corporate-sponsored health care program for retired employees and their families that included social work representation on the multidisciplinary health care team. Implications for social workers in the health field are discussed.

GENERATION PROGRAM

Like most U.S. corporations, Southern California Edison (SCE), an electric utility company that serves more than 3 million California customers, is concerned about the rising cost of health care, particularly because nearly half of full-time employees continue to be covered by employer-supported health care plans after retirement (Clark & Kreps, 1989). The Health Research Institute has estimated that the average Fortune 1000 company must allocate nearly 40 percent of its net earnings each year to regular and retired employee health benefits. Health benefit obligations to future retired employees by the country's 500 largest industrial companies exceed $2 trillion (American Association of Retired Persons and Pacific Presbyterian Medical Center, 1988). Contributing to these dramatic increases in health care costs are increases in life expectancy accompanied by more years of illness, disability, medical treatment, and hospitalization; the trend toward early retirement, which results in increased health care expenditures for retired employees; and general increases in the cost of employee health care, with employer contributions increasing more than 400 percent from 1975 to 1985 (American Association of Retired Persons and Pacific Presbyterian Medical Center, 1988).

Prompted by projections of future health care cost increases, in 1988 SCE's Health Care Department undertook an innovative clinic-based program designed to provide cost-effective geriatric health care services for its 9,000 retired employees and their dependents while containing health care costs. …

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