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Not all Wellness Programs are Created Equal

As our leadership team read the recent uChicago News article titled “Workplace wellness programs fail to improve health, study finds,” we felt compelled to share our counterpoints based on decades of experience supporting wellness and well-being programs that do drive quantifiable and significant results.

There are so many definitions of “workplace wellness” that we hope people won’t over-generalize after seeing this article and study. Our clients are experiencing strong, measurable health and wellness program results due to analytics-driven proactive outreach and support.

Some of the questions that we utilize to help companies to evaluate the structure and effectiveness of their current wellness and well-being programs are as follows:

  • Is your program data-driven?
  • How actionable are your interventions?
  • Are the clinical professionals accessible, and are your people comfortable talking to them?
  • Are you actively managing all of the right people via your disease and case management programs?
  • Are the results being measured?

Missing Study Considerations

The lacking cost savings in the study mentioned don’t take into consideration cases where there are significant savings based on early detection of a cancer, savings from preventing a stroke, heart attack, hospital admission, and more. These are all conditions and events that can be predicted six to 12 months in advance via predictive analytics so that they may be addressed as early as possible through clinical outreach programs.

A critical common success factor we see is that our clients are powering their well-being programs with advanced and predictive analytics insight that informs their targeted programs. Analytics findings coupled with a comprehensive longitudinal view of every individual in our Poindexter platform arm disease managers, nurse navigators and others with a holistic view of each member so that they may develop an effective action plan and support the member in fulfilling their jointly set and measurable goals.

This same platform also allows for the quantifiable measurement of results for program participants – delivering visibility to key data points (financial and clinical results) before and after program start for each participant.

Our Vice President of Clinical Operations, Barbara Rutkowski, EdD, MSN, CCM weighed in with this insight: “It is important to note that with wellness programs where there is not a disease manager / nurse navigator, no data to inform decisions, no attention to chronic health conditions or the ability to set a baseline, monitor progress and emphasize outcomes – it is very unlikely there will be demonstrable results. When there is no measurement or work on improving medical conditions and costs in addition to lifestyle habits – it may seem like any road will get you there, but you simply have no direction in the first place.”

With medical costs rising, pharmaceutical costs quickly meeting or exceeding medical costs and miraculous specialty drugs coming in at nosebleed costs, there is no wonder why employers have decided to take a more active role in launching and managing effective workplace wellness programs.

Wellness Program Data Insight Matters

The first step toward realizing wellness program cost savings is defining the top population issues and risks a company faces, and then implementing strategies to optimize employee health and wellness to improve both clinical and financial metrics.

Many employers have taken this task into their own hands, and are using advanced and predictive analytics data to identify everyone in their population who needs more support – coordinating with health plans, TPAs, and medical and clinical resources to ensure the needed support is delivered in care management, disease management, decision support, utilization management, second opinion support and identification of the best (cost and quality) sites of care within their network. Analytics and population health information, if given to the right people at the right time, can help an employer manage its covered lives much more effectively.

Anticipating the next wave of high-cost claimants is crucial for optimal wellness program implementation. Quality health data allows critical visibility into current state risks and costs as well as predicted costs, events (e.g. hospital admissions, re-admissions, ER utilization) and conditions (e.g. heart attacks, strokes, chronic kidney disease and more) 6-12 months in advance. Access to this data is essential to optimize strategies and preserve company baselines, progress and trends over time. Without the predictive-modeling enabled ability to identify those at-risk and intervene with targeted prevention strategies, wellness program optimization will be an uphill battle.

Wellness Programs Are Not a Quick Fix

In the uChicago article noted above, we were pleased to see the authors asking whether 18 months was long enough to judge effectiveness: “One line of questioning directly related to the JAMA study is whether 18 months is enough time to see an impact from a program like this, or do the kinds of changes in healthy behaviors the program produced take longer to yield measurable health benefits?”

In our extensive experience guiding wellness programs that work, we’ve come to know that 18 months is not enough time to gauge effectiveness. Wellness programs are a long-term strategy—not a “quick fix!”

Wellness Program Best Practices

An eBook from Advanced Plan for Health titled “Employer-Driven, Analytics-Powered Health & Wellness Programs” was developed as a comprehensive resource on what employers and their partners such as Brokers, TPAs and Health Insurers need to know to develop a successful analytics-powered health and wellness solution.

The eBook shares details from our research and client work in the area of analytics-powered health and wellness programs to guide you on how to implement key quality processes, ingredients and measurements that improve health plan clinical and financial outcomes.

In addition to many other best practices, it covers Twelve Steps to Elevate Member Health and Wellness Programs such as:

  • Understanding and Addressing Modifiable Chronic Health Conditions and Behaviors
  • Building A Culture of Health
  • Benchmarking Health Plan Trends and Impact of Changes
  • Optimizing Benefit Design and Health and Wellness Incentives
  • Understanding and Addressing Clinical Drivers to Save Without Compromising Quality
  • Finding and Bridging Care Gaps
  • Stratifying Risk
  • Conducting Quality of Care Reviews
  • Measuring Program Results
  • And more…

Click here to download the full “Employer-Driven, Analytics-Powered Health & Wellness Programs” eBook. If you have further questions for us about our best practices or analytics, please contact us here.


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