A Guide to design Win-Win Wellness Programs

Getting Started-Where do you begin?

The key to success in wellness is to take a strategic approach. When planning a company's wellness program, the first thing one should do is look around. It is important to understand from the grassroot level as to where they stand on health & wellness matters. Here are some steps to consider when embarking on a wellness initiative.

1. Assess the situation
   

• Senior management support-Without senior management support, a health management strategy can fall flat. Start with the health of the executive team and discover the wellness champions at the top of the organization.
  
• Analyze the problem- We have to look at the health care claims and analyze the trends. Which conditions are driving the medical, disability, and workers' compensation claims and which are modifiable?
  
  • What's worked and what hasn't so far? What is the long-term impact of doing nothing?
    
  • Do a Health Risk Assessment in depth interview with organization heads/department heads and compile their views on what's good and what's bad?
    
  • Review claims and utilization data and identify key areas of concern. Look at current offerings and see how they can be tailored to the needs of the population.
    
  • Find out what employees are thinking. Hold some focus groups to determine where people are with wellness. What's working? What isn't? How much interest do people have in wellness? What obstacles and barriers are employees experiencing when they try to change behavior?
    
  • Consider both healthy and unhealthy employees. Since 85% of claims are usually attributed to 15% of claimants, it is essential to reach those with the most costly conditions while also reaching people who are at risk for developing preventable diseases in the future. Voluntary wellness programs such as lunchtime seminars miss many of the people who need them most. Consider programs that are population-wide or target intact workgroups. Incentives help but do not motivate everyone.
    
  • Identify Bottlenecks
    
    • Psychology of the workforce
      
    • Resistance to Change
      
• Set goals for organizational health. Consider the more intangible benefits of a wellness initiative and quantify them whenever possible. Include employee turnover rates, cost of new hires, employee morale, benefit satisfaction data, and employer of choice issues in setting goals.
  

1. Determine outcomes
   

Once the current situation is analyzed, imagine the impact if it continues. Some of the questions to be answered are

• How much does the company currently spend on health care expenses?
  
• Are the health care costs trending upward?
  
• Does the group have a higher-than-average submission of health care claims?
  
• How might that affect the business in the future?
  
• How many working hours are lost to sick days?
  
• Can we identify any of the health problems that are common in the workplace?
  
• Are the employees getting any exercise?
  
• Is there a high percentage of smokers at work?
  
• Is the menu filled with high-calorie junk food?
  

Establish ROI- Wellness initiatives are expensive and most of the savings are not realized for a number of years. Projecting a Return on Investment for wellness initiative can play a big role in soliciting top management support. The ROI does not only come from reducing the healthcare claim cost but also in various other intangible forms. This could include benefits accrued because of lesser absenteeism, lower attrition ,improved productivity. Considerable research is being done across the world to develop a standard ROI matrix for wellness initiatives. However currently we have to develop a ROI index based on the determined outcomes

1. Planning
   

The better we plan, the easier it will be to realize the benefits of a workplace wellness initiative. The wellness program will need to fit in to the regular rhythms of the workplace, and that means getting support from managers and leaders in the company. It also means that the design of the wellness initiative fits into the company culture.

Factors to be considered

• Get support from management- Managers are leaders, and employees will generally assess the priorities of senior and mid-level management before investing time and effort in a wellness program. For this reason, support from company management is the single most important factor in the success of the wellness initiative. Senior and mid-level managers will have to participate actively and support wellness activities.
  
• Set Clear Goals - Desired Outcome Goals and Objectives
  
  • 25% decreased absenteeism
    
  • 75% Health Risk Assessment participation
    
  • 85% flu immunization
    
  • 75% participation in wellness program
    
  • Reduce number of employees with multiple risk factors: obesity, smoking, lack of exercise
    
  • Increase physical activity at work and at home
    
  • 60% participation in "walk at work" program
    
  • Increase consumption of fruits and vegetables
    

Designing the program

Here are some factors to be considered while designing the wellness initiative

Step 1: Keep it simple, positive and upbeat

Employees' perceptions of the wellness program will impact participation. We have to present a positive and upbeat image to the employees and their family members. The program should be user-friendly, sensitive, compassionate and confidential. It is important to communicate and reflect a firm company investment in the wellness initiative. To get the employees to take the program seriously, it's important to have adequate funding and support from management. Company-wide activities such as walks, runs or smoke-outs will help make the program fun for employees and can provide a welcome break from the workday. Web-based tools such as will help deliver user-friendly tools for use outside of work.

