It is a Matter of Time Before Every Health Plan Has a Rewards Program

Rewards for healthy behaviors have been growing at leaps and bounds as a way to reduce healthcare costs for several years. In 2009, employers offered employees $260 in rewards for making healthy choices. Now, companies are projecting to spend $693 per employee on wellness incentives. ObamaCare added fuel to the fire. It increased the allowable amount of rewards from 20 percent to 30 percent (and in the case of smoking cessation) 50 percent of annual premium. Forbes named “health rewards” as two of the top 5 health IT trends in 2014.“Incentive Driven Healthcare” is here to stay.

Why don’t health plans want consumers to know this? It seems like a win-win. Well in some ways they do. Health plans win by reducing costly behavior through prevention and lifestyle changes. Consumers benefit not only by getting healthier and making better health decisions, but by receiving rewards. This is all true. But in some ways they don’t. Once consumers realize that purchasing health insurance, while incredibly personal, is nothing more than purchasing another consumer product, the marketers of the world will be faced with a health rewards competition.

ObamaCare created “exchanges” or “marketplaces” through which health insurers compete for the business of individuals and businesses. These marketplaces were established with a series of pre-packaged health plan options, which limit the variations in using traditional levers such as coverage and networks. Health plans that were used to competing on these levers are left with a single lever – price. Selecting from gold, silver and bronze hardly creates differentiation among UnitedHealthcare, Cigna, Aetna, Humana, Wellpoint, the Blues and many other plans in the United States.

Think of your credit card, hotel, airline or favorite retailer. It is a sure fire way to create loyalty, brand affinity and engagement. Let’s be honest, you are more inclined to use specific services or retailers if they provide a robust rewards program. When marketers of consumer products ask themselves “what tools do I need to attract, retain, and generate loyal customers?” the answer inevitably comes to reward programs.

As further evidence, consumers across multiple demographics were interviewed on what they wanted from their health plan. The only item that appeared in every demographic was “rewards for healthy behavior.” Would you have a more positive opinion of your health plan if they sponsored a program that rewards consumers for healthy behaviors? According to a Welltok survey, 75  percent of respondents agree. Furthermore, 81 percent said that access to such a program positively influences their decision to renew with their current plan. Not to mention, the fact that incentives are a proven means to motivate health choices and change behaviors. More than 96 percent of consumers would engage in healthier behaviors if rewarded.

Health plans are entering a new competitive landscape. Rewards will not only be an essential component, but will also drive a healthier population – creating a win-win situation for all.


Dermer

Michael Dermer is the Chief Incentive Officer of Welltok. Prior to his current role, Michael was the founder and CEO of IncentOne, the first company that in 2003 identified incentives in healthcare as a critical solution to driving consumer and provider engagement.  Michael is considered one of the nation’s experts on rewards and incentives in healthcare –learned in running over 4,000 programs and 40 million transactions over ten years. His personal mission is a national reward program in which all Americans can “be healthy and be rewarded.” Since 2003, he has been guiding health plans, employers, health systems, governments and providers in how to use incentives to deliver cost reductions and health improvement.

Twitter: @rewardforhealth

Linked In: https://www.linkedin.com/in/michaeldermer

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Placing Workplace Wellness in Proper Context: Value Beyond Money

By Nicolaas P. Pronk, PhD, MA

Most companies in the United States now offer some kind of wellness programming to their employees. In 2012, about half of US employers with at least 50 employees and more than 90% with more than 50,000 employees offered a workplace wellness program (1).

Employer surveys (eg, the 2011 Automatic Data Processing Survey) suggest that the most often-cited reasons for offering these programs include improved employee health, health care cost control, increased productivity, and absenteeism reduction. Each of these reasons is quantifiable, and their value can be monetized, allowing for a calculation of savings and an estimation of a return on investment (ROI).

Yet it isn’t necessarily always about saving money. Dr Risa Lavizzo-Mourey, president and chief executive officer of the Robert Wood Johnson Foundation, notes in a recent online post that companies committed to nurturing a culture of well-being consider broader motivations, including low turnover rates, attraction of top candidates, job satisfaction, and recruitment and retention of workers (2). Each factor was reported as being a more important driver of workplace wellness programs than ROI.

