Although the ripples of health care reform are looming, 2011 is the potential beginning of a new era of the delivery of health care. Albert Ertel, chief operating officer of Alliant Health Plans, says employers as well as individual employees are facing tremendous responsibilities.
“When it comes down to it, the key to reducing the overall cost of care will come from reducing the overall necessity of care,” Ertel says. “The only way to do that is to move the needle toward healthier people.”
Smart Business spoke with Ertel about how wellness programs can benefit employers, and how to get employees to participate happily.
Why are wellness initiatives important?
No matter how much the government pushes it, the responsibility will land with individuals. Employers have an incentive to have healthier employees. Healthier employees are more productive.
Ultimately it benefits us, the insurance company, too, that is if we are paying fewer claims on ‘healthier’ people. That will allow us to hold down price increases in the future. That’s the domino effect: healthier people equal fewer claims. Fewer claims equal lower premiums. Lower premiums equal more people getting coverage with lower rates.
How can employers get employees to participate?
Our program, AlliantSense, works very much like a frequent flier program. You get points for doing the things you should be doing, preventing illness and improving your overall health and wellness. Points are awarded for getting your annual physical. If you get it in the month of your birthday, there’s a bonus.
It’s our way to try to create incentives for people to practice a healthier lifestyle. It can get employees in the habit of having an annual physical, losing weight or maintaining a healthy weight, participating in scheduled runs or walks, or getting a mammogram or colonoscopy.
Also, if a generic drug is available, points are awarded for picking it over the name-brand drug. It’s cheaper, no less effective and they get points. It helps with compliance. If the decision is a $10 drug versus a $50 drug, they’re going to take the generic drug. Especially if money’s tight, some people will say ‘I don’t have the money for it this month’ and they won’t get their prescription filled. That’s just wrong.
This program is not just wellness; it’s a prevention plan as well. It helps manage chronic diseases, too. It provides education and potential alternatives to care, while encouraging employees to get moving, eat right and exercise.
Who are the health experts involved in the program?
There are many wellness programs. Some bring in an outside vendor or consultant. In some cases, this could potentially compete with an individual’s physician. AlliantSense does not. The doctor/patient relationship is worth protecting. By design, and the way it works, our program pushes people back to their physician for guidance and advice that is specific and directed to the individual patient.
That’s important, because most people don’t drastically change their lifestyle unless there is some kind of trigger. For example, someone who has been smoking for 20 years won’t decide to quit unless this person or someone close to him or her has a ‘health incident’ — it’s the proverbial walk-up call. For that message to be heard, it needs to come from the family physician. The family physician is one of the most trusted resources for health guidance and information.
How do you get people on board?
Implementation is not the tough part. The tough aspect is the education — making people aware of the program and keeping it ongoing. That is probably the hardest part of any wellness program. It can be the same as joining a health club in January. The health club is built around the fact that 70 percent of the people are only going to use it 20 to 30 times a year. You need to give your employees a reason to participate. The education should be ongoing on a monthly and quarterly basis. Healthy competition among peers is one of the greatest ways to get things moving. Get creative. We’ve had companies measure and publicize the points in their break room. They formed a ‘Tons of Fun’ club, to keep track of the most points for losing weight. Wellness programs can become a social phenomenon.
It’s also helping us with brand loyalty. People start looking for it; they log into their personal health record, or PHR, for status. Some look for additional ways to earn points. They know they can get points for running in a race, so they try to find one happening this weekend. It helps reinforce an active lifestyle even outside of work.
What does a company need to know before getting started?
Many companies add wellness programs, and are charged for it. That’s something that sets us apart, because it’s part of what Alliant offers to every one of our insured groups. We’re banking on the fact that, if we get enough people involved, it will perpetuate healthy behavior among the people we cover, which will keep the pricing down.
Other alternatives can have employers bringing in a vendor to ‘take specimens’ and measure employee health status with ‘lifestyle questionnaires.’ Once they have that information, they have to do something with it — but what? You can tell your employees to go out and lose weight, exercise and change their eating habits for better nutrition, but somebody has to keep encouraging them. We found incentives work.
And the relationship between a patient and his or her personal physician is a ‘bond.’ AlliantSense ‘pushes’ individuals back to their personal physician. It is important for Alliant members to practice a healthy lifestyle and prevent illness as best they can. It is ultimately up to the individual.
Albert Ertel is the COO of Alliant Health Plans. Reach him at (706) 629-8848 or firstname.lastname@example.org.