Reducing Healthcare Costs Through Company Wellness Plans

Employers have seen their health care costs rise
dramatically over the years. To compensate, they have expected employees to pay
an increasing portion of the healthcare insurance premium, expected employees
to pay significant co-pays with each physician visit and have purchased
policies that restrict individuals to a narrow network of doctors and
hospitals. Largely these have not worked. They have offset some of the expenditures
but it has not done much to slow the inexorable rise of health care costs. The reason
is because they attack the wrong “problem.” What is needed is to institute
approaches to improve health and maintain wellness of the employee (and the
employee’s family) and to assure that the employee (and family) get outstanding
primary care including proactive population-style health care. Add to this
patient engagement – a stake in the financial arrangement. That combination will
reduce costs considerably. Here is one approach that progressive companies are
following.

Large companies
such as General Mills and
Safeway have demonstrated the utility of wellness programs.
Employees are invited to voluntarily participate in company sponsored programs
that are designed for behavior modification such as nutrition, fitness, chronic
stress reduction and smoking cessation. The employee (and sometimes the
employee’s family members) who participate are rewarded with a reduction in
their share of the health care premium. Given that employers are continually
increasing employee share, this reduction can be a real benefit to a person’s
paycheck. Large corporations often create these programs in house but smaller
and many larger companies can turn to wellness companies such as
Orriant that will do a
turnkey approach for a single larger company or a group of smaller companies in
a defined geographic region. Workplace wellness programs logically should
improve employee health but until now results were mostly anecdotal; there was
no definitive proof. Now, evidence has been published in the
International Journal of Workplace Health
Management
that an opt-in program encompassing biometric testing and a personal
wellness profile to guide individualized telephonic health coaching combined
with financial incentives led to improved health parameters, improved health
age and reduced healthcare costs. The authors concluded that
“health coaching effectively improved biometric scores among high-risk
individuals and narrowed the difference between current health age and
achievable age, more so among those with the greatest health risks at baseline.”

Here
are some of the specific findings:
Compared to nonparticipants, the participant’s claims paid
increased at a lower rate and they had fewer claims per person.
For those with elevated blood pressure, the average systolic pressure
was 170 mmHg which was reduced by 34 over the three year study; for diastolic
it was 105 down by 18 mmHg. For those with elevated glucose the starting
average was 164.4 and dropped by 31(58%) over the three years.
Those at the greatest
risk for cancer improved their lifestyle score by nearly 32 points, or 41%.

According to those in the company
wellness field, there are few key ingredients that make for a successful
wellness program. The majority of employees (and spouses) need to be working
one-on-one with a health coach to develop their own self-directed plan for
behavioral improvement. Individual care and concern by the health coach is the
most effective intervention. Employees need to like their coach (which I
interpret to mean they trust their coach.) Coaches need to be well trained with
a significant healthcare background. Individual accountability needs to be an
integral part of the program. This implies that the participant needs to call
the coach; not the other way around. That is part of accountability. The focus
needs to be on those with health risks, which most Americans have. Getting the
men in the company involved is important; women are more likely to volunteer
early so there has to be extra effort to attract the men.

Some
readers will not like the idea of health coaches “meddling in their affairs.”
But no
one is obliged to join into the wellness plan; it is always an option although
for
sure the employer often offers a financial incentive to do so. Whether in a
wellness plan or affiliated with your PCPs office, health coaches (when
properly trained and focused) have been found to be powerful advocates for
improved health.

Major health risks from life style
factors are being overweight (two thirds of the American population), lack of
adequate exercise (probably more than half of people), chronic stress (it seems
like everyone is stressed today) and smoking (still about 20%.). High blood
pressure can be in part lifestyle directed as is obesity. These in turn lead to
chronic illnesses such as heart disease, stroke, chronic lung and kidney
disease – just the diseases that account 75-85% of all claims paid by healthcare
insurance.

The cost of wellness programs, whether done in house
or with a consultant, can be self-funding, i.e., those who opt in get lower
premiums and those that do not have higher premiums. But the larger more
valuable benefits accrue to both the employer and employee. Staff become
healthier – that is good for them. But healthier employees use less total
healthcare resources. This in turn lowers company insurance costs or at least
slows the growth of premiums, often dramatically. The employee benefits from
better health, will likely be more productive, will have less absenteeism and
will have greater job satisfaction. That is a win-win for employee and employer
alike.

My next few blogs will relate what some companies
are doing to offer a complete package of wellness, prevention, consumer-directed
insurance, on site primary care clinics, prefunding a HSA or HRA, price
transparency and more to manage costs while improving employee health.

[Note: A look at the Orriant web site will show that
I am quoted. I am a proponent of wellness programs but I have no financial or
other association with the company. If you go to the link for the article on
wellness plans noted above you will find that you need to pay to read more than
the abstract. I read it and thought it was useful information which why I used
it here. You can also find the details on the Orriant web site. As with any
study there can be criticisms but I think it was pretty well done. The graph is  claims paid per participant]

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