Step 2: Implement the program

The wellness program will be more effective–and fun for everyone involved—if we execute it with the same degree of planning and organization that is applied to business development tasks and projects. It is important to get the right people, budget and resources to encourage maximum participation and follow-through from employees. So it is imperative to consider the implementation strategy and techniques to reach the target audience during the design stage itself

Step 3: Communicate

The success of the program will depend a great deal on communicating the cause and effect relationships to everyone concerned. It is critical to analyze the most effective communication methods to reach the target audience and weave it while designing the program

Step 4: Program Incentives

Another key element while designing a wellness initiative is to consciously plug in incentives for garnering participation. This is inevitable as the social mindset is still not inclined towards preventive health in our society. It can be a mix of monetary and non-monetary incentives

Step 5: Evaluate

It's important to measure, evaluate and improve the wellness initiatives on an ongoing basis if it has to be a truly effective wellness initiative. The design of the wellness initiative cannot be rigid and should have room for continuous enhancements

In summary, the best way of going about doing this is to embark on a study and analyze the factors to be addressed by different organizations in the group. The outcome of the study can be used for designing the wellness initiatives.

Tips for creating effective wellness initiatives. Perform a needs assessment Emphasize high participation rates Craft tailored behavior change messages for participants Stress that employees must be active participants in their healthcare Ensure that programs address multiple risk factors Provide easy access to programs and effective follow-up Provide social support Provide incentives for participation Maintain a healthy company culture and executive support for programs Ensure sufficient duration of program—at least three years Source: Thomson Reuters

Listen to the Lub-Dub- A campaign for healthier hearts

27^th September 2009 is World Heart Day. Over 17.2 million people die each year from cardiovascular diseases, making these the leading cause of death worldwide. Yet 80% of premature deaths from heart disease and stroke could be avoided by controlling the main risk factors: tobacco, unhealthy diet and physical inactivity.

Almost half of those who die from chronic diseases are in their productive years. The economic consequences - driven by productivity reduction and increase in costs caused by these diseases among workforces - are dramatic. Countries such as Brazil, China, Russia and India currently lose more than 20 million productive life-years annually to chronic disease, and that number is expected to grow 65% by 2030. The losses in productivity associated with those diseases like disability, unplanned absences and increased accidents are as much as 400% more than the cost of treatment. The WHO estimates that between 2005-2015 income loss (in international dollars) could rise to as much as $237 billion in India.

Yet it is mostly large corporations in developed countries that offer workplace health programmes. There is an urgent need to extend these benefits to all employees, in all industries and sectors in our country .

PeopleHealth, in line with its mission of educating and motivating people in to a culture of health is working towards mitigating the risk factors associated with workplace sickness through a series of communication and awareness campaigns.

We invite you to be a part of this continuous awareness programs and encourage your employees choose healthier lifestyle options.

What should you do to promote Healthier Hearts in the work place ?

· Display the Poster on Heart care

o You could also include your organisation’s logo and print as many of them to display it in your office surroundings

· Circulate the “Listen to the Lub-Dub”- A e-guide to a healthier heart to all your team members (e-mail benefits@peoplehealth.in for a free copy)

· Call peoplehealth on +91-80-653 00 999 if you need further support to promote the activity

Let’s all do our little bit in promoting worksite wellness which could lead to the prosperity of self, organization, society and the nation!

Go Healthy Now!

Getting the Maximum of healthcare benefits How do we avoid increase in insurance premiums?

 

My previous blog tried to expose the aspects of Health Insurance and Healthcare in the Indian context. The following blog tries to address matters on preventing the huge increase in health insurance premiums which is every organization's concern area during annual insurance renewals.

Haven't we all heard the old adage "Prevention is better than cure"? It can't be truer in the case of Health Management Initiatives at organizational levels. There are new benefit systems that is being designed that include flexible, hybrid designs that take a holistic view of employee health.

