Should Wellness Dollars Go to Disease and Lifestyle Management?

In most employee groups, a small number of employees with serious diseases accounts for a large share of healthcare costs. Disease management programs can help.

Willy Wonka Wellness ‘Golden Ticket’

We’re all hungry for a simple answer to the question of where to spend our wellness time and money, says Consultant Karl Ahlrichs, SPHR. He sees three alternatives:

• Disease management
• Wellness
• Do nothing

What works? There are three types of populations, says Ahlrichs, who is a consultant with Gregory & Appel Insurance. He offered his tips at BLR’s Advanced Employment Issues Symposium, held recently in Las Vegas.

Have a population with expensive chronic conditions?

Start with disease management to get fast payback. Work wellness in as your long‐term plan.

Have a population with average chronic conditions and a somewhat diverse population?

Balance implementing both a disease management and a participation‐based wellness program.

Have few chronic conditions and a very diverse workforce?

Implement a standards‐based wellness program. Apply disease management as needed.

What have we learned about selling wellness and Disease and Lifestyle Management (DLM)?

• CFOs will fund DLM if it can help slow the rising cost of health care.
• COOs will support DLM if it can increase productivity.

CEOs will align with DLM if it aligns with the organization’s goals.

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Fortunately, says Ahlrichs, all of these are core HR functions in the future. Furthermore, he says:

• High performers respond to a “Wellness Based” culture.
• Customer service is the “killer app” for the future of HR, and wellness is a big part of achieving that.
• Building a sustainable culture with values alignment is key, and wellness is the best way to do exactly that.

Exactly What Is Chronic Disease Management?

The provision of person‐centered care in which health services work with each other and with the client with a chronic illness (and/or the client’s care provider) to ensure coordination, consistency, and continuity of care for clients over time and through the different stages of their condition.

What is a HARP?

A HARP (Hospital Admissions Risk Program) provides similar services with the specific hope of identifying treatment methods that avoid expensive hospital stays.

8 Steps to Disease and Lifestyle Management

Ahlrichs suggests an 8-step program for disease management:

1. Secure Partnership

• Are you organized for success (leadership, governance, stakeholders, etc.)?
• How far are you prepared to go?

2. Understand Consumer Needs

• Most common condition(s) affecting your workers.
• Barriers to service access for your workers:
• Financial
• Time off
• Distance
• Access.
• Consult with consumer/worker representatives on needs and barriers.

3. Partner with Consumers

• Involve consumers in planning.
• Support and provide resources to consumer groups.
• Support consumers to be actively involved in their own care.

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4. Coordinate and Plan Care

• Chronic care includes systematic assessment, care plans, systematic follow-up and review, and a multidisciplinary team.
• Care should be evidence-based and reflect best practice.
• Provide/create service coordination tools.
• Develop pathways for local care.

5. Self‐Management Support

• Train service providers and clinicians.
• Promote the use of validated self-management models.
• Ongoing support of changes in clinician practice.

6. Health Promotion

• Raise community awareness of chronic disease risk factors.
• