Alisa Ford, senior director of human resources for the University of Kansas Hospital Authority in Kansas City, Kan., may be as uniquely qualified as anyone to gauge the impact of health and productivity management (HPM) programs on about 4,400 employees.

Not only is she fluent in the language of clinical data and outcomes by virtue of working in the health care industry, she's also a CPA by training - as is the hospital's CEO - and the value of having a number-cruncher at the helm of HR in this difficult economy can never be underestimated.

"We really recognize what data brings to the table to improve the health of our employee population," she told attendees of the 2009 Health and Productivity Forum, co-produced by the Integrated Benefits Institute and National Business Coalition on Health.

The University of Kansas Hospital, which has been named to popular magazine lists of the nation's best and most wired hospitals, identified during an employee survey and data collection process certain behavioral and health conditions that included obesity, high blood pressure, back pain and stress. The results, which were consistent with health-risk assessments, also showed that the prevalence of cardiovascular disease and total cholesterol were found to be higher than national averages.

Ironically enough, there was a high volume of emergency room visits (about 750 in the hospital's 2007 to 2008 fiscal year). When questioned about this after her presentation, Ford blamed the outcome on a supplemental health plan design that waived copays and deductibles for employees who sought care in hospital facilities, including the ER, and did not charge premiums over and above the basic plan. She surmised that in some cases, employees without a need for urgent care over the weekend might not have wanted to wait for their primary care physician's office to open.

At any rate, in response to this trend, employees now must pay half the ER bill at $50 per visit in hopes that they'll shop more carefully for their health care. About 80% of employees participate in the hospital's health plan, whose monthly premiums range from $60 to $400.

The hospital identified a number of opportunities for a return on investment, which Ford said is difficult to get one's arms around. The process involved cracking down on runaway costs in several areas. From a prevention standpoint, employees can save $120 on their health care premiums each year by agreeing to fill out an HRA. The hospital also is working on developing additional wellness incentives.

Another issue is that 1,100 hospital employees were found to have taken some sort of intermittent family and medical leave, but the claims are now managed more carefully with the help of protocols that have been put into place, and the expectation is to reduce costs in this area by about 30%. The hospital determined that there was a need to outsource the integration of absence, disability and leave management data, which resulted in improved absence reporting.

Two of the most critical HPM issues in a hospital setting are absenteeism and presenteeism. With regard to the latter, doctors, nurses, technicians and other key medical personnel obviously need to be at their best when treating patients. The hospital, whose compensation and benefit costs run about $300 million, estimates that its lost productivity costs about $15 million based on industry benchmarks.

With so many HR departments understaffed, particularly in this economy, Ford encouraged attendees to lean on their vendors and other partners as handy resources when creating and managing HPM initiatives.

The hospital is a member of the Mid-America Coalition on Health Care as well as the group's Kansas City Collaborative, whose 17 diverse member-employers are in the midst of a two-year pilot program to assess the effectiveness of value-based health and productivity interventions. The group's benefit design minimizes or eliminates out-of-pocket costs for high-value services that are identified through scientific evidence.