When we are all healthy and keep fit, the chances of falling sick and using the insurance benefits come down leading to lower claims. This in turn will help all of us in controlling the increase in insurance costs.

A step in this direction is a 'World of Wellness' initiative of PeopleHealth. Programs under this will be customized and implemented based on the diverse needs of employees. The main objective is reduce health risks of employees and thereby bring down the claim on lifestyle diseases.

Walking uphill together

PeopleHealth today is working towards incorporating Healthy lifestyle and wellness programs into benefit structures of organizations. However the stakeholders- Organizations, Insurance Providers and wellness Custodians will have to jointly assume greater responsibility for the success of such initiatives.

What should the organization do?

• Educate the employees of the organization in using the health insurance appropriately
  
  • Knowledge of insurance benefits is very important. Always do a thorough study before using the insurance benefits.
    
  • If its an emergency seek the support of your TPA in utilizing the benefits
    
  • If it's a non-emergency
    
    • Check if your requirement is a common procedure(E.g.: Maternity ,Bye Pass surgery, Cataract, Knee replacement etc)
      
      • If it is a common procedure enquire if the rates quoted is the same across similar facilities
        
      • Also check if the hospital has differential rates for insured and the non-insured.
        
    • If the rates for the non-insured is lower, you might opt to use that facility and claim your insurance later from your TPA
      

 

Excerpts from a PWC study

Eighty percent of companies surveyed said employers could help reduce costs by providing employees with more information about healthcare prices and quality. Most employers were confident of their employees' ability to make good decisions if given accurate and easily accessible information. Close to seven out of 10 employers believed that if they provided better information to evaluate drugs, doctors and hospitals, their employees would have lower healthcare costs and higher quality care. However, only 38% of employers indicated that they provide "a great deal" of information, updated regularly, to their employees for this purpose, while 42% said they provide a "moderate" amount.

When survey respondents were asked which actions, if taken, would reduce their company's healthcare costs, most agreed that the following three actions would do so:

1. • Make employees pay a higher percentage of healthcare costs
   
2. • Give employees more information about healthcare prices and quality
   
3. • Provide financial incentives for employees participating in healthy lifestyle programs
   

 

What will PeopleHealth do?

• Strategies: We will set a course that aligns health care strategies with people and business strategies. We will open up channels for collaboration that can increase information sharing and the development of new solutions.
  
• Flexibility: We will design benefit plans and programs and develop targeted programs that address the specific needs of the team members to most effectively improve the health as well as increase the opportunity for cost savings.
  
• Think prevention: We will develop a cost-sharing mechanism that promotes access to preventive services and take steps to integrate preventive services and insurance management.
  
• Revisit wellness: New initiatives to encourage healthy lifestyles and wellness will be considered as part of the benefit plan design to reduce healthcare expenditures
  

  These programs may need to include incentives for participation, in order to encourage employees to lead healthier lifestyles. This initiative provides an opportunity for innovation to collaborate with employees to design new wellness and prevention programs, fostering employee involvement in their own health.
  

• Value transparency: We can source and develop information on the costs of common procedures and the appropriate way of utilising it.
  
• Provide education: PeopleHealth will develop and deliver training and education to enable employees to be better consumers–to fully understand the benefits and understand the real cost of healthcare and its effect on their personal budget and the organization's bottom line.
  

  Deploy an education process that is continuous and engages employees in an interesting and convenient manner. In order to maintain a successful program, employees need to be reminded frequently what programs are available, how they can participate, and the rewards available for that participation. Executing these changes will require changes across the spectrum requiring leadership and changing roles and activities of each of the stakeholders
  

In Conclusion, there are many opportunities for us to take proactive steps in managing healthcare costs and enhancing the quality of the benefits that are available. We will take a more holistic look at the problem. The change to proactive healthcare is neither simple nor quick, but if executed well, may drive long-term benefits to all of us alike.

