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I understand wellness is important, but how do I know what are the important things to focus on vs. what’s a waste of time?

Everyone knows that healthier employees are a good thing.  Employee health affects more than just medical costs. Investing in an effective industry leading wellness strategy will reduce claim costs, increase productivity, reduce absenteeism and keep your employees motivated and engaged. Too often though, wellness programs are feel-good strategies that don't have the teeth they need to be effective.

Traditional Approach:  Reduce medical claims

For the last decade there has been much talk about "consumerism."  How can employers get employees to understand the drivers of health care spending and to take a more active role in effectively managing health? 

With the rise in consumerism also came a rise in HSA's.  If employees have to pay for certain things with their own money, they would be smarter about what they spent the money on which in turn reduces medical claims.

This creates an apparent short term savings, but incentivizes employees not to regularly see the doctor.  While reducing medical claims, it results in missed opportunities to diagnose future chronic conditions.  This is the unintended consequence of focusing on medical claims.

 

Innovative Approach:  Reduce hospital stays

Have you done anything this week that might save someone's life? 

If you have, you've just prevented a hospital claim - and 80% of medical spend consists of claims that result in hospital stays.  These are the claims that a wellness program should strive to avoid.  If one or two of these can be prevented each year, that's a material improvement in the performance of the health plan.

But for a wellness program to be effective, it has to start from the top and it has to have teeth.

These companies are implementing strategies that get their most unhealthy populations and highest risks to pay for wellness programs through incentives and surcharges.  This shifts the burden of additional costs to those who choose not to engage.  Smoking, lack of participation in voluntary wellness incentive activities, and choosing to not take part in health screenings result in higher premiums.  But by taking these dollars and allocating them to a portion of the wellness program to prevent hospital claims, the wellness and ROI discussion become irrelevant.


 


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