There is understandable interest in learning if, and how, workplace wellness programs produce results and generate savings. Publications on the effect of workplace wellness on financial outcomes continue to accumulate (1–5), but instead of producing consistency and clarity, they have introduced doubt and controversy. Systematic reviews and meta-analytic findings indicate that workplace wellness can generate savings (3). However, recent ROI studies indicate that such savings come only from disease management (DM) programs not lifestyle management (LM) programs (1). To gain clarity, 2 issues must be addressed. First, there is a need to standardize the definition of workplace wellness programs so that casual use of what constitutes such programs can be avoided. Second, research approaches should more explicitly recognize that workplace wellness programs generate a range of outcomes, many of them non–health related, that provide substantial value to employers even though they are often not represented in ROI analyses.

This essay addresses these 2 issues in the context of a set of best practice program-design principles that allow for properly designed workplace wellness programs to be differentiated from other activities that, although well-intended, may not rise to the level of a bona fide program.

Read the article.

Heads up HR managers! Check out PHA Forum 2014 Workplace Healthcare & Benefits Institute

PHA Forum Logo Final-01The Workplace Healthcare and Benefits Institute is a cornerstone of the educational program at the Population Health Alliance’s (PHA) annual conference, the PHA Forum 2014, to be held December 10-12, in Scottsdale, Arizona, with the theme, Collaborate + Communicate = Engage. Registration is open online.

The Workplace Healthcare and Benefits Institute, on Wednesday, December 10, from 10 am to 5 pm, will provide HR and benefits managers and employers across the spectrum a solid basis to assess their wellness programs, as well as, for newcomers a review of core metrics, engagement strategies, and comparison of emerging and existing trends in wellness, incentives and more.

“HR managers, employee benefits specialists, as well as organizations and vendors new to the population health management space will benefit from the in-depth analysis and interactive exercises on engagement strategies, incentives, measuring program impact, and value metrics,” said Karen Moseley, PHA Director of Research.

The registration for the annual conference is now open and members of the media can request press credentials. Employers enjoy a great rate of $195 for the entire conference.

Check the Agenda for the Workplace Healthcare and Benefits Institute.

Register for the PHA Forum 2014 and save with great early bird rates!

Want to Contribute to the Industry’s Discussion on Value on Investment?

By Michael Connor, Dr.P.H., Senior Vice President, Alere Health and Bruce Sherman, MD, Medical Director, Employers Health Coalition

The Population Health Alliance (PHA) Quality & Research Committee has identified Value on Investment (VOI) as a key initiative for this year. The goal of this work group is to empower purchasers of population health management (PHM) programs to adopt a comprehensive value proposition, which more broadly captures the business impact beyond healthcare costs.  Initial objectives include defining the scope of the VOI construct and determining a compelling rationale that is embraced by PHM purchasers.

The Health Enhancement Research Organization (HERO) and PHA led a collaborative effort to develop guidelines related to value domains and corresponding core metrics. The VOI model encompasses all of these domains as outputs as well as a broad view of investment or inputs beyond program vendor fees and incentive costs.

The domains are organizational support, participation, health impact, productivity and performance, financial savings and satisfaction. The Organizational Support domain addresses the degree to which an organization commits to the health and well-being of its employees. Participation recommends measures and definitions related to meaningful program interventions. The Health Impact domain covers measures associated with preventable health conditions.  The Productivity and Performance domain provides an employee continuum ranging from absenteeism through optimal performance at work. Financial Health Care Savings incorporates claims data and modeling estimates.  Satisfaction addresses participant and provider perspectives.

Initial reactions have been very positive related to both the domains and the VOI approach. Most stakeholders are intrigued with the concept, and some have enthusiastically volunteered to pilot the process. Others have suggested the need to develop a more compelling business case to discuss with purchasers.  There are clearly data implications related to a broader set of outcome measures beyond the more traditional and narrower focus of financial health care savings.

Work group discussions have questioned whether organizational support is an outcome or rather an input within the VOI framework. Additional considerations have raised the need for a greater focus on participant program engagement as well as assessing program impact on employee engagement at work and other business outcomes.