Reference:

1. Healthcast 2020:Creating a sustainable future-A study by PRICEWATERHOUSECOOPERS
   
2. www.irdaindia.org
   
3. www.ibef.org
   
4. PricewaterhouseCoopers' Health Research Institute
   
5. First Consulting Group
   
6. McKinsey studies on Healthcare
   

Health Care and Health Insurance -Indian Perspective

The Indian healthcare system is well defined on paper and was effectively implemented in the early years of independence. However over the last few decades the system of healthcare delivery has changed a lot with the advent of liberalization. We have well known public healthcare providers co-existing with private service providers. The Public health systems in most states barring Kerala and West Bengal have not progressed with the times and today cater predominantly to lower economic strata of the society. The Middle class has started relying on private nursing homes and hospitals owing to better hygiene and availability of better healthcare professionals. India spends about 6.5 to 7% of GDP on Health care (official estimates hover around 6%) out of which 1.3% is in the Govt. sector (this accounts for 22% of overall spending) and 4.7% in private sector (78% of overall spending).

Though healthcare costs in India is one of the lowest in the world, it is increasing at a fast pace .If proper measures are not taken by all of us jointly, it could reach price levels of the western nations making life difficult.

What is Health Insurance?

Insurance is defined as the equitable transfer of the risk of a loss, from one entity to another, in exchange for a premium. The insurance rate is a factor used to determine the amount, called the premium, to be charged for a certain amount of insurance coverage.

Cost of Insurance

Like mentioned earlier, the cost of health coverage has been going up and it is inevitable to maintain premiums at same levels. The reasons for this can be classified into two:

Macro Economic Trends: These are factors relating to the country as a whole. The factors include interest rates, law of supply and demand with respect to professionals, facilities, overall health status of the population and many more. This trend develops over a period in time if we do not take sufficient measures in our individual and group capacity.

Group insurance behavior: For most of us health insurance is provided/facilitated by the organizations that we work in. The organization helps in securing the best possible rates for insurance cover for all its employees and pays a combined premium for this. However at the end of the year when the policy is reviewed, if it is found that the insurance company has paid out more amount than it collected as premium towards financing the healthcare needs of the organization’s employees, they increase their premiums in the subsequent years to make up for their loss. This is called as claim loading and can vary between 40% to 400%.

We all can join hands together and ensure that we act responsibly when it comes to utilization of benefits. This will lead to containment of claims and if done continuously can lower the insurance premiums over a period of time

Global Health Coverage trends

In my last blog, I had touched upon the importance of having a healthy team especially during a downturn. In this let me cover some aspects of health coverage available to citizens globally .
How does Health Coverage work globally?
The days when healthcare sectors operate in silos must end. New solutions are emerging from beyond traditional boundaries and innovative business models are being formed as healthcare becomes globalized. In a world in which economies are globally interdependent and the productivity of nations relies on the health of its citizens, the sustainability of the world’s health systems is a national competitive issue and a global economic imperative.
Different countries follow different systems of financing the healthcare for its citizens. For citizens in most of the countries in Europe like United Kingdom, Sweden etc ,healthcare is free and taken care by the Government. The Government has created wide network of clinics, hospitals and pharmacies to take care of its people. Citizens in these countries are not used to paying for their health needs and believe that it is the Government’s responsibility to take care of their health. Typically in such countries, the income tax levels are very high as well. At the outset, this kind of system looks like ideal and don’t we wish it was the same here! However citizens of such nations are not very happy with their set up as it is characterized by lack of qualified professionals and long waiting time for simplest of treatments. Also they cannot afford to approach private service providers in their country as the fees charged by private hospitals are exorbitant.
Whereas in countries like the United States, healthcare is pre-dominantly driven by Health Management Organisations (HMO) which is a combination of Health Insurance Company and a chain of service providers. Healthcare is very expensive in such nations and every person is advised to take health insurance cover and they say; only God can save a person without the insurance cover. Also unlike in India, the insurance premiums are very high. Most business organizations in such countries help their employees by absorbing a portion of the health insurance premiums.
As health care costs skyrocket, patients in the developed world are looking overseas for medical treatment. Medical Tourism is a developing concept whereby people from world over visit a country for their medical and relaxation needs. India and many other Asian countries are capitalizing on its low costs and highly trained doctors to appeal to these "medical tourists." Even with airfare, the cost of coming to India for surgery can be markedly cheaper, and the quality of services is often better than that found in the United States and UK. The availability of multiple treatment options like Ayurveda & Sidha is an added advantage. Indeed, many patients are pleased at the prospect of combining their tummy tucks with a trip to the Taj Mahal.

