BUSINESS

Cummins opens its own innovative health center

Shari Rudavsky
shari.rudavsky@indystar.com

COLUMBUS — Like executives at many other large companies, Cummins leadership watched in dismay about a decade ago as employee health care costs continued to rise.

They tried standard fixes, such as transferring more of the burden to employees, and some less conventional ones, such as providing health coaching and trying to improve nutritional choices in the cafeteria. They armed employees with Fitbits and encouraged them to engage in contests to see who could log the most steps, offering discounts on benefits to winners. They even tried to counter the culture of cookies at meetings.

Still, costs continued to rise and so did the incidence of chronic diseases, such as diabetes, among the engine maker's workforce.

“Our health care costs were going up in an unsustainable way,” said Tom Linebarger, Cummins' chief executive officer and chairman. “We just started to think bigger. Maybe we can impact this. After all, we’re paying all the bills.”

Four or five years ago, the company’s top executives sat down to rethink the whole concept. Another company might build a state-of-the-art fitness center with plenty of bells and whistles to lure in employees.

But Linebarger wasn’t sure that would solve the problem, either.

“People who go to the gym are the same people who go to the gym,” he said. “We’d like to get some of the people who don’t go to the gym.

The answer turned out to be a radical new approach to employee health that this past month assumed a brick and mortar form: Cummins’ new LiveWell Center just steps from its headquarters.

At 28,000 square feet, the facility exceeds the span of many outpatient medical centers. The center includes a laboratory, X-ray machine and stress-test equipment, as well as a space dedicated to occupational health.

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But LiveWell is more than a standard primary care center. The idea that lifestyle choices are key to maintaining health and preventing disease infuses everything the center does. There is a training kitchen where a chef will teach patients how to prepare plant-based, healthier foods; occupational and physical therapy, where patients can rehabilitate after injuries or train for their next marathon; and massage and acupuncture services that aim to provide both stress and pain relief.

In recent weeks, Cummins has hosted both employee open houses and a VIP reception to unveil the center. The day after the employee open house, more than 500 people made appointments.

It’s a glistening new building with plenty of glass and clean lines, but the architecture isn’t what’s drawing people. Instead, it’s the novel mode of health care the center, managed by Premise Health, offers. Cummins officials declined to disclose how much the center cost to build.

LiveWell emphasizes achieving good health through positive lifestyle choices, such as avoiding tobacco and eating a mostly plant-based diet. Cummins leadership hopes to sway medical practice not by paying for procedures or on the basis of how many patients are seen in a day, but on how healthy those patients are over the course of time.

“They (the doctors) are not paid on how fast they can move rooms,” said Dexter Shurney, chief medical director and executive director of global health and wellness at Cummins. “We have a lifestyle medicine index. … We pay more for moving the health status of the population.”

To help doctors achieve that goal, Cummins had a curriculum especially designed to train the physicians who would be working for them. Even more challenging was developing an electronic medical record to match. If a patient has high cholesterol, for instance, the doctor is not only supposed to discuss methods of ameliorating the condition, he or she is also encouraged to talk about what causes cholesterol levels to rise, Shurney said.

Such conversations may take longer than the typical 10-minute-at-best interaction a harried primary care provider can eke out with his or her patients, Shurney acknowledged. The LiveWell doctors will take as long as it takes, even if meetings stretch to 40 minutes or beyond.

Even before the center opened, its model for care attracted praise. One day Shurney answered his phone to find a man on the line who identified himself as Rear Admiral Jim Lando, U.S. assistant surgeon general. At first Shurney thought a colleague was playing a joke on him. Then he realized Lando had a genuine interest in the center Cummins was building and its plan for delivering care. Lando came to the VIP reception to see it for himself and make a few remarks.

“Most of medicine is not health care. Most of medicine is disease care. You have a problem, you go to the doctor and they take care of that problem,” Lando told the gathering. “This is just really innovative stuff that’s poised to change the way health care is being practiced.”

Already patients have embraced the approach. Since the clinic opened, Cummins employee Josh Duncan has visited three times, most recently for his allergy shots. After just one visit he decided to switch to a LiveWell doctor.

At his first visit, the doctor assured him he was pretty healthy but challenged him to cut some meat from his diet, which Duncan has been trying to do. If you eat meat at every meal, the doctor told him, try to eat a little less and some more vegetables.

“The doctor spends a lot of time with you. You’re not rushed at all,” said Duncan, 39, who works on the Cummins Six Sigma team. “The quality of care is better … and the whole experience is different.”

That is made clear from the moment a person enters the clinic. Patients enter into a welcome area rather than a traditional waiting room. A concierge greets them and is there to help navigate the system. Patients are expected to be shown into an exam room within five minutes of their arrival.

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The center also has an Anthem employee on-site all the time to help patients decode any complicated medical charges that they might incur if they need to seek specialty help outside the center. That representative also is available to help any Cummins’ employees in the United States.

But patients won’t need much help figuring out the price for services they receive in the clinic. Everything provided there has a transparent price.

“They don’t have to worry about getting (explanation of benefits) in the mail that they don’t understand,” Shurney said.

Premise Health will have 46 employees at the center, including eight providers, some of whom will have family medicine expertise so they can see employees’ children. A full-time pharmacist and optometrist also are on staff. A travel medicine nurse will deliver shots for Cummins employees traveling to company sites abroad.

Some days of the week a dermatologist and women’s health specialist will be on-site, though obstetrics care will not be provided at the center.

Part of the clinic is devoted to alternative modes of pain management, such as massage and acupuncture. Occupational and physical therapy also are offered in a wing of the center. An athletic trainer will be on-site to assist employees who want to improve their physical prowess.

In some cases doctors may prescribe food as medicine, Shurney said, and employees will be able to stop by the kitchen staffed by a full-time chef to get prepared meals to go. The chef offers courses on preparing plant-based foods, such as chickpea and tomato salad.

“Our thought is you can learn how to cook chicken anywhere,” Shurney said.

Other communal space includes a multipurpose room that can host a range of activities, such as  group doctor visits for common conditions or fitness classes. The center will provide lifestyle coaching as well as courses such as sleep management. It will be open from 7 a.m. to 7 p.m. on weekdays and 8 a.m. to noon on Saturdays.

Not every employee is likely to benefit, however. Cummins officials estimate that the center can only serve about half of the company’s workforce. If the program proves to be the success that Cummins thinks and hopes it will be, the challenge becomes how to bring its lessons to workers elsewhere, Linebarger said. This may sound like a tale of how engineers solved a problem that vexed health care for decades, but not to Linebarger. While the Cummins head allows a connection exists, he shies away from making too much of it.

“There’s an analogy there,” he said, “but like any analogy you can overplay it because a human being is not an engine.”

Call IndyStar reporter Shari Rudavsky at (317) 444-6354. Follow her on Twitter: @srudavsky.