by Stuart M. Sutley
Wellness, health management, care management, population risk management, well-being programs, etc. The names are synonymous and the outcomes are the same; they either succeed or fail, and honestly, most fail. Due to a lack of structure and direction, most programs grow stale, and those administering at the employer level burn out. Just having a program in place to “check the block” is not what counts; what counts is the adherence to a multi-year strategy to drive results, the key to a sustainable program. But why is this critical component often overlooked or ignored? Is it lack of focus, stagnant programs, poor engagement, lack of usable data?
Think about it…every competitive organization focuses its energies and resources to deliver its product or service efficiently with consistent quality. We strategically write business plans to sell and market our products/services, buy the right components, focus on quality outcomes and ensure our business is founded on sound principles with the ability to grow. But if the human capital we rely on at work cannot consistently succeed because of poor health, high stress, injury, chronic absenteeism, and escalating presenteeism, then how can we expect to deliver our products and services efficiently with consistent quality? Leadership, vision and compensation attract and keep the human capital required to be successful. Compensation other than salary, bonus or commission is an employee benefit. Developing and managing an evidence-based health plan focused on prevention, compliance and elimination of care gaps is the only way to sustain competitive benefits while developing a more productive environment.
Many organizations have successfully addressed key healthcare challenges by investing in a population health management strategy. While individuals have the greatest control over their own health, employers have a vested interest in promoting good health and have a unique ability to do so by providing a healthy environment and by offering powerful incentives and disincentives through workplace benefits and compensation programs. The ability to add value to the business through the management of employee health may be the largest untapped source of competitive advantage for organizations in the future.
Employers traditionally have managed their health plans through changing plan designs or shifting risk to employees. The future is management of the health plan, disability, worker’s comp, voluntary benefits, employee assistance programs, and other benefits as one continuum of health. As cited in the article, A Pragmatic Approach for Employers to Improve Measurement in Workforce Health and Productivity, by Thomas Parry, PhD and Bruce Sherman, MD, FCCP, FACOEM, employers recognize that managing the total health of a population is a more effective solution to cost containment, and it is useful to execute a strategy with a focus on:
- Leading indicators, which demonstrate health status; health risks, biometric screening, chronic condition prevalence
- Care indicators, which demonstrate health activities; preventive care, program participation, employee engagement, health care utilization
- Lagging indicators, which demonstrate health outcomes; financial, time lost from work, productivity.
When so grouped, these indicators provide a relative time frame for anticipated change in values:
- Leading indicators provide a basis for health management strategy development
- Care (Intermediate) indicators typically reflect early outcomes of strategic plan implementation
- Lagging indicators generally are the last of the groups to change.
For example, the prevalence of metabolic syndrome (precursor to diabetes, heart disease and stroke) within an organization may help to prioritize implementation of a metabolic syndrome management program. Intermediate indicators would include individual participation and engagement in the program, along with clinical values reflecting improved condition and prescription-adherence management. Lagging indicators would include health care cost with absence and presenteeism reductions following effective and sustained metabolic syndrome management. This approach can help the employer better understand the ‘‘cause and effect’’ of interventions.
In the April 2013, edition of the Journal of Occupational and Environmental Medicine (JOEM), a new peer reviewed study conducted with employees at five large companies looked at 19 modifiable well-being risks which suggests strong evidence between productivity and these risks. Researchers looked at modifiable wellbeing risks, such as emotional health, social support, job satisfaction, the nature of supervisor support and individual financial health. Workers whose total well-being risks decreased over time showed improvement in several measures of productivity. “This study should be a wake-up call to business and the wellness industry that a focus on physical health alone is insufficient,” said James O. Prochaska, Ph.D., Director of Cancer Prevention Research Center and Professor of Clinical and Health Psychology at the University of Rhode Island. “We need to be considering the comprehensive range of well-being risks that influence productivity, not just illness and health behaviors.”
Healthcare is heading towards an outcome-based system of care where the primary care physician will once again be the quarterback in directing a person’s health, and will be economically rewarded based on proven outcomes and financial results. Unlike the HMO days of the past where lack of technology and actionable data lead to limited results, the advent of electronic health records, connected health platforms, wireless monitoring devices and mobile health are leading us towards a real opportunity to finally make a change in the delivery and outcome of care. Using this same mindset of coordinated care, employers now have the ability through technology and connected data processes to manage all employee-related benefits to specific and coordinated outcomes to improve the total health of their population, and drive down costs for a sustainable future.
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