by Paul Risner, U.S. Preventive Medicine
Corporations are flocking to wellness programs, and it appears they will continue to do so for quite some time. According to a 2007 survey of CEOs of global companies, conducted by PricewaterhouseCoopers Health Research in conjunction with the World Economic Forum, more than half of multinational corporations expect to introduce or expand corporate wellness programs over the next 5 years. The survey, “Working Toward Wellness: Accelerating the Prevention of Chronic Disease,” identifies chronic illness as a growing and costly threat to employees and their companies.
As companies continue to view wellness programs as an effective means of addressing employee health and healthcare spending, many are exploring developing in-house wellness programs. While wellness programs are beneficial—healthier employees equal reduced illness, increased productivity, reduced absenteeism, and, over time, lower insurance premiums/reserves—creating an in-house wellness program as a means of achieving these goals is not a good idea for a variety of reasons.
Participation. Participation is the key to realizing a cost-savings benefit from a wellness program. Full participation requires information about life away from the workplace. Generally, employees are extremely wary about sharing details about their out-of-office choices, lifestyle, and habits. They are innately suspicious about what their company or insurance provider might do with the information. Their reticence to share this information creates an insurmountable hurdle to implementing a successful in-house program.
Capability. Chances are, you know more about how to run a business and about the particular business you’re running than you do about providing a clinically sound wellness program.
Exposure. Driven by all the right reasons, companies can become overzealous in the information collecting aspect of implementing a wellness program and run the risk of inadvertently violating existing privacy laws. Even inadvertent noncompliance puts them at risk of violating pertinent state and local insurance laws, and national acts such as the Health Insurance Portability and Accountability Act and Americans with Disabilities Act, which include privacy protections.
The key to implementing a successful wellness program is using a third-party provider. Third-party providers have the distance necessary to be fair and impartial, and they overcome employee reticence to share the personal information key to full participation. The challenge is identifying a qualified provider. Here are some tips to identifying the right provider for your company.
Experience/Expertise. The third-party wellness provider should have documented evidence of providing the type of service you require. What is their track record? Are they able to demonstrate their ability to overcome human resistance to change? Do they provide the services you require? Are they clinically knowledgeable and accredited by recognized agencies? Will they represent you in a manner consistent with your approach and culture?
It’s important that the third-party provider is skillful in addressing the issues of your employee population; a service firm with desk workers is likely to have different health issues/risks than an industrial facility with factory workers or a delivery company with drivers.
Certification. Look for providers that have been certified by recognized regulatory bodies such as URAC (formerly the Utilization Review Accreditation Commission, now acronym only) and the National Committee for Qualification Assurance (NCQA), both of which are government-sanctioned accreditation entities that qualify the soundness of a healthcare services provider.
Foundation. The third-party provider must be able to function independently of your organization, and have the legal understanding and support necessary to ensure they won’t inadvertently run afoul of local and state laws, and/or national regulations governing employer/employee interaction. Additionally, it’s important that they have a general sensitivity to discrimination and privacy issues. Ultimately, the noncompliance of a third-party service provider is your company’s responsibility, and your company will be held responsible and liable for whatever penalties may be associated with that noncompliance.
Lastly, beyond all the clinical, legal, and regulatory issues, the best way to ensure successful adoption of a wellness program is management involvement. While providing encouragement, access, and freedom to participate is important, it’s not enough. Management cannot simply direct, it must walk like it talks and lead by example.
And, perhaps most important, once a wellness program is in place, companies should ask themselves “Is it working?” While not every dollar spent will reflect a dollar saved, your company must realize a cost benefit and this must be matched to the company’s bottom line. Be sure to measure the results.
Wellness programs have proven useful in improving employee health and indirectly reducing healthcare spending. While implementing a wellness program in-house may seem tempting, it’s not as easy as it may seem and it’s fraught with risk. Even contracting with a third-party provider requires careful due diligence to eliminate risk and garner the desired outcome.
Paul Risner is Executive Vice President and General Counsel for U.S. Preventive Medicine, a privately owned global prevention services company providing primary, secondary, and tertiary clinical prevention services to government, employers, and consumers.