Wellness programs are the last great frontier in the drive to contain health care costs. Quite simply, unless we focus on prevention, we will be stuck with reactive issues that almost always cost more in the long run. Just like changing oil in a car prolongs engine life, so too will a preventive approach improve the health of your workforce and ultimately the success of your business. The goals of wellness programs are to help your group stay healthy and keep your health care expenses down.
A comprehensive approach to population health management will help identify potential health risks and permit skilled care counselors and health coaches to work with employees at risk for disease to achieve real health improvement. Using personalized health and wellness tools and resources, employees learn what they can do to better manage risks to stay healthy, now and in the future.
By carefully structuring your wellness program around a mix of online interactive software, a balanced approach can be engineered to achieve real behavior change. All elements of your program - assessment, personalization, educational content, program tracking and incentives contribute to the total effect. Your mission should be to empower individuals to take responsibility for their own health.
Begin with a Strategic Plan
A strategic plan that correlates program offerings and incentives into measurable outcomes will help you keep score and determine the return on investment (ROI) of the program. To begin, have a plan to assess improvement over time. Some key points to consider include assessing the critical issues in need of improvement and using claims data or health assessment results to establish a baseline with the audience around those key issues you can change (BMI, diabetes, cholesterol, etc.,) then tracking progress and success by using year-over-year reporting on equivalent information. Annual reviews and setting new goals each year will maximize program results. To assure ongoing success, include and continually reinforce these three key components:
- a solid program/platform of services and resources integrated within a culture of personal health and wellness
- leadership from the top down, including key executives reaching out year-round to all employees
- tangible, meaningful incentives that drive participation and appropriate lifestyle behavior modification.
With a commitment to these components you will be in position to successfully deliver the message about the importance of living a healthy lifestyle.
Building a Complete Health Management System: Awareness, Engagement, Improvement
When selecting a wellness program provider or platform, it should be both comprehensive and personalized to each participant. A focus on prevention through awareness, engagement and improvement will set the tone for sustaining behavior change. Engaging tools and resources that include tracking and compliance programming built into the software and delivery platform are also a must.
Focus on the individual, not just themes like weight loss or smoking cessation. Adopt a delivery format that is personalized and unique to each participant, tracks participation and improvement at the group level and includes an incentive point management system to assist with administration of incentive and reward programs.
Creating a culture of healthy living starts with the building of awareness about the personal health issues facing your employees. The first step is for each individual to complete a confidential health assessment or questionnaire using a tool developed by wellness experts to help identify individual health risk factors. Online versions are very low cost and permit archiving of individual data for comparison over time. No physical exam is required. User privacy should be protected using a secure web interface with private usernames and passwords.
Completing the questionnaire should be so easy that even computer novices will find the format simple and intuitive. Each participant receives reports, including information about their health risks, concerns and suggestions for improvement. Offer personalized programming and support by tailoring educational programs and resources based on the specific health risk factors unique to each individual. Charts and reports can provide easy to understand information about specific health issues.
The format enables people to reach a "readiness-to-change" mindset and gain a better understanding of which health issues can be modified. Communication is also an essential part of the awareness process. Newsletters, mailings to employees' homes, flyers, posters and email blasts all work but mix them up with some coming from the wellness vendor and others from within the organization, especially from key company leaders. If employees see their top management participating, it improves their view of the program and increases adoption at all levels.
The next key phase is getting employees engaged in regular use of the programs. The program should be interesting and meaningful to each participant. This will promote a better understanding of individual health issues and guide participants toward better lifestyle choices.Individuals should be able to access their program 24 hours a day, seven days a week and be convenient to use anywhere, anytime. The program should allow them to take classes, update their health profile, review related health news and monitor their own progress in an easy to follow self-directed format.
Educational content needs to be from a credible source and organized in a format that is easy to access. General content and links to a variety of other web sites will not yield the same results as a personalized approach. Educational content that addresses these five categories will help participants to focus on all relevant and modifiable health risks:
Health Education - about disease conditions and symptoms
Stress Management - to reduce health risks
Nutrition - including proper dietary guidelines and healthy recipes
Exercise and Fitness - demonstrating proper form and promoting individual progress
Personal Development - designed to improve interpersonal relationships and communication skills. The program should monitor each individual's participation and produce regular progress reports for both the participant and management. Frequent reports help strengthen an individual's long term commitment to achieving their goals.
- Use reports to track group health status and improvement.
- Track participant progress in various programs.
- Manage incentive program qualification and distribution.
Reporting: Web-enabled reports should be HIPAA-compliant and contain information on participant activity, the number of lessons completed and incentive points earned. Aggregate reports on health risk profiles for the entire population should also be available at the sponsor level.
Incentives: Look for a program or platform that permits customized administration at the client level and automatically calculates incentive points earned as individuals progress through their personal wellness program. At key stages throughout the year, an administrator can run reports to reward individuals on a company-based system.
