Mark Gow is the 2007 Benefits Management Forum & Expo Benefits Professional of the Year.

At a time when most companies are struggling to contain their medical spending, Mark Gow, HR director at IAP Worldwide Services, has managed to produce uncommon cost savings in his company's health plan through a carefully designed disease management and prevention program.

Gow is "an extraordinary visionary," says Deborah Ault, president of Ault International Medical Management, which provides the disease management services to IAP Worldwide Services. "With Mark, it was more about the people than the cost all along, which is a really unique stance in today's world."

Among his other attributes and accolades, Gow's skill and success in dramatically reducing his company's health costs earned him this year's Benny Award for Benefits Professional of the Year.

Attacking medical costs

Like most U.S. companies, IAP Worldwide, a government contractor headquartered in Cape Canaveral, Fla., was feeling the pinch of rising health costs. In 2003, the health plan was in dire straits, with a nearly $4 million shortfall on $12 million in claims. The troubled plan faced a takeover by the Defense Contract Audit Agency, which proposed to segregate the assets into separate government and commercial accounts.

IAP's self-funded health plan covers 14,000 employees in more than 70 U.S. locations and at least 10 international locations, with about half of the workforce assigned to government contracts and half commercial.

With Gow's leadership in 2004, IAP (formerly Johnson Controls World Services) began using a patient-centric disease management program with evidence-based clinical care guidelines, allowing the health plan to generate immediate impact and reinvest saved money into additional services.

This new approach yielded steady progress toward an employee population that is well-educated and empowered to use preventative health measures, early intervention for health problems and best-in-class medical care. Resources were allocated to the areas of highest need through the results of data mining.

The first step was creating utilization management, case management and maternity management programs, which decreased projected claims by $54.11 per member per month. The number of hospitalizations per 1,000 members fell, as well as the average length of stay.

The next step was to identify health risks using medical claims data and employee surveys. Workers reported making lifestyle and behavior changes based solely on the survey. Registered nurses called patients and sent mailings to educate patients about their health conditions. Ault calls this an outreach model, as opposed to an opt-in/opt-out model.

By the end of the first year of these interventions, IAP's self-funded health plan went from a $3.5 million deficit to a $4.5 million surplus, a remarkable turnaround. Emergency room visits almost disappeared, as did premature births. The health plan now offers preventive services at no cost to patients, and the savings were used to enhance benefits.

For example, the company made test strips and glucometers (to measure blood sugar levels) free for diabetics to encourage compliance with doctors' orders. Gow says his efforts to revamp IAP's health and wellness efforts were guided by several basic industry truths:

• Prevention costs less than a cure.
• Quality care costs less than substandard care.
• Noncompliance with recommended medical treatments is expensive and dangerous for the patient.
• People will take the path of least resistance, including the path of lowest cost.

Most patients don't understand how to pick quality doctors and hospitals. The answer lay in writing down these truths and looking at our claims experience," Gow explains. "We just went after the places that were the most at-risk or the most expensive. It was very, very aggressive" in finding patients who needed help, such as smokers or people who missed recommended cancer screenings.

Overall, "we wanted to stop the growth of the cost and create a process that is replicable," he notes. Ault recognizes that is a difficult task that requires persuasive business skills. "Mark takes an approach that right is right, and you have to do what's right for your employees and your business," she says. "He does a good job of marrying up the people with the business" and making the business case to the executives. "He doesn't mind leading both up and down. He is a true 360-degree leader."

Well-rounded in HR

Gow started his HR career in several jobs that focused on training and development. "I like the idea of helping people learn, grow and develop. I think that's how it started for me, and it just expanded from there," he explains. He likes doing HR work because "you're in the position where you can make a difference. You can help people. That's the most satisfying part of the job." He says the biggest challenge in the job is convincing senior management to approve and fund new benefits or new programs.

Ault points out the reasons why Gow is effective: "He's probably the biggest evangelist in his organization about health, about benefits, He's a great communicator, and he also leads by example. He shares his own stories." She adds, "He's such a strong, well-rounded individual that he's one of those people that you say, I want to be like him when I grow up.'" In fact, after meeting Gow, Ault's young son declared he wants to work in HR when he grows up.

For ambitious HR/benefits professionals looking to advance their careers, Gow recommends, "Start by understanding the data. If you follow the questions [that arise in the data], you'll find the path out." Beyond that, he also advises, "Keep training, keep learning and keep developing. Surround yourself with smart people."

Now that the changes to IAP's health benefits are in place, Gow is spending more time on HR information systems, labor relations and employee training. "The role of HR is rapidly evolving. It's become more strategic and critical. The ability to attract and retain the right people is becoming more difficult," he asserts. "Benefits are becoming more and more critical."