Employerism… Leveraging Wellness to Generate Better Health Plans

by | Sep 23, 2015 | Program Design

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DSC_3284This post from Cathy Kenworthy, Interactive Health CEO, was originally published in LinkedIn here. Please visit the original piece to leave any comment.

Our clients often tell me about the impact their workplace wellness plan makes on employees’ lives and productivity – as well as the company’s bottom line. They tell me what an important role wellness plays in their overall health plan design.

Of course, I love when clients recognize the positive impact their wellness programs deliver. But this positive feedback from clients has also caused me consider whether wellness programs can offer even more.

Specifically, I’ve been thinking: Could wellness, and the rich data associated with active wellness programs, cause fundamentally new thinking in health plan design, with plans that provide for greater access and heightened cost effectiveness? Just as we know of “consumerism” as an important trend in health care, could “employerism” be an even more powerful trend?

Consumerism has come to stand for the power of an informed individual participating in the development of their own options and decisions with regard to health care. In truth, access to information is already transforming the way all of us think about getting care. Along similar lines, perhaps “employerism” can also emerge from the power of aggregated data and insights of a strong and credible wellness program, creating the mechanism for employers to control their own destiny with regard to health plan design, plan options and ultimately cost. I consistently see our most forward-looking clients doing just that, and decided that I wanted to explore what “employerism” might look like for Interactive Health.

This year, Interactive Health made the transition to self-insurance, from fully insured, which gave us a unique opportunity to shape our own health plan design. We are, of course, a provider of wellness and our employees are very dedicated to our own program. We also need to be fiscally responsible in how we provide health care, and recognize the need for instruments like high deductible health plans and health saving accounts. Finally, we have many employees who face issues of affordability with most health plans options as well as those who work with us part-time; accessing health care is a daunting challenge for too many of our employees.

So, this year, we developed medical plan options that took advantage of our strong wellness program as a foundation and it was, indeed, empowering. Using our own data, we were able to create a “zero-dollar” monthly premium option for those employees that participated in the wellness program. We created high deductible plans with strong HSA contributions. What happened? We saw significantly increased enrollment in our plan offerings overall, and also saw a meaningful shift in the mix of employees that chose plans with high deductibles and HSAs. We also expanded our wellness program offerings, integrating employee assistance services. Oh, and while the year is yet young, it looks like we are poised to save money year over year, even in our first year of this transition. Much is possible, and much is left to do. And, as the CEO of a mid-size company, I must say that it was a tremendously empowering feeling to begin to see how much is possible in striking a good balance between the health needs of our people and our financials.

Wellness is often viewed as a part of the health plan; in reality, I now believe the opposite is true: wellness is a catalyst for better health plan design. The tail wagging the dog, if you will, should be the dog wagging the tail. Using data about the actual health status of your population (not claims history alone which looks in the rear-view mirror), employers have a forward-looking tool to create a better and more empowering health plan design. And while the move for our company came with our transition to self-insurance, the opportunity for “employerism” exists for every employer that puts their arms around and acts upon their own (depersonalized of course) data.

Suppose diabetes or pre-diabetes is a significant issue for your employee population; you could consider new plan design options tailored to these needs, including access to medication and tools necessary for glucose management. (By the way, if you think diabetes-related topics are not an issue for your population, let me ask you to consider that belief as your first red flag… as they probably are.) Do you, or does your benefits team, know specifically what percentage of your population is facing these health issues? Do you have benchmark data, adjusted for industry, size, gender, age, and geography, to get context about your population, what is unusual, and what is the rate of improvement or deterioration? What do you think is the effect of diabetes on the impact and cost of other seemingly unrelated health issues, such as obstetric care, muscular skeletal problems, or cancer treatment? Perhaps you’ve been told that your plan costs are driven by a series of unusual events and most of your costs cannot be controlled by preventive care…. As you’d guess, I’ve heard this before.

I believe, and I have seen in our company directly, that knowledge of aggregate health status, whether it shows good news or challenging news about the state of health in your population, is a vital catalyst for employers to act and improve upon the future, with better health plan design that provides more access, more options and lower cost. Acting proactively and with data goes to the heart of preventive care – and your people, especially the health of your people, are too important of an asset to leave to chance.

How can a strong and credible wellness program empower your own version of “employerism”? I’d love to hear your views. And, by the way, what do technology and friendship have to do with good health?

Written By Laura McKenzie

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