Three years ago, the Rand Corporation published a report on Worksite Wellness Programs (1) revealing positive returns on investments in disease management, as well as some disappointing results for changing lifestyle behavior. But the authors of the Rand report were careful to balance their cost/benefit analysis with this caveat: "However, no study to date has taken a long-term look, at least from the perspective of a workplace wellness program, at the health benefits of risk factor reductions.
"The good news is that we have a clear view of the risk factors in greatest need of improvement. According to a study released last year by the Population Reference Bureau, up to 50 percent of all premature deaths in the U.S. are preventable, with 37 percent attributable to just three causes: diet and patterns of inactivity (18 percent), tobacco use (15 percent), and alcohol/drug abuse (4 percent).
What remains unquantified are the trillions of dollars in preventable healthcare costs incurred in the decades before those deaths. The annual healthcare costs of diagnosed diabetes alone were $176 billion in 2012 (3) with undiagnosed diabetes and prediabetes adding $43 billion more to that total.
We founded Force Diagnostics around the time the Rand report came out to pursue a long view approach to wellness ROI. Employers can use wellness plan design to generate a long-term picture of the value of risk factor reductions that Rand suggests.
- Annual Health Index Exam - The first priority in wellness plan design should be the Health Risk Assessment and biometric screenings performed either annually or at age-appropriate intervals. The Health Index Exam establishes a fact-based index (measurement) on which to create a strategy for risk factor reduction tailored to the individual employee's health and lifestyle.
It also creates opportunities for uncovering undiagnosed issues, such as cases of untreated high blood pressure. According to the Center for Disease Control, one in three Americans (86 million people) are pre-diabetic and most of them are unaware.
Our focus has been on making non-invasive, point-of-care diagnostic screenings (requiring just a finger prick of blood and an oral swab) available at either employer sites or convenient retail clinic locations. This supports higher wellness plan participation rates through a process that offers convenient, quick and painless rapid biometric testing. Results are available within 20 minutes.
- Continuous Health Monitoring - A one-time health index exam is not enough to move the needle on wellness and prove the efficacy of disease and lifestyle management wellness programs. A more effective route is to provide employees with the tools they need to monitor their health on an ongoing basis.
This solution should feature a mobile app that integrates ongoing Health Index Exam data with all of the leading fitness and health tracking wearables and health monitoring devices. Social competitions or "challenges" in which employees join with co-workers and friends to set and reach new goals have been very successful at boosting engagement and changing behavior.
- Predictive Analytics to Drive Healthy Plan Designs - Healthcare expenses can only be minimized if we're successful in changing behaviors, and behaviors change when they're being monitored on a long-term basis. (Every diet is more successful if the dieter steps on a scale every day).
Recognizing this, the wellness and insurance industries are moving away from singular health index exams that provide only a snapshot of health at a specific time, to embracing "continuous monitoring" of risk data and diagnostic data.
Continuous monitoring of health data and changing behavior allow employers to act immediately to reinforce wellness strategies that are working and to stop paying for those that aren't.
These combined strategies - rapid health index exams, continuous monitoring and predictive analytics - provide a much broader view of group and individual health. Armed with this valuable information, employees can make better decisions and live longer and healthier lives; and employers can make wellness plan design decisions at a group level that reduce healthcare expenses.
About the Authors
Michael P. Curran, CEO, Force Diagnostic, Inc., Brian G. Mulconrey, cofounder and advisor to Force Diagnostics, Inc., and Chuck Ritzke, FSA, MAAA, actuarial advisor to Force Diagnostics, Inc.Force Diagnostics develops and commercializes FDA-cleared, CLIA-waived rapid diagnostic tests that identify underlying disease states and the presence of Nicotine and Drugs of Abuse. The tests are administered at retail points of presence, or the workplace, and results are immediately transmitted back to life insurance and wellness constituents both domestically and internationally.
- Worksite Wellness Programs Study, Rand Corporation, July 2013
- A study by the Population Reference Bureau concluded that almost half of premature deaths are preventable - physical activity, diet, smoking, other wellness related diagnostics http://www.prb.org/Publications/Articles/2015/us-premature-deaths.aspx
- American Diabetes Association - http://www.diabetes.org/advocacy/news-events/cost-of-diabetes.html