Change in thinking required

Wellness program reduces health costs, increases productivity

By Michael J. Moody, MBA, ARM

If there has been one overriding concern shared by large and small employers alike, it's how to control employee health care costs. Without a doubt, maximizing employee health and productivity has been and continues to be a top priority for business leaders around the country. Because most employers consider these programs to be a vital part of an employee's benefit package, corporations are eager to find some way to control these escalating costs.

However, despite the best efforts of the employers, medical cost trends have risen steadily over the past 20 years. In most cases, annual health coverage costs are rising at a pace far outstripping general inflation. Historically, employers have looked to the health and disease management industry for assistance. It was believed that motivating the employee was all that was required to reduce costs, but low engagement rates have made it difficult to effectively activate employee health behavior. As a result, to date, these types of organizations have been only marginally successful in providing more cost effective programs.

New insights

Recently the National Business Group on Health (NBGH) completed a study of 3,000 employees and dependents on their perspectives, behaviors and attitudes towards employer health and wellness programs. The study provided some very interesting insights for employers to be aware of when developing strategies to hold down health care costs. The study revealed that employees "want their employers to do more to help them improve their health, and get the most from their employer-provided health and wellness plans."

According to the survey results, employees are looking for four specific things from their employers:

• Make it easy—programs and communications that are easy to use

• Make it personal—personalized information and ideas

• Make it move me—motivate them to participate through the use of rewards

• Make it meaningful—care and support healthful living

As a result, the survey confirmed that "many employers aren't aligning their strategies with the goals, needs and concerns of the employees."

A new approach needed

As confirmed by the NBGH survey, employers should not only build awareness regarding health and wellness, but they should also provide the services and support that employees need. Some organizations have already had an understanding of this important issue for some time. For example, OptumHealth is a leading health services provider that offers programs directed at making health care simpler and more affordable. Recently, they published a white paper that summarized the results of one of their pilot programs. It is interesting to note that much of the pilot program incorporates the features that the NBGH respondents had requested. "Solutions are needed to help employees find the right treatment at the right place and time, while providing an environment that makes it easy to achieve a healthy lifestyle," according to OptumHealth.

Focusing on what matters most to employees is critical, says Erin Carnish, senior vice president for innovative and technology solutions in OptumHealth's Care Solutions division. "When it comes to their health care, time, information, convenience and affordability are extremely important," she says. OptumHealth's pilot project called "GOh!" establishes a healthy workplace culture, offers convenient "concierge-like" services and provides local expertise with optimal access and care delivery options. To prototype and test this comprehensive consumer-centric solution, OptumHealth launched a pilot program for the 1,500 employees at their Golden Valley corporate headquarters, says Carnish. "The GOh! Golden Valley pilot program uses a workplace environment to showcase innovative consumer messaging and supporting services to increase employee engagement with the health care system," she points out.

"GOh! aims to reduce health care costs among workers by proactively influencing health care decision-making," she adds. The program localizes cutting-edge services to employees through multiple modalities, seamlessly addressing all stages of health by making engagement and participation easy and convenient. The approach is comprehensive; Carnish points out, "True engagement not only impacts medical costs, but improves health by getting the employee to the right health care provider as well."

Tailored marketing campaigns, compelling consumer messaging, a loyalty program and a significant on-site presence help GOh! establish an identity and build a sustainable culture of health at the worksite. Publicizing executive and senior management support for evolving the existing workplace social norm into one focused and committed to improving or maintaining health is also key. Carnish indicates that "changing the corporate culture was a big deal."

Improvements to the worksite environment also included a complete makeover of the Golden Valley cafeteria. The re-branded "Fresh Fork" includes a dining hall that now offers 80% nutritionally dense whole food options, and nutrition content is posted for all meals. The Fresh Fork displays daily healthful meal selections as employees enter the food service area, and the most healthful menu choices are highlighted. New meal stations are available, including a grab-and-go cooler stocked with salads and fresh fruits, as well as a Cooking Light grill station.

In addition to the above, GOh! oversaw construction of a new fitness area (the GOh! Studio), as well as an on-site, dedicated health services destination (the GOh! Center). The GOh! Studio provides "space for multiple group exercise classes offered each week at reasonable prices for employees," according to OptumHealth. The GOh! Center is located in a high-traffic area, providing space to access services when, where and how employees want them. Features include "two private consultation offices, a flexible space for partnerships with visiting physicians and other providers, stand-alone workstations for health hub browsing, meeting space for social networking groups and classes, and space allocated for workstation treadmills aka walkstations," according to the white paper. Employees are also offered one-on-one consultations with personal trainers and opportunities to participate in individual and team challenges.

One of the big issues noted in the white paper involved offering "a 'concierge-like' relationship via 'help!care' advocates." Similar to a broker-consumer relationship, GOh! assigns either a dedicated nurse or a non-clinical health care advocate "to all employees who participate in the program, making decision-making support more accessible and valuable," according to OptumHealth. The purpose, Carnish says, is that "once the 'GOh!' program and worksite environment changes pique employees' interest in their health, help!care advocates are ready to become a first touch-point for all health-related needs, providing employees with unbiased guidance and appropriate referrals for more complex needs." The goal is to create trusting and lasting relationships that drive real behavior change by focusing on the unique needs of each employee.

An on-site health specialist provides added support, Carnish points out, by bridging the relationship between participation in workplace activities and telephonic care management support. She says, "The health specialist acts as a conduit to broader solutions by personally consulting with employees to help them better understand their benefit options and by directing them to appropriate telephonic care experts as needed."

GOh! stratifies local markets to identify the best health care providers for employees and directs consumers to preferred partners by leveraging market information and trusted relationships. GOh! identifies high-performing providers based on access, convenience, cost and quality using claims data and a database with local information from third-party resources on providers, clinics, hospitals and retail clinics. Preferred providers are identified based on consumer considerations, such as cost, consumer feedback, availability and convenience, as well as provider accountability on variables like cost, quality, and appropriateness of treatment and consumer experience. "We establish partnerships with local health care providers in exchange for practicing high-quality medicine at lower costs," Carnish indicates.

According to Carnish,"We are trying to make health care simple and affordable, which are two sides of the same coin. First, by improving health we are enhancing productivity and engagement." On the other side of the coin, "We are working to get them to use the system appropriately." Thus far, OptumHealth is encouraged by the results:

• 51% of employees say their productivity at work has increased

• 45% say the program has removed the time barrier related to addressing their health

• 87% place higher priority on improving their health

• 46% say "help!care" is their first resource for answers on important health care questions

OptumHealth hopes to be able to provide additional data and further insight into the program's progress during the upcoming months.

Conclusion

The OptumHealth program provides visibility into opportunities and specific services that lead to closing gaps in care, including monetized estimates of potential medical cost savings for populations engaged in care management programs. Results for employees at the Golden Valley offices show significant increases in the number and amount of savings opportunities identified, as well as the amount of value delivered compared with the same time period in the year prior to the launch of GOh!.

With the design and implementation of the GOh! program, OptumHealth has employed and tested innovative consumer engagement and activation strategies and worksite cultural changes that directly reflect the mission to help people live their lives to the fullest. According to Carnish, "The GOh! Golden Valley pilot offers what our employees want: a personal advocate to help them navigate a confusing health care system and local market expertise that empowers them to access the best care with quality and cost in mind." And as the NBGH survey confirms, at the end of the day, isn't that what any consumer wants?