Is your wellness plan really working?
I cannot begin to tell you the gut wrenching feeling I get when starting to talk with a prospective client and one of the very first questions they ask is: “Can you help support our wellness plan?” Forget, plan savings, plan design structure, value added services and providing real solutions, all we care about is if you can support our wellness program.
Honestly, these meetings never end too well and employers that focus on wellness solutions as the silver bullet are doing themselves and their employees a disservice. Wellness plans have been one of the biggest sidebar distractions for employers in the midst of chaos created by healthcare reform. Instead of grabbing the bull by the horns and addressing the problems that exist within our system, employers have dumped millions of dollars into solutions that frankly have no ROI and distract them from taking real measures to control cost and build sustainable health plan solutions.
So who’s to blame? Unfortunately I think all three parties involved bare responsibility…Brokers, Employers and Wellness Companies.
Let’s address the first “bad guy” in this equation, Benefit Brokers/Consultants. In the face of healthcare reform and large rate increases, many brokers are not very innovative; therefore they had no real solutions to bring to the table. Wellness plans offered an easy opportunity to bring something new to employers and make more money off of existing clients through forms of commission paid by the Wellness vendors. It is what it is, we cannot turn back the hands of time but honestly 1,000’s of employers nationwide have been sold wellness solutions by subpar consultants to provide a distraction to rising cost. Brokers need to focus on delivering real solutions that have a direct ROI in the future while having honest conversations with their clients about the ineffectiveness of traditional wellness plans.
Problem child #2, Employers…Honestly, you are not really the root of the problem, it’s just that many of employers have drunk the Kool-Aid because they were honestly looking for real solutions. Most employers depend on a broker/consultant to guide them through all matters pertaining to their health plan, unfortunately, the problem stems from what I mentioned in the paragraph above – Lazy brokers and another commission item for them to slide by you. The only employers that have created a problem with wellness programs are the ones that have the “set-it and forget it” mentality. Creating an effective wellness strategy is a constant shape shifting task. Employers genuinely want to invest and do what is right for their employees, why not; they are the greatest asset of any company! By listening to the advice of brokers and wellness vendors many employers have been mislead on the effective ROI of a wellness plan. Additionally, as your insurance costs continued to go through the roof there was always that glimmering star that the wellness plan was going to solve all your problems down the road…Well many employers are far down the road and still not seeing any ROI, in fact just wasted annual expense on their failing wellness program. Employers have to be ok with changing their current programs into meaningful action and stop throwing good money after bad. If you happened to sip the Kool-Aid and bought into the empty promises that were made, it is ok to admit that you made a mistake and take a different direction. Too many employers are afraid of admitting that they know their wellness program is not working, simply because of the amount of dollars that have already been invested. I’m not telling you to scrap your entire current wellness program; I am asking you to re-evaluate the reason why you are really providing the program.
Saving the worst for last, Wellness Vendors…Personally, I am going to put these guys right underneath the fraudulent PBM’s for selling fake promises and phantom ROI results. Wellness vendors have preyed on the desperation of employers in looking for solutions to control their healthcare costs. Every time I bring up ROI in talking with a wellness vendor I always get one of two answers: 1. “Well it’s always hard to gauge ROI because every employers situation is different.” Or my favorite soft ROI statement: 2. “We have seen our employer’s healthcare costs trending below the local averages.” Please don’t ever ask these folks to show you the results because you will end up with case studies that are as flighty as the answers provided. Of course they are going to manufacture wonderful reporting to show you how well they are performing, otherwise, you will not continue to pay them large sums of money each year to continue their services.
Alright, so what’s the solution? There is no silver bullet!
Drive real results through real solutions…The majority of cost drivers in healthcare stem from lack of employee education. There are fantastic programs, i.e. – Quizzify created by Al Lewis, that exist today rewarding employees for participating and completing education regarding healthcare and topics that are specific to their conditions. Knowledge is power, arming employees with knowledge will lead to better healthcare decision making. Providing educational resources should in no way be immediately linked with ROI. Think about the effectiveness of social media and how thought leaders are able to hand out free education with results coming later.
Using analytics to drive plan design change and employee behavior through a customized plan design. Understanding your health plan data to effectively target cost drivers within your plan will help employers customize your health plan to drive specific behavior. If you have Type II Diabetics not staying compliant with insulin let’s make insulin free to these patients to keep them compliant. This will inevitably avoid extremely high inpatient costs in the future. Having a wellness plan that does not tie-in real time healthcare data is a fruitless effort. You have to have the flexibility to mold your health plan to target conditions that are driving cost in the present or will in the future.
Stop rewarding unhealthy behavior. So many employers just want to give rewards for every little thing an employee does. The last time I checked, when I was a kid, I did not get rewarded for cleaning my room, taking the trash out, and doing my daily chores, it was expected. So many employers reward employees for meaningless results that do not drive change. Just because someone lost 10 pounds for a biggest loser weigh-in doesn’t mean they are entitled to a lofty reward, when inevitably they will turn around and gain the 10 pounds back in a week. If you want to make effective change you have to breed a high expectation into your company culture, without employees always expecting a reward. Culture will drive any change you desire, start by investing in your culture and the results you desire will come.
Lastly, there is no end all be all solution when it comes to wellness or caring about the well being of your employees. Wellness programs are performing poorly because they were started for the wrong reason: “We will implement wellness to control our healthcare cost.” We all missed one very important part of the equation, how about implementing and following through on wellness because we care about our employees? Every employer is indeed different so it takes a multitude of services, programs and vendors to successfully invest in a culture of wellness. Please stop trying to draw a direct line between your wellness programs and decreased medical costs…It will keep your sanity intact.
TJ Morrison is Vice President of Benefit Design Specialists, Inc. BDS is committed to a two-fold goal; delivering quality, cost-effective employee benefit plans coupled with hassle-free benefits management for our client’s HR departments. Transparent Health, By BDS is a solution that drives down Healthcare costs while giving complete investment transparency.