So what are your thoughts regarding …

  1. What are the barriers to a purchaser acceptance of a broader value proposition and how these can be addressed?
  2. What practical measures and methodologies best assess value components and will be readily adopted?
  3. How do the value domains align with purchasers’ (employers, health plans and government) strategic priorities?

Comment here or email us your thoughts at kmoseley@populationhealthalliance.org

 

Guest Post: Preventive Care & the Affordable Care Act: Why Engagement Is Essential for Success

By Jordan Dolin, Co-founder of Emmi Solutions 

Jordan DolinAll new models of care, including ACOs, medical homes and shared savings, are looking to answer the same question: What’s the most cost-effective and efficient way to manage the health of large populations? This is a major challenge, and I’ve found patient engagement is an ideal way to address the issue. However, patient engagement needs to happen both within and beyond the four walls of the hospital, especially when it comes to preventive care.

Patients not following recommended screenings and preventive services are a large contributing factor to the spiraling cost of healthcare. For example, despite colorectal cancer being the second-leading cause of cancer-related deaths in the United States and one of the most preventable, only 53 percent of people 50 years and older follow recommendations for screenings.

On the surface, the new preventive services provision under the Affordable Care Act (ACA) should help address this issue, as the screenings are one of many preventive services recommended by the United States Preventive Services Task Force that insurers must now cover without cost-sharing.

Yet, even with an estimated 71 million Americans now eligible for copay-free colonoscopies, what remains to be seen is the level at which these patients will take advantage of the benefit.

That’s why forward-thinking health plans, hospitals and physicians are turning to outcomes-driven patient engagement solutions that close gaps in care and inspire patients to take action.

The following engagement strategies are powerful ways healthcare professionals can increase utilization of preventive services as well as member satisfaction and loyalty:

  • Multi-modal communication: If the goal is to put patients at the center of care, then patient messaging efforts need to be designed with their convenience in mind. Patients need tools that allow them to be engaged on their terms, when and where they choose and on the devices they already own.
  • Customized contact: Tools such as the Patient Activation Measure (PAM) that gauge individual members’ ability and interest in managing their own health and healthcare can be used to meet patients where they are, tailor engagement strategies and increase activation levels.
  • Web-based interactive programs: Web-based programs cannot only increase the bandwidth of providers, free more time for the delivery of care and motivate patients to schedule colorectal cancer screenings and other types of preventive care, but they can also help patients to follow through. A study presented last year at Digestive Disease Week found that patients who viewed a 30-minute online instructional video were 40 percent more likely to keep their colonoscopy appointments.
  • Financial incentives: Financial incentives and wellness programs can be great motivators—if members know about them. Effective programs engage patients not only about the health benefits of preventive care, but also the more tangible ones, such as insurance premium reductions for adherence to scheduled screenings.

Empowering patients isn’t just good for their health—it’s good for disease management and the business of managed care.

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Jordan Dolin is co-founder of Emmi Solutions (www.emmisolutions.com), a healthcare communications company that builds technology-focused patient empowerment solutions for health organizations that measurably impact outcomes.

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Guest Blog Post Disclaimer

CCA invites guest bloggers to post on Voice on Population Health Blog as a benefit for our members and the industry and to allow for exchange of ideas and information regarding population health.

The views, opinions and positions expressed within these guest posts are those of the author alone and/or of the company the author represents and do not represent those of the Care Continuum Alliance (CCA), its members, or the industry as a whole. CCA is not responsible for the accuracy, completeness and validity of any statements made within this guest post article. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author(s) and any liability with regards to infringement of intellectual property rights remains with them.

Partners’ Center for Connected Health: CCA Members Employee Wellness Showcase

Partners HealthCare Center for Connected Health's 2012 Progress Report Forward CurrentsEmployee wellness competition shown to statistically reduce weight, improve BMI and significantly greater satisfaction with weight by MGH employees

Partners’ Center for Connected Health (CCH) and Massachusetts General Hospital (MGH) at Revere partnered in a joint effort to improve employee wellness. Utilizing an activity monitor, 37 employees participated in a 6 month challenge to increase physical activity and decrease weight. Every month, employees experienced new and fresh program challenges such as the “buddy system,” “frenemies” and “top your highest score.” This wellness program measured step count, self-reported weight data, and dietary habits through surveys and activity data reports.

