All it takes is a drive around Nashville, or perhaps most any city, to validate the results of a new study on the health of hospital employees. Along sidewalks on 21st Avenue a major artery near Vanderbilt University Medical Center scores of hospital employees, banned from smoking inside, huddle together in a cloud of their own cigarette smoke. Just a few blocks away, the Krispy Kreme doughnut shop is across the street from Baptist Hospital, luring those hospital employees into artery-clogging treats of fried batter. Like the hospital, it is open 24 hours.

Hospital employees are less healthy than the general workforce, Thomson Reuters says in a study released Sept. 12, adding that healthcare spending is 10 percent higher for hospital employees than the general population and 13 percent higher when their dependents are added in. Part of the reason is the 24-hour nature of hospital work, which requires thousands of personnel on shifts that make it hard to maintain a discipline of cooking healthy meals at home.

Hospital employees and their dependents had an 8.6 percent greater illness burden than the U.S. workforce at large and were more likely to be diagnosed with chronic medical conditions, including asthma, diabetes, congestive heart failure and others, the study concludes.

While some may look at this study and get even more depressed about medical spending trends, another way to look at it is as an opportunity, especially for accountable care organizations, or ACOs.

ACOs are one of the big, new things in the Affordable Care Act. They're set to launch in 2012 for Medicare patients, but hospital systems and payers are developing ACO-like projects for commercial and Medicaid patients. They basically involve being accountable for a specific group of members/patients to improve their health long-term and save the system money.

Hospital systems can start their ACOs with their own employees, and can incentivize the use of onsite fitness facilities by their own employees. Healthcare folks like to talk about low-hanging fruit. Improving the health of hospital employees may be the very definition of picking low-hanging fruit.

Thomson Reuters says a hospital or health system with 16,000 employees could save an estimated $1.5 million annually in medical and pharmacy costs for each 1 percent reduction in health risk. Hospitals might need to change a few business practices that could relieve stress and make the working environment more amenable to good health something employers of all stripes are doing to get on the improve health/lower cost bandwagon.

But it also sounds like a coordinated care approach for hospital employees through an ACO might be just the ticket. Seeing the right specialists, coordinating care through a primary-care physician, staying compliant with prescription drugs are all concepts ACOs will be promoting. Those measures plus wellness benefits built around no smoking, more exercise and fewer doughnuts may help make the 7 a.m. shift change at Krispy Kreme a lonely time.

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