Ohio ranked 45th out of 50 states in the 2010 Gallup-Healthways Well-Being Index, which assesses the overall health of U.S. residents based on several qualifiers including emotional health, physical health, work environment and basic access to health care. Many employers are turning to preventive measures like wellness programs to improve their employees’ health and, in turn, reduce health care, disability and workers’ compensation costs.
“This is a big issue in workers’ compensation because we mostly deal with injury management, but if we don’t understand the preventive side and how it affects someone’s overall health, it will certainly delay recovery, impact disability and increase health care costs to employers,” says David D. Kessler, DC, MHA, CHCQM, vice president and MCO medical director — OH for CompManagement Health Systems, Inc., a workers’ compensation managed care organization (MCO).
“Wellness programs offer the ability to monitor physical or mental health issues, but they require the employer to be fully engaged in its work force. Senior leadership must understand the current status of its work force and, as that changes, be prepared to change course if needed.” Smart Business spoke with Kessler about how wellness initiatives are helping employers control costs.
Why are many employers focusing on wellness as an important part of their health care plans?
The biggest reason is today’s escalating health care costs. Wellness is seen as preventive care, used to reduce the severity, frequency or disability associated with illnesses and/or injuries. To see how preventive or wellness measures can control costs, consider the aging population. As employees age, they have more chronic conditions. That process can be time-consuming, with more frequent doctor visits and trips to the ER. Employers need to be aware of this and have a plan in place to address those issues.
Small employers may be at a disadvantage, because they don’t have the resources a large employer does. But they still have access to certain plans, or can group with other small employers. These employers can reach out to their insurance agent or MCO for guidance.
How can wellness and preventive health programs help companies reduce workers’ comp costs?
Studies show that health promotion programs have average absenteeism reductions of 28 percent, health care cost reductions of 26 percent and workers’ comp and disability reductions of 30 percent. It works because health management and risk management go together. Wellness and safety are two concepts most employers understand.
From a workers’ comp or MCO perspective, we need to have an injury management focus with disease management collaboration. We can’t do it all, but we need the ability to help an injured worker get back to work as soon as possible in a safe manner and understand the benefits of being engaged at work without risk to themselves or their coworkers.
How are health plans addressing wellness?
Traditionally you’ll have a health risk assessment (HRA) performed. That process accumulates aggregate data, not individual data, which would be a violation of HIPAA. So we have to make sure we look at the entire population, not just individuals. Looking at analytics through the HRAs is only the first step. Ongoing engagement and participation is critical to the success of any wellness program.
What are the keys to creating and implementing a successful wellness program?
Senior leadership has to be part of the process. They have to take a stand that this is what’s good for the organization. But to be successful, it also has to focus on what it can do for individuals both inside and outside the workplace. Maybe they want to play better golf, or be able to enjoy playing with grandchildren, or maybe they like to garden.
To that end, you have to know your audience. Some people value monetary incentives, some value paid time off to participate in a health program.
How can an employer ensure a program is a good fit for their company?
You have to have benchmarks. When you look at wellness programs, two factors are assessed: direct costs and indirect costs. Direct costs are easy to measure: simply look at medical costs and how the program impacted those costs. For example, if you ran a smoking cessation program, review how it decreased instances of pulmonary or cardiovascular disease.
Indirect costs include productivity, absenteeism and presenteeism. Measuring indirect costs requires defined and established parameters because senior management will want to track results related to the invested resources. Most studies show ROI anywhere from two-to-one to six-to-one. However, the length of time is anywhere from two to five years, which shows that wellness is not a short-term fix.
What types of issues should a wellness program focus on?
The three big issues are tobacco cessation, stress management and weight management. The good news is tobacco use is declining; the bad news is obesity is increasing.
Employers can research local health clubs and negotiate favorable rates. Some employers consider partial reimbursement of services, as long as there is a plan in place and some way to measure the outcome.
Some program components could be as simple as employee education. You could bring in an expert to do a presentation on yoga and other relaxation methods to reduce stress in the workplace. From a workers’ comp perspective, a heightened level of stress is a barrier to an employee’s recovery from injury or illness.
David D. Kessler, DC, MHA, CHCQM, is vice president and MCO medical director – OH for CompManagement Health Systems, Inc. He can be reeached at (614)760-1788 or [email protected].