Incentives have been proven to increase participation rates and reinforce long-term behavior change. Your wellness provider can assist with suggestions for designing the most effective incentive program(s) for your group. A service like this takes the "paper and payroll" hassles off the table and makes program management fun.
At the group level, activity and feedback reports should help companies track compliance and program success. In a perfect world, these efforts and costs should be tied back to your health care claims to show a reduction in claims costs, especially among program participants. Encouraging additional participation in all program areas can have a huge impact on future claim reduction and overall return on investment.
The Orange Stick Approach (looks like a Carrot but, if not compliant, can hurt like a stick)
The key is to find a mix of incentives and penalties that will get their attention and promote real behavior change. People don't feel different from Monday to Tuesday, so it's not likely they'll change behaviors from Tuesday to Wednesday. Their health issues evolve over time and it takes meaningful and tangible incentives/penalties to get people's attention and move them toward real change.
While incentives such as free healthy food choices, an on-site fitness center, health screenings and seminars are good, real program success demands even better incentives. Employers find more sustainable success by offering cash, gift cards, lower deductibles and better health plan premium contributions to those who participate at higher levels.
Return on Investment - ROI is the ultimate goal
While helping employees to live a healthy life is one goal of a wellness program, the motivation from the business perspective is often the financial ROI. It has been proven time and again that an investment in population health management via a wellness program does save money in the long run. Using claims data and statistics, groups that implement comprehensive programs with tangible incentives often see ROI from 2.5 to 1, on the low end, to over 7 to 1 when factoring in all savings like reduced absenteeism, improved productivity along with the dollar-for-dollar savings in actual annual health plan claims costs. Tracking each of the programs, incentives and participation rates over time builds a strong correlation between program data and claims data. It can also assist in making adjustments to align with program goals and objectives.
Designing Your Health Management Program: What services do I need?
The Health Management program is simple in concept but powerful in results.
- Personal Health Assessment. An online health assessment gathers personal and family medical history, diet and nutrition habits and exercise routines. Questions related to stress, lifestyle and readiness-to-change round out the series. Following completion of the questionnaire, a personal health report is generated to help participants understand their current health risks and concerns. Some even generate a personalized wellness program complete with educational lessons.
- Health Screenings and Lab Values. An annual health screening that tests for such things as cholesterol and blood glucose levels provides employees (and spouses) with information and education about their health risks to help develop awareness about what diseases or other health issues the individual may be at risk for. Health screenings and lab work are also good for establishing baseline measurements to help manage risk factors going forward.
- Health Coach Program. Telephonic advice from a health coach can make the difference in helping motivate someone to make sustaining lifestyle behavior changes. Having a personal health coach can encourage you to take action by developing your personal wellness plan and getting involved in a lifestyle management program.
- Disease Management Program. Trained health care professionals can deliver hands-on care and support for individuals with chronic conditions and/or serious medical conditions. Each participant receives a comprehensive assessment of their individual medical situation with programs and counseling designed around readiness-to-change, medical acuity and lifestyle behaviors.
- Smoking Cessation Program. A smoking cessation program designed to help people quit tobacco use can help smokers "kick the habit" through a combination of basic education designed to create awareness of the health related issues brought on by smoking.
- Maternity Management Program. A maternity management program can provide valuable information, support and assistance throughout pregnancy and the early weeks at home with the new baby. Participating mothers have access to round-the-clock counselors who offer support and answer pregnancy-related questions.
These services are all geared toward maintaining a healthy lifestyle and ensuring access to quality support services when serious health issues develop. The key is to choose a starting point. Whether you can afford everything suggested above or you are just getting started and your budget demands being selective, the important thing is to take the first step.
Building a foundation for your program with tools and programs that have something for everyone is essential. You can add programs and services as your budget grows. Think of your wellness program as a lifeline to a better waistline which, in turn, can improve your bottom line.
About the Author
Barton H. Sheeler currently serves as CEO and as a Director of ActivHealth - The PHD Network, an online health and wellness platform provider in partnership with Duke University's Center for Living. Mr. Sheeler served as a Director and Chief Operating Officer of ActivHealth from May 4, 1998 until being promoted to CEO in March 2002. Through a careful mix of entrepreneurial drive and tenacious leadership, he has been the driving force behind the company's growth and success to date.
Mr. Sheeler joined the Business Development Team at First Global Corporation in January 1997 and was instrumental in working through the business partnership relationship between ActivHealth and Duke University's Center for Living which eventually lead to his role as a founder with ActivHealth. Mr. Sheeler earned an MBA in Marketing and Management from the University of Dayton in 1984.
ActivHealth's PHD Network is a state-of-the-art platform designed to personalize a wellness program for each individual user that includes advanced software to integrate health assessment results and individual risk factors with personal reports, educational lesson plans, goal setting tools, program tracking and incentive point management - all within one health management platform. For more information about ActivHealth please contact Bart Sheeler, CEO at firstname.lastname@example.org or by phone at 615-846-1500.