With a convergence of holistic medicine and data analytics, traditional employee health and wellness programs are gradually giving way to a more comprehensive approach that examines physical, financial, emotional and social well-being.
The emerging model makes sense in an evolving healthcare marketplace, and it’s also paying off for employers. U.S. companies with high levels of well-being achieve a range of better business outcomes, according to Willis Towers Watson’s 2017/2018 Global Benefits Attitudes Study and 2015/2016 Global Staying at Work Survey.
They include $1,000 lower annual healthcare costs per employee, 70% fewer highly stressed employees, 6.2 fewer days missed per year to unexpected illness or presenteeism, and twice the number of highly engaged employees. Other key findings show that 62% of the workforce is less likely to work past age 70 and there’s 22% higher revenue per employee.
This movement is expected to gain traction. Two-thirds of companies with at least 1,000 employees plan to encourage the adoption of healthy behaviors by focusing on building a culture of health and well-being in the workplace over the next three years, notes the 2017 Willis Towers Watson Best Practices in Health Care Employer Survey.
A broader approach to wellness began taking hold in the past decade, observes Don Powell, CEO of the American Institute for Preventive Medicine and author of “101 Ways to Well-Being.”
Noting that a person’s mental and emotional state, along with social interactions, can cause physical ailments, Powell says it behooves benefit professionals to embrace a multidimensional approach to health plan management. Some employers even add spirituality as a fifth component.
AIPM has worked with the U.S. Department of Veterans Affairs over the past year developing a program that’s seen as a key component to helping veterans improve their well-being. It also offers a HealthyLearn.com well-being portal, which has been sold to benefit brokers who have made it available to their employer clients.
Employee well-being and productivity are inextricably linked. Powell cites a 2014 Healthways study of 11,700 employees that found those with low well-being were two times more likely to have costly healthcare claims, and four times more likely to visit the ER and take short-term disability days. They also were seven times more likely to be absent from work and have poor job performance, as well as 47 times more likely to have high presenteeism.
Employers increasingly are abandoning the segmentation of wellness, disease management, employee assistance programs and occupational health, says Neal Sofian, CEO at tuzag, whose vision is to create infinite variations of healthcare content tailored to each individual. Instead, he notes that they’re embracing a unified view of well-being to attract and retain a highly functioning workforce that in the end will prove to be more profitable.
Removing engagement obstacles
Building a culture of well-being depends on a company’s overall culture, according to Kirstie Settas-Jones, national leader/mid-market health management practice, at Willis Towers Watson. Areas of importance could encompass anything from innovation and quality to customer service and team dynamics.
Some jumbo accounts with bigger budgets may decide on a hub-and-spoke model featuring best-in-class specialists handling medical, dental, vision, EAP, 401(k), etc. “Not every vendor can be everything to everyone,” she notes, cautioning that dealing with multiple carriers could dampen employee engagement.
Others that lack the bandwidth to pursue this path may prefer to bundle their well-being services with a single service provider. For those employers, she believes the ease of managing a centralized approach is preferable to a high level of individual expertise.
Whatever the case, the process will unfold differently for each employer. For example, Settas-Jones notes that communications or compliance may be the focus in year one before well-being experts are plugged in.
One huge challenge is persuading employees to actually use a myriad of healthcare-related resources made available to them through work. “A smoking-cessation program is only useful if people are participating,” says Sofian, noting poor engagement rates for EAPs and telehealth.
Settas-Jones is realistic about program engagement. “We’re not going to get everybody engaged, though we would love to do that,” she says.
What’s needed is personalized communication on why these program options can be meaningful and resonate with each individual employee. Sofian, who describes his firm’s approach as eHarmony meets Amazon, recalls an eye-opening chat with a physician whose diabetic patient ignored repeated warnings about developing heart disease, neuropathy, blindness and amputation of toes or feet. What turned him around was when the doctor suggested he cancel an upcoming fly fishing trip with his grandson because his feet wouldn’t be able to handle the cold water.
“He started taking insulin that day,” the doctor told him. “The patient was not interested in his health, but he was interested in fly fishing with his grandson.”
Employers can offer two types of personalized benefits communication dashboards, according to Sofian. One is daily information that’s pertinent to each individual sent through a mobile app or smart speaker such as Amazon Echo or Google Home powered by artificial intelligence. Another possibility would be to allow primary care physicians, caregivers, case managers or health coaches access to all dashboard messages that are sent to their patients or clients.
Using healthcare analytics to mine claims data will help identify cost drivers and care gaps en route to a more Amazon-like experience for well-being programs, Settas-Jones predicts. For example, recommendations may be made for cancer screenings, insulin delivery to the homes of diabetics, a behavioral health assessment, tweaking 401(k) plan design, etc.
Plugging in HSAs
Financial wellness, which has become popular in recent years, clearly affects an individual’s willingness to make other types of behavior changes, according to Powell. “Stress is clearly rampant in today’s society and money problems tend to be one of the greater stressors for people,” he explains.
One tremendous tool for reducing financial worries, of course, is a health savings account. Powell says “helping people become wiser healthcare consumers becomes an important component of financial wellness.” Using an HSA to fund medical self-care becomes an important component of financial well-being that also saves employers money considering how 55% of all ER visits and at least 25 of all doctor visits are unnecessary, he adds.
But engaging employees is still an uphill battle. Only 25% of those responding to the Willis Towers Watson 2018 Health Accounts Employee Attitudes Survey rank contributing to an HSA a top current financial priority. In addition, 69% who didn’t enroll in an HSA said they didn’t see the benefit, understand, or take the time to understand, the concept.
While there’s no denying the extraordinary triple tax benefits of an HSA, Sofian questions its worth for people living paycheck to paycheck who may end up rationing care in the face of rising out-of-pocket costs unless there’s an employer contribution.
Employers may want to tie HSA contributions to completion of well-being program components, Settas-Jones suggests. Once employees become more comfortable with an HSA in conjunction with a high-deductible health plan, she says the time may be right to emphasize how these accounts can accrue in value and fund post-retirement medical benefits.
There also could be long-term benefits associated with embracing this model for industry producers. Recommending a team of well-being experts can generate lucrative business opportunities for benefit brokers and advisers, Settas-Jones believes. “That’s a huge sell to a prospect,” she adds.