By Steven Dodder, CLU, CSAHU President, NAHU Certified Corporate Wellness Instructor, Co-founder and Chairman of the Board for the Colorado Society for Wellness & Prevention and Regional Sales Director for Assurant Health
&
Dr. Ron Loeppke, M.D., MPH, FACOEM, FACPM,
Vice-Chairman of U.S. Preventive Medicine and co-chair of the company’s International Advisory Board.
If all goes according to plan, PPACA will disburse $50 million in federal grants in 2011 to businesses with less than 100 employees so that they may set up new corporate wellness and prevention programs for their employees. In fact, a total of $200 million in wellness grants is scheduled to be disbursed to any eligible small (< 100 employees) groups between now and 2015.
Even if these federal grants do not occur a transformation is now underway within in our healthcare ecosystem that will take employers and individuals from an illness oriented, reactive “sick care,” system to a wellness-oriented, proactive true health system that will be focused on prevention and keeping people healthy. As employers and individuals seek the most effective solutions, health insurance professionals are in a pivotal position to expertly guide their clients through this historic conversion.
Understanding the coming transformation, the worlds largest retailer, Sam’s Club / Walmart, demonstrated their recognition of the new wellness opportunities, as referenced in the January 19, 2011 CFO.com article entitled, “Sam's Club's new preventive-care plan “The Prevention Plan” for members could enable smaller companies to offer a useful benefit at minimal cost.” Go to www.samsclub.com and scroll down to see more about the “Prevention Plan”.
Given the numerous positive aspects of Wellness Reform that are contained within PPACA there are two key points that benefit advisors should understand in order to capitalize on the coming Wellness Tsunami.
#1) “What value will corporate wellness and prevention programs provide to my business model and why should I be presenting these programs to my individual and/or group health clients?”
#2) How will my business owner clients benefit by installing employee wellness and prevention programs? (Check out the Member Resources Page at www.nahu.org to see all of the discounted wellness vendors that you have access to)
Based on my past partnership in two corporate wellness companies with a combined population of 25+ million members, as Co-founder and Chair for the Colorado Society for Wellness & Prevention and as a Regional Sales Director for a national health insurance company I will address the 1st question.
In order to address question #2, we have interviewed Dr. Ron Loeppke, M.D., MPH, FACOEM, FACPM and vice-chairman of U.S. Preventive Medicine www.uspreventivemedicine.com and co-chair of the company’s International Advisory Board, as well as the chairman of the board of the Integrated Benefits Institute and board member of the American College of Occupational and Environmental Medicine. Few are as well versed in the specialty area of preventive medicine than Dr. Loeppke,
Question #1: “What is in it for health insurance professionals to offer their clients corporate wellness and prevention programs?”
A: For those who look at this question from an altruistic point of view, a satisfactory answer might be:
I want to positively impact hundreds and thousands of lives. I want to become part of the health care cost crisis solution. Because it is the right thing to do. I want to help change America.However, for some these answers may not be adequate.
So, let’s begin with the idea of creating an additional stream of continuous revenue to your agency. Since the beginning of this year all of us have felt the pain of significantly reduced commissions as a result of the minimum loss ratios. Given that most of the wellness & prevention providers on our NAHU Resources page provide commissions that are equal to or higher than group health commissions for the sale or referral of their wellness plans, doesn’t it make sense to begin presenting these programs to your clients? Also, corporate wellness consultants can be well compensated with a fee based agreement between you and the employer.
As the transformation from “Sick Care” to “Preventive Care” rolls across America, whom else besides health insurance agents will the hundreds of thousands of small businesses turn to for helping in shopping for the right wellness & prevention program, one that makes sense for them? Who else besides you will help them sort through and implement these programs? This Sick-Care to Preventive-Care transformation promises to create more excitement and open up more new business opportunities for you then the introduction of MSA’s and HSA’s did in the last two decades. In fact I predict that corporate wellness and prevention programs will become the most popular and fastest growing stand alone employee benefit program offering within the next one to four years.
Here are some additional reasons as to why you should begin to market corporate wellness & prevention plans now:
Wellness programs will become the newest ancillary benefit plan, a great door opener. Client retention – employers may drop their group health plan, but they won’t drop or start over on a new stand alone corporate wellness program. Wellness is the hot topic and it will only get hotter. Creates a differentiator from your competition. Wellness programs don’t have rate increases. Enhances your credibility in the market place. Public speaking and media exposure. Diversifying your practice.At this point you are probably asking yourself, “How do I become educated about corporate wellness and prevention programs and how do I market and present them?”
