More employers are discovering they can reduce health care costs by embracing wellness programs. In a recent study by Hewitt Associates, more than 33 percent of organizations planned to boost their emphasis on wellness. Unfortunately, harsh economic times have led to slashed budgets so many organizations can't afford to promote programs like they've done in the past.
Recently, OptumHealth made several enhancements to its wellness coaching program, designed to help employers increase engagement and enrollment without additional costs. These innovations include claims and on-site screening data feeds to identify at-risk program candidates, a dedicated wellness consultant team, ongoing direct-to-member communications, a coaching model open to all members who are ready to change and comprehensive reporting with detailed behavior improvement metrics.
The coaching program offers two unique ways to reach potential enrollees. At-risk individuals are identified through a proprietary technology platform which scans claims for health intervention opportunities. In addition, at-risk people can be identified through on-site health screenings. As a result, the wellness programs will now reach more people who can benefit by adopting healthier behaviors, some of whom may about to be at risk of suffering from a serious health event and not even know it. This innovative approach identifies ten times more employees than relying on only health assessments and self-referrals.
And because this information is not self-reported, it provides a more accurate picture of an individual's health. The combined data sources allow us to identify those individuals who can benefit from lifestyle change, such as people with prehypertension, hypertension, prediabetes, diabetes or metabolic syndrome, just to name a few. This is important because this allows a health intervention and helps our coaches educate at-risk individuals about what's in it for me?'
It's a much more effective way of activating them for behavior change and reducing their future health risk. Other ways for wellness program candidates to be identified are still in place: health assessment, self-referral, other OptumHealth programs or external vendor programs, such as disease management programs and nurseline. Along with the other program enhancements, all these implementations work together to help prevent more chronic conditions and more costly events.
With regard to wellness, a big problem for organizations is how to create awareness and enroll individuals in appropriate programs. In fact, many organizations consider it their biggest hurdle and the biggest need of improvement. Very often it's not the program itself that's costly - it's the cost of employee incentives. That's why Optum Health's wellness coaching program has been enhanced to provide built-in ongoing promotions without additional costs. These include mass communications as well as targeted communications that are based on monthly claims.
Another enhancement is the use of cross-trained coaches. This is extremely helpful in coaching people as a whole. For example, many people who want to quit smoking are concerned that they will gain weight. In this case, the wellness coach can help the person kick the habit and help the member develop healthy ways to deal with the nicotine withdrawal instead of turning to food.Also new to the program-and unique in the industry-is individuals are now able to enroll more than once per year.
Previously, after a member completed a program, they could not enroll again until the following enrollment year. With the new model, for example, if someone enrolled in tobacco cessation with the goal of cutting back their smoking, had success and now wanted to try quitting smoking, they would be able to start a new program immediately to help them achieve that goal. Statistics show that only five percent of people who want to quit smoking actually do so without the help of a coach.
In the old model, this person would have needed to wait until the next benefit year. And by then, it's quite possible they might have lost that confidence and intrinsic motivation while waiting. In addition, the coaching program is open to anyone who wants to be coached, which is essential to preventive care. Heart disease is the number one cause of death is this country for both men and women.
We cannot change our age, sex or family history but we can all take steps to reduce our risk of heart disease by making wise nutritional choices, being moderately physically active and if overweight or obese-achieving a healthier weight. The changes we made to our program allow anyone who wants to make a lifestyle change do so with the help of our trained wellness coaches.
Also new, a dedicated consultant is now assigned to each organization to help them plan campaign promotions, understand the reporting, and evaluate their program's success. If the current campaign strategy is not working, the wellness consultants are there to help evaluate the situation and get the right promotions in place.
Knowing whether a wellness program is truly working has been another challenge for employers. Historically, results could take 12 months or longer to measure. At OptumHealth, we've added behavior change metrics to extensive monthly reporting. That means we can now determine program effectiveness in months or even weeks, so organizations can make adjustments to get the most out of their investment.
Through the technology platform and reporting structure, OptumHealth can also show employers just how much healthier their workforces are getting. And by evaluating metrics, it can be determined if the program should evolve or change to maximize positive results.Now the organization is able to see how their programs are creating healthy employees, and therefore a healthier, happier more productive population.
About the Author
Dr. Nagurka is the National Medical Director, Wellness, for OptumHealth.