Article: The Importance of Measuring the Effectiveness of a Wellness Program

Article: The Importance of Measuring the Effectiveness of a Wellness Program

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  The goal formost employers when implementing a wellness program is to improve the health of their employees and positively impact healthcare claims cost. While wellness programs provide reporting results on employee participation and changes in health metrics, companies are usually unable to demonstrate the long-term impact on healthcare expenses. When an employer cannot see data that portrays a positive impact on healthcare costs it often allows the wellness program to stagnate or even terminate. Understand Cost Drivers Recognizing the need for clients to see the impact of wellness programs on member health and healthcare claims, USI’s Population Health Management (PHM) team has developed a proprietary CORE Health Report that connects wellness and claims data to demonstrate the financial benefits of the wellness program. This report provides clients with information needed to determine the effectiveness of their programs. If the CORE Health Report reveals the program is not positively impacting claims cost, it can be redesigned utilizing USI’s proven wellness strategies to reduce healthcare expenses. A USI food-manufacturing client with approximately 250 employees began working with USI’s population health team in mid-year 2013 with the goal of reducing healthcare costs. The population health manager reviewed the client’s claims data and identified a significant number of claims generated from emergency room care that could have been handled by a primary care physician (PCP). A program was implemented to incentivize employee engagement with primary care physicians which resulted in a 49% decrease in the cost of emergency room care from 2013 ($40,194) to 2015 ($20,500). The most recent CORE Health Report for this client showed per member per year healthcare claims cost declined by 25% from $4,985 in 2013 to $3,707 in 2015. Prior to reviewing the CORE Health Report, the client expressed hesitation regarding additional wellness initiatives. After meeting with the population health manager to review the financial impact outlined in USI’s CORE Health Report and the proposal for additional wellness incentives, the client recognized that implementing USI’s recommendations would yield a further decrease in emergency room utilization and reduced claims cost. The client implemented the additional incentives recommended by USI, and now mid-way through the current plan year is realizing lower emergency room and urgent care facility utilization compared to a year ago. Make it Personal USI’s team of population health managers report that in addition to improved health data there is a very real, human element to program success. Clients often send emails, cards and letters with stories of employees who credit the wellness program with improving or even saving their lives. Often, these stories are about early stage cancers discovered during the recommended preventive screenings such as mammograms and colonoscopies. With preventive screening, cancer can be detected early, enabling both employers and employees to avoid the financial and other burdens associated with advanced cancer treatment. Recently, a USI population health manager shared an email received from a senior executive, a self-described forty- something year old husband and father, The Importance of Measuring the Effectiveness of a Wellness Program Property & Casualty | Employee Benefits | Personal Risk | Retirement Consulting Employee Benefits Insight
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  who skipped annualphysicals due to his active lifestyle and healthy weight. As part of the new wellness initiative, this executive made an appointment for a physical with his primary care physician (PCP). The PCP diagnosed a heart murmur during the physical and an echocardiogram revealed a malfunctioning heart valve. A cardiologist confirmed the PCP’s diagnoses and referred him to a heart surgeon to repair the heart valve. In preparation for the surgery, the heart surgeon performed an angiogram that revealed a blocked coronary artery that required bypass surgery. The surgery for the valve repair and coronary artery bypass was successful and the patient made a full recovery. The executive wrote in his email to USI: “If I didn’t have my annual physical due to our wellness program I’m not sure what would have occurred with my health. I can say with full confidence and passion that I believe in USI’s approach to wellness as it has been life-changing and life-saving for me.” USI’s Population Health Management solutions are one more facet of the USI ONE Advantage® collaborative approach to reducing healthcare costs. Please contact your local USI employee benefits consultant to learn more about solutions that can improve the health of your employees and decrease your long-term benefit costs. www.usi.biz The USI ONE Advantage® To analyze our client’s business issues and challenges, our benefits team leverages USI ONE™, a fundamentally different approach to risk management. USI ONE integrates proprietary business analytics with a network of local and national technical experts in a team based consultative planning process to evaluate the client’s risk profile and identify targeted solutions. Clients then receive tailored recommendations for improving their employee benefit plans. To learn more about USI ONE and the USI ONE Advantage® , contact your local USI team today. ©2016 USI Insurance Services. All rights reserved. USI CORE Health Report The CORE Health Report is a tool designed specifically to measure the effectiveness of the CORE Health strategy and lays out a three-year plan to improve claims utilization, reduce cost drivers and ultimately improve the health status of members. It illustrates how employers can effectively measure the success of a wellness plan, while incorporating specific cost-saving strategies.