Many health insurance carriers are getting involved in wellness but their service offerings don’t quit match up to what a wellness partner can provide.  The level, or lack, of service carriers provide could drastically affect the long-term results and ROI of a wellness program.

It is certainly enticing to use FREE carrier wellness services, however, if the wellness program does not produce verifiable cost savings, then FREE could result in an expensive lesson learned.

Based on our experience and industry data, here are some top reasons why employers are choosing wellness partners over carriers:

1. Owning the Data- carriers who fully insure companies will most likely not allow them to “own their date”, such as HRA data.  This inhibits companies from integrating their data with 3^rd party partners or keeping it if they switch carriers in the future.
2. Low Participation Rates- outside wellness partners provide employees with a sense of security and confidentiality.  With carrier wellness programs employees are often paranoid about sharing personal information.
3. Sensitive Cost Information- wellness partners analyze program outcomes with a true investment in population health management.  Carriers may use the HRA or program data as a reason to increase premiums.
4. Localized Services- wellness partners can easily create a one-stop-shop for employees to access the wellness program, other 3^rd party resources and carrier information.  Plus, they segregate reporting into sub-groups and provide customer support locally.
5. Total Population Health Management- wellness partners have more flexibility to offer services to the entire populations, regardless of health insurance eligibility if the employer chooses.  Carriers only offer services to plan members and can prohibit wellness cultural growth.
6. 6. Comprehensive Delivery- wellness partners assess, educate and engage employees in healthy behaviors.  Carriers typically just assess without providing tools or direction for sustainable growth and improvement.

The key is finding a highly advanced wellness portal capable of supporting partnerships with employers and carriers.  One that is able to integrate carrier data, compliment existing carrier programs or fully replace carrier wellness programs if desired.

FAQ: $10 Million in Affordable Care Act Funds for Workplace Wellness

The U.S. Department of Health and Human Services announced it would be releasing $10 million in Affordable Care Act funds to help create workplace wellness programs on June 23, 2011.  This news certainly peaked the interest of brokers, employers and wellness vendors alike and everyone hit the web to find out more information.  Sifting through all the legal jargon on the official government website (https://www.fbo.gov) can be tedious.  Tri Wellness’ team of experts has investigated the information to help answer the frequently asked questions that are flying around the industry right now.

Q: Why are the funds being released?

A: For comprehensive health programs to address physical activity, nutrition, and tobacco use in the employee population.  The Affordable Care Act of 2010 elevates prevention as a priority providing unprecedented opportunities for health promotion and disease prevention.  Within CDC's National Center for Chronic Disease Prevention and Health Promotion, the Workplace Health Initiative serves as the focal point for worker health. It includes promoting the following public health goals:

• Creating the standard for what employers should do; and how to measure progress.
• Increasing the number of employers that provide workplace health promotion programs.
• Improving the quality of employer's efforts.

Q: Will the funds be released to employers or workplace wellness vendors directly?

A: The funds will be released to workplace wellness vendors (referred to as “contractors” by Health and Human Services, and the Center for Disease Control) who meet the contractor requirements as stated by the HHS and CDC.

Q: When are applications due?

A: Wellness vendors need to submit all required documents on or before August 8, 2011, 4:30 EDT.

Q: How will employers be chosen to participate in the program?

A: Wellness vendors will be required to follow the CDC’s recruitment protocol and choose various employer groups of different sizes, industries, and within 7 different regions (determined by the HHS) across the nation.  Each of the 7 different regions will include 10-15 employers.

Q: What are the size requirements for employers to participate?

A: All size groups will be considered.  Small-size employers are 100 or less full time employees, mid-size employers are 101-250 full time employees, and large-size employers are more than 250 full time employees.

Q: What other requirements besides size are there for employers to be considered?

A: Employers must meet the following requirements:

• Demonstrate CEO/C-Suite commitment to allow employees to fully participate in wellness initiatives.
• Cannot currently have in place a workplace health program that consists of a majority of the interventions as described by the HHS and CDC.
• Only domestic employees and worksites are eligible
• For employers larger than 500 full time employees, the employer will be required to invest a matching amount of funds equal to those provided by the wellness vendor ($50,000).

Q: Are there specific requirements for the actual wellness program once the vendor has recruited the employers?

A: Yes.  There are specific guidelines that have been established in order for the CDC to evaluate outcomes with a consistent study group.  These guidelines include:

• Designate vendor a staff member as program manager
• Establish workplace wellness committee
• Establish site level champions
• Establish community linkages and resources
• Establish specific, measureable goals and objectives for the program

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Assessing the health of an employee population should be the first step when implementing a wellness program.  Additionally, annual assessments should take place to evaluate the impact of the wellness program and the employee population’s health improvement over time.  Health screenings (also known as biometric screenings) produce the most objective data.  This data can usually be integrated into an online health risk assessment providing a more accurate and overall look into an employee population’s health risks based on actual clinical data and lifestyle factors.

Getting employees to participate in health screenings can pose a challenge.  In order to get high employee participation it is important to pick the type of health screening that will work best for your employees and provide the type of data you are looking for.  There are two methods for health screenings:

1. Capillary puncture, “finger-stick”
2. Venipuncture, “blood draw”

When choosing a health screening method consider your employee population and review the following pros and cons:

The venipuncture method allows for more specialized test to be performed, but could also be perceived as more invasive and time consuming by the employees.  The capillary method can be more susceptible to contamination, but may also be more convenient for employees, especially remote workers.  Cost will vary between the two health screening methods and service provider.  The ultimate goal is high employee participation, so choose the health screening method that employees will be most likely to comply with and you’ll be getting the most bang for your buck.