According to Scott Leavitt, a Boise, Idaho-based broker and president of Scott Leavitt Insurance, there are two trends going on right now in wellness technologies and one is good, while the other is bad.

Good news first: There seems to always be new companies wanting a piece of the wellness pie.

And the bad: "Most wellness companies want to do 1,000-employee clients, while 80% of companies have less than that number," Leavitt says. "In the last five to 10 years, companies try to go small with wellness but they always end up going big."

Leavitt is speaking from personal experience. The past National Association of Health Underwriters president began his own wellness company in 2008, which was targeted exactly at those smaller employers that he says aren't serviced. By 2010 he realized he wasn't going to be able to maintain this goal of focusing on those companies with less than 1,000 employees, so instead of expanding to larger employers, he got out.

"The economy got tough and wellness was the first thing the smaller companies let go," Leavitt says.

Now he's back to the insurance brokerage business because he wanted to continue to help small employers in the benefits business in a way that he could financially stay afloat. But the difference is - he's now aware of the importance of a good wellness partner for new technologies and innovative ideas.

"Most brokers out there ... just piggy back on what a carrier offers and I think those are very poor because they're not well promoted, they're very inexpensive and they don't really do anything," he adds, saying that most get less than 5% traction. On the other hand, he's seen some wellness companies do some really innovative things and says, "Great things can happen."


New technologies

Leavitt says one such company is Real Coaches. The group stood out to him because of their use of one particular technology: social media.

"There are wellness communities to meet-up and walk at lunch time, bike on weekends and more," he explains. "I see social networking becoming a bigger part of wellness."

But, he adds, Real Coaches did exactly the same thing that he alluded to before, they shifted their focus up to the bigger employers more recently.

One option that is available for brokers to use with smaller companies is the resources of NAHU. Kathryn Gaglione, spokeswoman for the group, says there have been new videos added to their original wellness campaign that started in 2010. It's called Wellness Works and is accessible for NAHU member use.

The most recent additions to the campaign are videos on anaphylaxis and immunization, but staples that have been around for years include: obesity awareness, medication adherence, smoking cessation and controlling medical costs. There are also educational flyers available for download to supplement the video.

NAHU's current president, Tom Harte, did the video on controlling medical costs and talked about it with EBA in his sit-down interview with us last month: "I did a video ... about specific examples in my own home state of New Hampshire where we looked at tests that are being done - CAT scans, MRIs, natural childbirth, C-sections - and we looked at the alarming difference in reimbursements between providers. I often talk about how a CT scan of your head, from the least expensive hospital in New Hampshire to the most expensive hospital in New Hampshire, is 446%. So the issue is that a consumer is accessing those services without any additional expense to them."

Harte reiterated in that interview that making sure brokers have access to wellness content is a big goal of his presidency. He did not provide specific plans for more tools or products.

So what else is new in the field? Amy Bucher, associate director of behavioral science with Wellness & Prevention, Inc., a Johnson & Johnson company, says there is a new concept the company is exploring with the Human Performance Institute in Orlando, Fla., called energy management coaching.

Like the tried and true wellness coaching, this off-shoot is a resource that Bucher says "motivates people to increase and direct their energy ... [and] orient people to what they really value."

She explains a lot of it has to do with common sense - eating properly and enough, moving frequently, sleeping well - but there's also a mental component that coaches people to seek and determine what the institute calls a life mission and stick to it.

Bucher says there is an online course that is launching now, and Wellness & Prevention plans to "weave" the energy coaching more tightly into the company's existing digital health coaching this year.


Reality check

Craig Hasday, chief operating officer of Frenkel Benefits in New York City, thinks that the reality for brokers with wellness companies is a bit different than Leavitt explains.

Hasday, whose company is a workplace wellness provider, says wellness is on the upswing with more attention on the subject in the media and also from the Affordable Care Act requirements.

But he does agree that brokers are too fixated on the easiest product for them to sell. "Most brokers ultimately get comfortable with one product and they push one product," he says. "They wouldn't admit to it, but I would say that most brokers say they do wellness but they give the keys of the car to the insurance carrier."

In addition to brokers not being product-agnostic, he says the other big issue for wellness technology is employers' hesitancy at full integration.

"Integration is the biggest issue, if your tracking system isn't integrated with the benefits information system it's too complex to roll out and administer," Hasday says.

He urges brokers to truly think beyond their favorite carrier because it will help them in the long run, too. "It's another value-added service that a broker can provide and offset reduction that they're seeing in their primary [health insurance-focused] lives," he adds.

So what will finally fix the problem of wellness companies not really focusing on small businesses?

Leavitt thinks it's a combination of a few factors. First, there may be a better economy, but small employers are just on the cusp of starting to realize that.

"One that happens: money frees up," Leavitt explains. "Also, employers are paralyzed by the ACA and they need to figure out what's going on with that, how it will impact their current premiums, before they can move on to thinking about wellness."

And finally: "The other thing that's hurting them is brokers and advisers are also still trying to wrap their hands around the ACA. We've seen a 25% reduction in agents across the country because of the MLR issues, employer groups going out of business and so on. So less people are doing what they're doing and that means less people focused on wellness."


Light at the end of the tunnel

Leavitt says that we can't get away from the core of what wellness and improving wellness technologies will really mean - "it's the crux of how we solve the problem with America's health care system."

He continues: "How can we have doctors charge less? The government pay less? If we're all healthier that's the only thing that can solve the health care crisis in this country. If we don't control health, the obesity rate and other things, it doesn't matter who pays the bill. The real solution is taking control of our health." Leavitt says it was his mother's personal struggle as a diabetic that made all of this click for him. "She didn't take care of herself and ... now you find two thirds of America overweight or obese," he says. "To me it's about responsibility, if we don't get the true health care issue under control we're going to bankrupt the government."

Brokers need to truly grasp this message. "They need to find wellness offerings that diversify and open up doors," Leavitt adds. "Groups are downsizing but wellness is a big piece of adapting to the future and brokers aren't focusing on it."



There may be a lot of wellness companies popping up, but this one has a different spin. MedEncentive has been around for eight years but they've been quiet, very quiet. Executive Vice President Cecily Hall says the company is now ready for primetime, bringing a concept of education between doctor and patient into the incentives world.

Essentially the service works like this: An employer signs on with MedEncentive to help educate employees about their medical conditions; once an employee opts in, their doctors are contacted and told that for every time they give that patient reading material on their medical condition, the doctor gets $15 and the employee/patient gets $20. "We're using financial incentives to promote healthy behaviors," says Hall, describing, of course, an old trick in the benefits business.

But can education help our health? Hall says yes. "We see health cost savings," she explains. "The lowers is 3-to-1, so for every dollar on the program, there's a three dollar savings and the largest we've seen in 17-to-1." She says with people more knowledgeable about their conditions, they're seeing their doctor less, not going to the emergency room, and so on. The company just won a big client: the state of Oklahoma.

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