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by Alexandra Goebel

Are you looking for ways to take control of your company’s healthcare expenses? Right now, 60% of Americans are living with chronic conditions (this proportion increases each year). As such, the need for prescription medications and medical treatments continue to grow at a record pace. This takes a financial toll on employers, like you, who end up paying more for their employees’ healthcare every year.

You may find yourself asking, “What is the most effective method for managing my healthcare costs and who can help me achieve this?” I can tell you that the most effective solutions will integrate a healthy blend of both cost and cause containment strategies to properly impact the root cause of expenses (individual health) and manage expenses directly. However, to find the right solution for you, it is important to first consider the needs and goals of your organization.

How to ensure the effectiveness of a wellness program

To implement an effective solution that improves the well-being of your employees, you have to first identify what you want to achieve. Goal identification is the difference between implementing a cultural wellness initiative vs. a powerful, results-driven strategy. Below are some ideas to help you consider your wellness goals.

 

  • What are your goals in implementing a wellness program for your organization? 

Do you want some of your employees to participate in a health initiative like a 5k run? Or do you want to empower all of your employees to be accountable for improving their health in a way that makes sense for them?

 

  • How are you going to measure success? 

Do you want to measure success through employees’ self-reports? Or do you want to measure success through biometric health data (ex: blood pressure) and decreases in individual claims expenditures over time?

 

  • Why do you want to offer a wellness program in the first place? 

Do you want to try out something cool and health-oriented in order to promote your company culture? Or do you want to prove, beyond a shadow of a doubt, that a program has measurably impacted the health of your employees, resulted in a sustainable model for group healthcare, and generated an ROI?

 

How to choose the best wellness program

After identifying your goals, asking pertinent questions will ensure that you find the best solution for you. Do your due diligence to understand the value, historical data, and impacts of a wellness program before implementing it. 

Question: Will this strategy effectively impact the health of my organization?

Participation is critical for a successful wellness program. Ask for the historical participation rate of the program you are considering. If less than 50% of your employees are projected to participate, the strategy is severely limited in its ability to have a measurable impact. 

Statistically speaking, in your employee population, the unhealthiest 10% will comprise 66% of total health claim expenditures. What’s more, is that the unhealthiest 20% typically make up 82% of expenses. A participation rate that captures less than half of your population likely does nothing to impact these people and their expenses continue to drive the cost of your health plan higher. This point is illustrated by the conclusion of the National Bureau of Economic Research (NBER) that healthier employees (those who already have fewer medical expenses and healthier behaviors) are likely to be the ones participating in your program. 

Short answer: Wellness programs statistically have low participation rates and end up attracting employees who are already considered healthy. This typically leaves the unhealthiest people, who cause 82% of total healthcare expenditures, unengaged and unimpacted.

Question: Will this solution reduce expenses or create excess expenses?

If your unhealthiest employees are successfully being incentivized to improve their health risks (meaning they are losing weight, reducing cholesterol, bringing blood pressure or glucose back to normal levels, etc.) then the program is reducing the need for prescriptions and treatments, thus reducing claims expenses. However, If your unhealthy employees are not being effectively incentivized, your wellness program may sound good in theory, but it will not produce results. NBER did not find statistically significant effects on average medical spending after one year of wellness program implementation. 

Short answer: Without measurable health improvements and decreased medical spending, a wellness program is an added expense.

Question: How will this program measure success for my employees and reduce my health expenses in the long run?

What methods does the program use to incentivize, track, and measure health improvements? Does it operate with self-reports or data? Do my employees have someone to help them through the process or are they on their own? 

Self-reports of healthy behaviors and productivity do not have a significant impact on healthcare expenses because they rely on a person’s awareness, which is fallible.  Programs that use data-based health reports are undeniably accurate. 

For example, measuring and recording biomarkers in the participant’s blood in tandem with analyzing their claims history will show you data that illustrates whether or not your program is reliable in showing an ROI. Additionally, make sure the program is equipped with personable professionals. For example, if there is a health coach who is accountable for developing and maintaining a relationship with employees throughout their health journey, they can create clinical reports to track participant’s progress and help empower an individual to achieve their goals. 

Short answer: Health improvements for employees should be measured in hard numbers and data reports. Measures of BMI, Blood pressure, Blood Glucose, LDL Cholesterol, and Tobacco Use and how they change overtime will directly relate to success for your employees. Measurable health improvements correlate to measurably saved healthcare dollars in the long run. As employees bring their health biomarkers back into healthy ranges, their need for treatments and prescriptions decrease. 

Question: How will this program be accountable for helping my organization decrease my healthcare expenses in the long run?

It begins by making sure that the culture of the wellness program aligns with the vision you have for the culture of health at your own organization. Does this program have any skin in the game? Is your win their win, too? Or do they make out with optimum profits regardless of the impact on your organization? Are they invested in your company’s well being?  What is their performance guarantee?

Short answer: There are programs out there that profit only when you profit-- this is a true partnership. A company that is willing to risk their own revenue is more likely to ensure the success of the program than a company who profits regardless of whether or not they made an impact for you.

 

When you find a program that effectively engages the top 20% of unhealthy employees, empowers them to be accountable for their health, and drives measurable results, it is a strategy worth investing in. When your employees improve their health, their need for treatments and medications fades away. This is how you can take control of your group healthcare expenses and drive a culture of health with a wellness program.