In summary, healthcare costs are rising all over the world. Unfortunately higher costs over a longer period of time lead to increase in the costs of healthcare. The costs can be controlled only if there is greater importance given to proactive and preventive care by adopting wellness management.
Await views on: Health coverage in India, the boon and bane of health insurance coverage and wellness management trends!

How Healthy is your team?

Off late, it has become routine to wake up every morning to a bank collapse, liquidity crunch, SLR/CRR cuts and many more such jargons that many of us have read in graduate school and forgotten. There are umpteen numbers of articles written or views aired about this and its effect on the Indian Economy, the jobs, the pay cuts and so on. I am raising a more pertinent question that is to be thought about by an individual, addressed by an organization and that is of paramount importance to the nation.
How healthy is our Manpower? Will we able to sustain the growth rate at the current levels and achieve the vision 2020 dream or projections set by various leading consultancies of India being the most powerful economies vis-à-vis the health status of our human capital?
Reality Check ?
We, the younger employed generation today have imitated the western world in many of our practices, be it the pizza or a coke revolution. Unfortunately we have not learnt the importance of taking care of our health. Contrary to the old adage “prevention is better than cure”, we tend to practice the opposite.
Already considered the diabetes capital of the world, India now appears headed towards gaining another dubious distinction — of becoming the lifestyle-related disease capital as well. A recent study shows the incidence of hypertension, obesity and heart disease is increasing at an alarming rate, especially in the young, urban population. According to WHO Heart Diseases to be single greatest 'killer' in India by 2015 with 1 in 8 affecting people under the age of 40. According to the study, the average Indian waist size has increased by two inches over the last three decades. It also indicated that around 100 million people suffer from hypertension now, compared with 4-6% in the 1970s.
The contribution of the service sector to the country’s GDP is also mounting over the years (1980-81: 41%;2006-07: 54%)and is expected to go up further. Needless to say the most important producing asset in the service sector is the manpower. The service sector and knowledge based economies rely on intellectual capital which is critically dependent on the quality and health of employees. It is important to note that by 2020 an estimated 17% of the population will be in the age group of 35-54 years. This is the age group when an individual peaks in his/her knowledge quotient and intellectual inputs. We need to assess the health & productivity status of our Manpower, (the most important capital) and take steps to improve the health & wellness condition if we are to dominate the world economy in the years to come. A detailed analysis needs to be done and steps taken towards maintaining and improving one’s wellness condition.
For instance lets take the IT/ITes sector which contributes close to 5.5 % to The GDP. This industry employs close to 10 Million people directly and indirectly (Crisil survey). The sedentary lifestyle of people employed in this sector invariably leads to long-term damage to health and wellness thus rendering an individual unproductive. For organizations in this sector the key revenue and profitability driver is the human capital itself and hence should form the core of the people management as only a healthy individual can be optimally productive to meet organizational requirements.
A PeopleHealth study over the past three years has indicated that health risks have increased phenomenally. 1 in 3 have at least one health risk and the happiness index is at a dismal low of 8%. Also awareness about general health conditions and wellness is missing. These health risks if not addressed by modified lifestyle could lead to serious disorders. Productivity Loss due to Health conditions have started affecting the bottom-lines. Each health risk in an individual leads to approximately 1 day of productivity loss in a month. The monetary loss because of health risks if computed throws startling figures.
What is the solution?
The need of the hour is to evaluate the situation and understand the implications this could have on an individual’s health, organisation’s growth and the country’s economy. Thereafter it is imperative to create an effective long term execution plan, both at macro and micro level to protect the human capital from health disorders.
Organisations and the Policy makers can at best make healthcare more accessible and lay guidelines. However nobody else can be held responsible as much as the individuals themselves for managing their health
Watch out for views on how the developed world has tried to manage its corporate citizen’s healthcare, the global trends, the current Indian scenario and the possible ways of protecting human capital for years to come