Here are a few approaches to consider:
Search out and partner with an established corporate wellness expert in your geographical area. Look through the wellness and prevention providers on the NAHU Resources List at www.nahu.org, contact them and ask them to train you in their particular field of expertise. Have your Chapter’s Education & Programs chair contact Yashica Joyner at the NAHU offices, yjoyner@nahu.org, to find out what is needed to set up and hold a “NAHU Certified Corporate Wellness Training Course” for your local or state Chapter. NAHU has certified instructors that are available to conduct these classes, so be sure to make use of us.For question #2) What is in it for your business clients and why should they install a corporate wellness programs for their employees and to help you “Make the Business Case for Corporate Wellness Programs” with your prospects and clients, I now turn to Dr. Ron Loeppke, M.D..
Q: Dr. Loeppke, you are the vice-chair at an organization at the forefront of prevention. Can you tell us about U.S. Preventive Medicine’s experience in this area?
Dr. Loeppke: In the United States health insurance is the second largest expense beyond payroll for many employers, with average premiums increasing 131% since 1999. Several studies show that reducing employees’ health risks decreases health care costs and improves productivity in the workplace. U.S. Preventive Medicine sole focus is reducing health care costs by providing comprehensive prevention programs such as our Prevention Plan to both individuals and groups of 2 or more employees.
The Prevention Plan has received a good deal of national attention because it is proven to significantly reduce the common health risk factors that create those high health care costs. It assesses each member’s health and provides customized online tools and one-on-one personal coaching with nurses and health educators to teach the individual how to lower those risks and better manage his or her health over time.
The program features individual and team interventions, challenges, prize drawings, tutorials and employer incentives to increase engagement. Another part of the program is a proprietary innovation called the Prevention Score℠, which enables employers to measure and reward individuals' proactive health efforts. Intensive care management programs also are available to help those with expensive chronic issues better manage their health.
The program is targeted primarily to employer and government groups with adults, ages 18 and older. The most successful member has average or better computer skills, is encouraged to participate and engage in their Prevention Plan through financial incentives and a culture of health from their employer. However, we recognize most employers have a workforce of individuals with a wide range of computer skills, backgrounds and health knowledge, The Prevention Plan accommodates and supports the majority and is designed to be sustainable and beneficial year after year. The result is higher engagement, healthier employees and lower health care costs.
Q: Why are preventive programs program needed in the workplace?
Dr. Loeppke: Approximately 70 percent of the American workforce is employed. According to the Milken Institute study, three types of prevention implemented in homes and workplaces nationwide would reduce the economic impact of disease by 27% -- saving $1.1 trillion annually by 2023 and preventing 40 million cases of chronic disease. These prevention categories are:
1. Primary--wellness and health promotion to keep healthy people healthy
2. Secondary--screening for earlier detection/diagnosis
3. Tertiary--earlier evidence-based treatment to reduce complications and disability
That same study calculated that seven chronic conditions -- cancer, heart disease, hypertension, mental disorders, diabetes, pulmonary conditions and strokes -- cost the U.S. economy more than $1 trillion per year. The Prevention Plan incorporates primary, secondary and tertiary prevention to provide members with a step-by-step program to better health.
Q: How do you present the business case to employers for the value of health and the power of prevention?
Dr. Loeppke: Poor health has cost consequences to business, industry and our economy that have largely lurked beneath the surface and not been recognized until the damage is done. Medical and pharmaceutical expenses are just the tip of the iceberg that is threatening to sink many corporate ships. There is a growing recognition that health-related productivity loss such as substandard performance on the job (presenteeism) as well as employee absences due to illness, injury and other factors (absenteeism) add compelling cost burdens to employers.
Research published in the Journal of Occupational and Environmental Medicine (Loeppke, et al.; Health and Productivity as a Business Strategy: A Multi-Employer Study); JOEM, April, 2009), showed that workforce health conditions caused an average monetized productivity loss of 2.3 times the medical and pharmacy expenditures for chronic health conditions ($2.3:$1). Medical and pharmacy claims were matched with the health-related presenteeism and absenteeism data obtained from the Dr. Ron Kessler (Harvard)/WHO Health and Work Performance Questionnaire (HPQ) to identify the top health conditions driving total cost for employers.
That multi-year study of 10 companies employing more than 150,000 workers indicated that employers who focus only on medical and pharmacy costs in creating employee health strategies may misidentify the health conditions that most impact the productivity of their employees and the bottom line for the company. The study found that when health-related productivity costs are measured along with medical and pharmacy costs, the top five chronic health conditions driving these overall health costs shift significantly, to depression, obesity, arthritis, back/neck pain and anxiety.
To bring about real change to the corporate bottom line, employers must look beyond healthcare benefits as a cost to be managed and rather to the benefits of good health as investments to be leveraged.
Q: How effective are these kinds of programs in lowering health care costs?
