1: The Cleveland Clinic is a globally renowned academic medical center headquartered in Cleveland, Ohio. It self-insures over 100,000 team members and their dependents,
In 2008, under the leadership of Chief Wellness Officer Dr. Mike Roizen, the clinic began working to help team members get healthier while reducing both personal and organizational medical costs. Mike, Peter Linneman, and Albert Ratner describe this journey in their book The Great Age Reboot.
As the program began, “you may be surprised to learn that only 6 percent of the individuals had what we called ‘6 Normals +2™,'” the authors share.
So, what are the 6 Normals + 2? They represent markers for overall health:
- Blood pressure of less than 125 mmHg systolic and less than 85 mmHg diastolic
- BMI (a measurement of height-to-weight ratio) of less than 27 or, better, a waist-to-height ratio of 0.40 to 0.55
- Fasting blood sugar (associated with diabetes) of less than 106 mg/dL
- LDL cholesterol (a risk factor for heart disease) of less than 70 mg/dL
- No cotinine in urine (an indicator of tobacco use)
- Completion of a stress management program
Seeing a primary care physician and having current immunizations are the “+ 2.”
Ten years later, 44 percent of participants had achieved 6 Normals + 2, showing clear, measurable progress in improving team members’ health.
2: Wowza! How did Dr. Mike and his team at the Cleveland Clinic achieve such incredible results?
They created a wellness culture that provided team members and their adult dependents progressively larger financial incentives to reach 6 Normals + 2.
“In 2018, the incentive was a $1,440 deduction in medical premiums,” the authors write. “If their levels continued to stay normal (as substantiated by their primary care practitioner), they got another reduction in premiums each year.”
As a result, the Cleveland Clinic saved millions in medical and benefits costs. Over the first 10 years, the clinic did not spend $855 million compared with trends and similar institutions. Reduced spending now exceeds $180 million a year, they note.
Not only that. There was also an increase in productivity and a decrease in sick days.
Team members not only saved over $250 million in premium costs but also experienced notably healthier lives, reinforcing the value of the wellness program.
“At the Cleveland Clinic today,” the authors write, “the cost of health benefits for every employee has experienced only a modest increase since 2008 and costs have been stable since 2013, while in the United States as a whole the average employer cost per employee went up $7,000 per year from 2008 to 2018.”
Projecting these results nationwide for all U.S. workers and Medicare enrollees suggests savings could reach over $1 trillion annually.
3: Achieving results like these begins with choices made by individual people.
Imagine a car. “Even if you know nothing about engines or spark plugs or transmissions,” the authors observe, “you know this: Your car is a complex machine with a lot of moving parts. And it is capable of getting you from here to there.
“But that car can be the best in class—beautiful, cutting-edge, and slick—and it won’t mean squat if the driver is reckless.
“The best-engineered car in the world (your initial genetic setting endowed at birth) will crash if the driver is intoxicated or driving with a blindfold,” they note, “while a run-of-the-mill car in the hands of a highly skilled driver will make the trip effortlessly.”
The premise of Mike, Peter, and Albert’s book is that “science is about to offer us the Garden of Eden—a chance not just at prolonged life, but at prolonged youth or rather (and even better) prolonged youthful years.”
To take advantage of what is coming, however, you must be intentional about making good decisions now.
It’s not about being perfect. “When it comes to self-engineering, you’re not going to be—nor does your body expect you to be—perfect all the time,” they explain.
“You can think about it like any other skill you develop over a lifetime, whether it’s shooting free throws, playing piano, or learning a new language. You will miss shots, hit the wrong key, and use the wrong words.”
The key is to practice consistently over time because you will be accurate more often than not.
“Our goal here is not to tell you to ‘do this’ or ‘do that’; it’s to convince you that you control far more than you think,” the authors believe.
Despite the prevalence of information and the most medically advanced health industry of all time, two-thirds of Americans are overweight or obese, and millions more will die or become ill from choice-related health problems, including heart disease, lung cancer, strokes, diabetes, and dementia.
Which is a shame. Because the data shows “it’s possible to reduce more than 60 percent—even 80 percent—of that risk,” they write.
“How can we inspire change? How can we make change? How can we collectively get to better decisions?” they ask.
The Cleveland Clinic example demonstrates that meaningful change is achievable.
Key takeaways: Strive for the health markers listed above, focus on small habits, utilize technology and financial incentives, and foster a community that values healthy choices. These steps can drive significant and lasting improvements.
More tomorrow.
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Reflection: What health habit, if improved consistently over the next decade, would have the greatest impact on my energy, longevity, and quality of life?
Action: Choose one health metric—sleep, exercise, nutrition, stress management, or preventive care—and commit to one small improvement this week. Focus on consistency rather than perfection.
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