Gambling on Better Employee Health – and Winning

When it comes to employee health, the Casino Queen in East St. Louis, Illinois hedges its bet. For around 10 years, the casino's ownership and management has contracted with Dr. Ken Rybicki, an internal medicine physician, who, along with a nurse and a medical assistant, help keep casino workers healthy by providing them with the convenience of an onsite and totally free medical clinic.

"We've evolved this set up here from occasionally seeing employees for their colds and flu's to keeping them on the job to really a very aggressive disease management/wellness prevention center," Rybicki says.  "About three years ago, we put into place some really aggressive screening programs. Employees get screenings for cholesterol, diabetes, blood pressure, height, weight, prostate –if you're in the right age-range and mammograms – and that's free for every employee in the fall."

Workers who have a health issue, such as high blood pressure, high cholesterol or diabetes, are put into a disease management group to support them in their efforts to control its progression and help them maintain healthy lifestyles.

"If somebody's got diabetes, they go into one of our programs for diabetes.  We help them track their blood sugars; we give them free diabetes test strips and free monitors for their diabetes," Rybicki explains.  "And this year, we started free diabetes medicine for employees."

They are working on developing a similar program for employees with asthma.  Rybicki said when they had the boat – there were a lot more problems with employees with bronchitis and asthma.  He says the high-tech air filtration system at the Casino has made a big difference.

"When we moved from the boat to the facility here, I saw a big decrease in those types of things," Rybicki says.  "Then after that, it became non-smoking, so I don't know that I've seen anything real different since then."

Results of last year's employee health screening show that the disease management groups are working.  The employees' cholesterol levels are down, blood sugar levels in diabetics have improved and employees are healthier overall.  And Rybicki says there has been a reduction in the overall cost for providing employee health care –a 20 percent reduction in its overall health insurance costs per employee.

"Although the Casino Queen is providing all these free services… their health care cost is going down because we are keeping people healthier," he says.

"It's a pretty rewarding program because, as a doctor, we are always used to getting people over their sickness – not as much as we should or like to – prevent their sickness," Rybicki says.  "And with the programs we have in place over here, over half of what we do is just getting people healthy and preventing their problems."

There are about a dozen free medications for employees that they can get through the onsite clinic for free and also medications are delivered there for free.

"What we are doing here is a total health care for all employees who want to participate – and we've really made some headway into employee health," Rybicki says.  "The point is – we are saving employees –they are staying on the job; they don't have to leave to go to the doctor; they are staying healthier; they are staying out of the emergency room."

The employee plan health benefits are offered to employee spouses and dependents too.  By gaming rules, no person under age 21 is allowed in the casino.  Underage dependents are treated in a paramedic room that is outside of the employee entrance.

Rybicki serves as the primary care doctor for many casino employees and he said they are eligible to visit him at his offices in St. Louis and in Belleville, Illinois at no cost because they are Casino Queen employees.

With additional measures in place, such as healthier choices for employee dining and vending options, there are hopes that the health trend will continue.

"The good thing about being here is that people will drop by anytime and just say, 'Hey, I'm on my break – can you check my pressure?' 'Can we weigh in?' It's gotten very popular," he says.

Through their own version of "Biggest Loser" type staff weight challenges, Rybicki's office is also helping employees lose and manage their weight.

"Last year we had 227 employees participate.  It was a four-month program and they lost a total of 920 pounds, so almost half a ton was lost here," he says.  "The winner got a trip for two to Vegas with the flight and hotel and everything."

A 2009 Mercer study reports 34 percent of companies with 500 employees or more offer healthcare onsite or near their facility.  As a result, workers maintain better overall health, and each company sees an increase in productivity with a decrease in healthcare costs.  As reported in the American Journal for Preventative Medicine, employers can see a return of $3 to $6 for each dollar spent over two to five years on employee health strategies.

Rybicki says other companies are taking an interest in what the Casino Queen is offering employees as health benefits.  And he said it is very much a model for health reform.

"This is what they want with the Obama health care plan," Rybicki says.  "They want employers to really take charge and take care of their employees and help them become better and prevent their disease, and it's interesting – despite their expense, they are saving money, so it's a win-win.

Dr. Ken Rybicki

Casino Queen employees have an onsite doctor to take care of their health needs, whether its common colds, injuries or preventive health – at no cost. The result is lower health costs for the employer, higher employee attendance and retention.