Dr. Loeppke: Studies are documenting how organizations with comprehensive wellness programs achieve remarkably lower total healthcare costs, with shorter sick leaves, reductions in long- and short-term disability, and improved general workforce health. Medical costs fall by about $3.27 and absenteeism costs fall by about $2.73 for every $1.00 spent on comprehensive workplace wellness and prevention programs, according to a Harvard meta-analysis study of the literaturetitled "Workplace Wellness Programs Can Generate Savings" published in Health Affairs.
In fact, a study published in the journal of Population Health Management evaluated the impact of The Prevention Plan on employee health risks after one year of implementation showed a significant health risk reduction of members moving from higher health risk levels to lower risk levels. The population studied encompassed three diverse employers ranging in size from approximately 139 employees to 7,661 employees, from a total eligible population of 10,899 in 2008.
There was an overall health risk transition among the groups studied, with individuals from higher risk levels moving to lower risk levels. There was a net increase of 9.40% of people in the low-risk category, a decrease of 3.61% in the moderate-risk category, and a 5.79% decrease in the high-risk category. When compared to the data of Edington Natural Flow of risks, a model that has measured the expected health risk transitions in populations in which employees did not participate in a health improvement program, the impact is remarkable:
48.70% of individuals in the high-risk category moved to moderate risk (Natural Flow 31%) 46.35% moved from moderate risk to low risk (Natural Flow 35%) 15.65% moved from high risk to low risk (Natural Flow 6%) 87.33% remained in the low risk category (Natural Flow 70%).Q: How do you introduce it into an employer’s culture?
Dr. Loeppke: High employee engagement and active participation are required to achieve the desired health outcomes and costs savings. Employees not only must be educated about the benefits of joining the program, they also must be motivated to improve their health behaviors. It is not easy to convince people to put down the cigarettes or go to the gym instead of the sofa. Appropriately structured incentives often referred to as “carrots,” play a starring role in a successful preventive medicine program.
To date, a variety of incentive strategies has been used to promote healthy lifestyle choices and discourage behaviors and attitudes detrimental to good health. Incentives can be extrinsic or intrinsic as well as tangible or intangible, and often include peer recognition; group competitions; merchandise; vacation days; cash for allocations to a 401(k) or flexible or health savings accounts; or reductions in healthcare premiums.
In a 2009 study, Aon surveyed 1,313 employers nationwide and found that just greater than 40 percent offered gift cards, the most common incentive used, followed by premium reductions (28 percent) and cash awards (24 percent). Almost 40 percent of employers offered an incentive value of $50 to $249 per employee per year.
Q: What are your predictions for the adoption of prevention in the workplace?
Dr. Loeppke: The adoption of workplace wellness programs will continue to increase in every sector and across all sizes of employers. The reality is that individuals do not leave the impacts of their personal health risks on the doorstep when they leave for work just as they cannot leave the impacts of their workplace exposures when they return home. Health impacts work and work impacts health.
Therefore workplace health initiatives are uniquely positioned to leverage integrated strategies across the entire prevention continuum that can enhance the health and well-being of the whole person and the whole population.
The bottom line is that good health is good business.
About the author
Ronald Loeppke, MD, MPH, FACPM, FACOEM, is an international thought leader and consultant in health and productivity. He is Board Certified in Preventive Medicine, Fellowship trained in Occupational Medicine and is a Fellow of both the American College of Occupational and Environmental Medicine (ACOEM) as well as the American College of Preventive Medicine, (ACPM). Dr Loeppke is currently the Co-chairman of the ACOEM Section on Health and Productivity, which is actively involved in health and productivity research. He is also on the ACOEM Board of Directors, the Co-Chair of the USPM National Advisory Board, the Health Enhancement Research Organization Board of Directors and a consultant in Health and Productivity Strategy to Alere. In addition, Dr Loeppke is Co-Investigator of a CDC-funded employer research study related to integrated health and productivity solutions. Previously, he was the Chief Strategic Officer and Executive Vice President of Matria Healthcare, Inc. Matria acquired CorSolutions in January of 2006 where Dr Loeppke was the Chief Medical Officer, Chief Strategic Officer and Executive Vice President. Prior to that, Dr Loeppke was the Founder, President and CEO of the Health and Productivity Corporation of America (HPCA), headquartered in Brentwood, Tennessee. HPCA provided health and productivity services to employers for their employees, dependants, and retirees. In October of 2003, HPCA was acquired by CorSolutions. Dr Loeppke has over 20 years of clinical and physician executive experience in the Occupational Health, Preventive Medicine and Medical Management arenas. He has authored numerous articles and book chapters relating to health and productivity, occupational health, managed care, quality care improvement, adoption of evidence based medicine, employer health initiatives, consumer driven healthcare, preventive medicine and innovative models for the business of healthcare. Ronald Loeppke can be contacted at: ron_loeppke@matria.com
Visit the original publication: http://www.hiu-digital.com/hiu/201103#pg39
Visit the original publication: http://www.hiu-digital.com/hiu/201103#pg39
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