Deep in the core of the successes and failures within employer corporate wellness programs lies a simple truth- behavioral change of an employee is what breeds a stronger return on investment (ROI).
Other corporate wellness yardstick measures, like value on investment, today measured in counting smiles of happy employees, are what employers often use because of unmet expectations in not achieving a positive ROI.
"If employers are looking at counting the smiles of happy employees, that's fabulous, as quality programs can also reduce absenteeism, medical claims, disability and workers' comp costs," Dr. Janis DiMonaco, president and founder of HMC HealthWorks, Inc., and HMC Movere, a division, shared.
"So if employers have asked themselves, what is the return on value without feeling compelled to measure a return on investment. That is great!"
Observing that employers are frustrated today with cookie-cutter wellness programs that do not achieve ROI goals, DiMonaco draws from simple truths from her nearly 40-year time span in the behavioral health and corporate wellness industry. Measurable improvements in clinical outcomes results in savings.
The crux of the problem, she said, is that "we took our eye off the ball." Case in point-how the overall numbers for the prevalence of diabetes is astronomical. Diabetes is the seventh leading cause of death in the United States, according to the American Diabetes Association.
"The health care cost containment industry started focusing on, 'how can we squeeze the physician and medical practitioners to give up more money? How can we get cheaper discounts from the hospitals?' This approach is a cost of care issue, not a focus on health improvement.
The University of Michigan in its research has been observing this for years, and no one has been listening, that over utilization of health care by all of us is a major cost driver of the overall cost of health care spend."
Her entry into behavioral health, employee assistance programs (EAP) and wellness programs began in 1976 when she launched a private practice in her hometown of Springfield, Massachusetts. She remembers how an easy-to understand yet serious Surgeon General Report in the mid- to late-1970s showed poor lifestyle habits to be the culprit of chronic disease.
Smoking, obesity, alcoholism, stress, lack of exercise, and poor eating habits during that time (as it does now) contributed to problems at home and in the workplace and increase health spend. ROI back then was never discussed. Savings did not have to be proven.
Fast forward to today, and the culprits to chronic conditions and poor health remain the same, with stress as a sobering addition to the equation.
Tackling Today's Health Crisis
"We are saying the same thing today as we did in 1976. For example, people who come to work with undiagnosed mental health issues will present other health problems as a result of being undiagnosed and untreated," DiMonaco explained. "Then, we did not have the medical education, data and knowledge that we do today."
According to DiMonaco, the pendulum has swung back to the direction it had when she started in the industry four decades ago.
"I think there is a recognition today that lifestyle exacerbates and/or can cause poor health for individuals, and employers want better answers to the question, 'What programs will improve our bottom line?'"
As the industry changes, according to DiMonaco, positive ROI is possible-one must remember being sensible as a means to success.
"We use very conservative numbers when calculating an ROI, but are able to help achieve a 3:1 or 4:1 positive ROI," she added.
How Around-the-Clock Care Comes into Play
DiMonaco, who is an early adopter and advocate of behavioral health and corporate wellness, founded her company HMC HealthWorks, Inc., headquartered in Jupiter, Florida, as a continued and larger means to help individuals, employers, brokers and others in the industry; for example, programs for how to eat properly as a diabetic and how to work with doctors on their prescription medications.
Among other offerings, they provide annual biometric screenings and preventive exams, and a nationwide staff of 90 people help provide these services and accommodate the needs of their clients.
An inbound call center helps individuals with stressors in their lives, among various health-related matters. Health and wellness coaching, parents with suicidal teens seeking a provider for behavioral health or other individuals wanting more immediacy in responses to health answers via telemedicine are part of the hundreds of calls fielded on a daily basis.
With over 90 employees nationwide, located in six cities, the company's delivery model can be customized and focuses on the whole person approach by providing personalized assistance, early intervention, around the clock care management, crisis assessment and triage.
Credentialed clinical care managers serve as guides to participants. Companies that are self-insured and want more of an emphasis on chronic condition management, also recognizing lifestyle as a gap in care, seek HMC HealthWorks.
Specific to employers and brokers wanting a customized wellness program with more "teeth to it, focusing on cost reduction," DiMonaco added, the HMC Movere division.
"Once you start looking at the cost of care and utilization of health care services, and things like weight, lack of exercise, nutrition and other underlying causes, we help by being an extension to the physician for their patients, our members and clients," she said.
"Because our roots are in behavioral health, it is natural for us to look at the whole person. That is what clinicians do in behavioral health. You don't just look at their symptoms, you need to look at their families, their culture and the communities they live in."
Vision for the Future
Improving an individual's health status, improves the bottom line for employers, and DiMonaco hopes to see a greater integration between primary care doctors with companies that offer condition management and wellness programs. With the burden of wellness and improving employee health falling on employer shoulders, this would be a natural fit.
"When we are part of the health system and working with a self-funded group, we would like the treating physician to collaborate with us, and perhaps provide an incentive to them. There are many cost saving benefits to having greater physician integration and greater health care integration overall," she noted.
For more information, visit us at our web site at: www.hmchealthworks.com
