An Ounce of Prevention is Worth a Pound of Cure

In last week's HealthLeaders article, "Connecting with Prevention," the author described that employers are adding more armament to their arsenal on managing healthcare costs. 

"Not long ago, employers tackled bulging health costs one way—by shifting more costs onto employees...but businesses are turning to health and wellness programs as a way to both reduce healthcare costs and improve employee health. A report released last week is giving employers some pointers as to how to create programs that engage workers."

The report mentioned was conducted by the Harvard Medical School's Department of Health Care Policy reviewing the BlueCross BlueShield Association's Engaging Consumers@Work program.  This is a 10-week pilot program aimed to study the impact of different interventions on physical activity, nutrition, self-reported health status, self-reported workplace productivity, and health knowledge.  The report's key findings included:

• "Education combined with an activation program is more effective than education alone
• Knowledge and awareness of health-related information improved post-intervention
• Employees are more likely to remember in-home communication than worksite materials "

Prevention and wellness programs continue to get attention as promising approaches to medical cost containment. MedPharma Partners did some work last year on best practices in the area of medical cost containment.  In speaking with many brokers, employers, and solutions providers, there were many different approaches to cost containment.  The more traditional approaches focused on cost shifting and consumer-driven healthplans.  More innovative approaches tried to address the root causes of escalating healthcare costs - healthcare utilization.  Some of the more common programs included preventive/wellness programs, health risk assessments, disease management, and in-house clinics.  The cost containment reality for employers is that utilization drives rates.    ROI is more difficult to measure for a wellness program, and there is more of a leap of faith in buying these.  There was an article in USA Today several years ago with one company achieving a 3:1 ROI.  Industry insiders balked at this, complaining about unsubstantiated claims which will create unattainable expectations upon the entire industry.We have seen that managing utilization can only be done by integrating plan design and modifying employee health behavior.  Even the best wellness program cannot be effective if participation rates are low.  Some industry best practices integrate wellness programs into benefit plan design, often including ‘play or pay’ incentives with lower employee contributions, co-pays, and deductibles for those who participate.  This can lead to participation rates in the 90%+ range. Prevention alone cannot solve the escalating healthcare costs in this country, but it is a very important part when integrated intelligently within an employer’s overall healthcare arsenal.