Employee weight and BMI decreased significantly during the six month program. On average, weight decreased by 4.56 lbs (M= 167.29, SD = 50.58) to M = 162.73, SD = 46.40); t(29) = -2.75, p = 0.010) and BMI decreased from a mean of 29.33 (SD = 8.66) to 28.52 (SD = 7.99) (t(25) = -2.52, p = 0.0186). In addition, employees reported being more satisfied with their weight at the end of the program (t(34) = 3.055, p = 0.004). There was no change in self-rated health.NEWM_2013_Supporter_Logo_f

Employees agreed that since joining the program they were more likely to make choices that increased their physical activity (81%), felt better about themselves (70%), were better able to reach their physical activity goals (57%), and had improved weight control (56%). Seventy-seven percent agreed that competing with other employees helped them to be more active. Ninety-one percent said they were satisfied with the program.

Among the 37 employees that participated, 32 uploaded step count data, measured using wireless activity monitors. Average daily steps deceased from 5,597 in August to 3,226 in December (t(62) = -2.941, p = 0.0046). Self-reported days of exercise per week, however, increased from 2.2 (SD = 1.85) to 3.3 (SD = 1.78) days  (t(36) = 3.037, p = 0.004). There was no change in minutes of physical activity per week or in the proportion of employees who meet CDC recommended levels of activity. There was no change in fruit, vegetables, or soda consumed.

Overall, there was a statistically significant drop in weight, BMI and a significantly greater satisfaction with weight by MGH employees who participated in this employee wellness competition.

Engage with Partners’ Center for Connected Health

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https://www.facebook.com/pages/Center-for-Connected-Health/297446901564?ref=ts

Twitter: @connectedhealth

Capital BlueCross: CCA Members Employee Wellness Showcase

Here’s what Capital BlueCross President and CEO Gary D. St. Hilaire had to say about the strategic importance of the comprehensive wellness program available to company employees:

“Employees are our most important asset, and without question nothing is more important than their good health.  A key corporate priority is to enhance organizational and employee performance, which includes our comprehensive employee wellness program.  When employees are healthier, they are happier and more engaged in seeing the company succeed.  Living healthier is important for each of us personally and for the business.  On behalf of the entire management team, I wish all employees much success with their healthy endeavors.”

According to the Health Enhancement Research Organization (HERO), a national non-profit organization that serves as a leader in the creation of employee health management research, education, policy, strategy, and infrastructure, Capital BlueCross offers its employees one of the most comprehensive employer-based wellness programs in the nation.  The Capital BlueCross Employee Wellness Program achieved a HERO Scorecard rating of 183 out of a possible 200 points. The average rating nationwide is 93.  Capital BlueCross also recently achieved the prestigious American Heart Association Fit Friendly Award.

Likewise, the wellness incentives Capital BlueCross offers employees are among the best in the nation.  According to standards set by the Wellness Council of America, taking into consideration the many programs that qualify for incentives, the different types of incentives available (gift cards, HSA contributions, special promotions), and the dollar value of incentives available.  By participating in a variety of voluntary screenings, wellness activities and healthy community events, employees have the opportunity to earn up to $650 in incentives for their healthy endeavors.

Capital BlueCross provides employees all of the following onsite:

  • Health clinics and fairs
  • Biometric, blood pressure and skin cancer screenings
  • State-of-the-art fitness facilities
  • One-on-one fitness, nutrition, stress management, weight management, tobacco management and other classes and coaching
  • Zumba, yoga and tai chi classes
  • Lactation area
  • Care management counseling
  • etc.

The Capital BlueCross Employee Wellness Program also offers employees an array of digital coaching and activity trackers to help employees successfully achieve their healthy endeavors.

A near $50,000 (127.7%) return on investment was achieved in 2012 for company-paid flu shots, when considering the impact to medical costs and productivity.  All told, Capital BlueCross realized a $1.7 million savings based on programs offered, participation and health/disability-related cost avoidance.

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