Employee Wellness: A Combination of Personal Accountability and Corporate Responsibility
An individual’s daily health routines are the best determinant of both overall health and a feeling of wellbeing. A strong employee wellness program is no longer a luxury, but a strategic imperative. It can be the first step to encouraging better health and creating meaningful, positive change in the lives of employees and their families.
Employers, regardless of company size, have an important opportunity to encourage better health among their employee population. Various programs and incentives can optimize healthcare spending and improve employee health:
- Wellness Programs
- Healthcare Insurance Plan Design
- Population Health Management
- Self-Funded Benefits
Progressively deploying these elements, enables employers to offer a generous, competitive, and affordable benefits package. It also promotes an understanding and shared accountability for healthcare costs between the employees and the company.
Wellness is more than exercising and eating right. A 2010 Harvard Business Review study defined it as:
- An organized, employer-sponsored program that is designed to support employees (and, sometimes, their families) as they adopt and sustain behaviors that reduce health risks, improve quality of life, enhance personal effectiveness, and benefit the organization’s bottom line.
Health Catalyst has created a wellness program, Get Fit, Stay Fit that strives to meet those criteria. The program, developed for team members by team members, uses gaming principles and behavioral science. Teamwork, competition, rewards, and fun motivates team members to embrace healthy behaviors and maintain them over time.
Results to date have been profound. The Q3 2015 GFSF Challenge, resulted in 353 enrolled in the program— an 84% participation rate. The program had 640 total participants—including more than 286 friends and family. Together with Health Catalyst team members, they walked over 120,000 miles, biked over 17,695 miles, slept right 19,764 nights and had over 7,218 hours of mindfulness.
Healthcare Insurance Plan Design
Healthcare insurance plan design has only recently become a priority for executives. The level of strategic focus companies are putting in to plan design today is a prime indicator of the evolution of the healthcare system.
Over the past 50 years, healthcare consumers in the United States have been conditioned to rely on a fee-for-service system where a patient’s economic responsibility ended after the copay. It’s no surprise that utilization is increasing and healthcare costs have skyrocketed. New plans and programs, such as high-deductible health plans (HDHP) tied to a health savings account (HSA), were designed to empower consumers to take responsibility for their health.
In order for companies to truly see the value of high-deductible plans tied to an HSA, adoption of these plans as a percentage of total plans offered should be high, certainly greater than 80 percent, and ideally closer to 90-100 percent. In fact, many companies are beginning offer only a high deductible plan with an HSA, foregoing a traditional plan completely.
Health Catalyst’s has seen a similar trend. The company first offered an HSA plan in 2013, achieving an adoption rate of approximately 50 percent. Today, while continuing to offer both HSA and traditional plans, adoption of HSA by team members exceeds 90 percent.
Population Health Management
With the right plan design and basic economic incentives in place, employers can begin to add population health management (PHM) tools and programs. PHM enables an employer to more effectively manage wellness and healthcare spending among employees and remain HIPAA-compliant.
De-identified patient data, combined with analytics, could prove to be an essential aspect of PHM as employers seek to manage healthcare costs. Today, efforts are underway among payers to utilize data and analytics to define, create, and refine healthcare insurance plan design. In the future, employers may use de-identified employee data and analytics to refine healthcare insurance plans, mitigate risk, and provide economic incentives to high-risk, high-cost patient populations. Over time, employers may be able to conduct predictive modeling for employee populations to plan for the future with greater confidence.
Two challenges are inhibiting PHM from becoming commonplace. Employer access to private employee health data raises serious concerns regarding patient privacy. Using de-identified data, in compliance with HIPAA guidelines, can allay those fears. Companies with high numbers of employees are best positioned to perform in-depth analytics about the health of the employee population while still maintaining employee anonymity and privacy.
The second challenge is most employers don’t have access to payer data and if they do, they are lacking the tools to perform a proper analysis. Payers providing data feeds directly to companies and employers adopting analytics technology will do much to address this issue.
With an effective healthcare insurance plan design, wellness programs to encourage greater accountability, and an analytics infrastructure that delivers insight, organizations can feel confident to take on additional risk and implement self-funded benefits. Self-funded benefits have previously been the province of large employers. However, smaller employers are also choosing this route as data and analytic solutions become more prevalent.
Health Catalyst made the commitment to become self-funded in 2014. Self-funding affords team members the opportunity to impact, and directly share in, the benefits of responsible population management (including lower premiums or premium-free months).
Demonstrating to team members the direct link between company performance and the cost of healthcare is essential for a successful self-funding model. It provides team members with an even greater sense of ownership in the company and a better understanding of the impact of their healthcare decisions on the bottom line.
Self-funded benefits can only be implemented after the establishment of a trusting relationship between employees and the company. Leaders, assured their teams will make wise decisions regarding their wellness and healthcare, are more confident when taking on a higher level of risk in the employee population.
Personal Accountability Meets Corporate Responsibility
A sustained culture of collective responsibility provides tangible benefits to both the company and team members. The company is rewarded as the team member population collectively manages care costs. Cost savings, which can grow over time through sustained stewardship, can lead to a number of rewards for team members. The company can elect to declare a premium holiday (eliminating monthly payments for a set period of time), reduce premium payments, or increase plan benefits without increasing premiums.
High Deductible Health Plans and HSAs
A HDHP is a health insurance plan with higher deductibles and lower premiums than a traditional health insurance. With the exception of preventative care, all medical expenses are the employee’s responsibility until the deductible has been met. HDHP plans, combined with an HSA, enable employees to better understand healthcare costs and be more accountable for their personal healthcare spending.
High-deductible payment structures provide incentives to drive employee accountability for healthcare usage and spending. Rewarding employees with a profound economic bonus to encourage greater interest in their own health holds the promise of ultimately helping solve the cost problem in healthcare today.
Employee Wellness Programs
A robust employee wellness program empowers employees and their families to take charge of their overall health, beyond diet and exercise. On-going management support, combined with financial incentives, can motivate employees to embrace and sustain healthier behaviors.
Health Catalyst’s wellness program, Get Fit, Stay Fit, uses teamwork, rewards, and a little friendly competition to encourage and motivate team members to adopt salubrious practices and maintain them over time.
Embracing the concepts outlined above—good plan design, a well-defined wellness program, created in conjunction with technology-enabled population health management, and a self-funded benefits model —will establish a culture of personal accountability for wellness and collective responsibility for the financial health of the company.
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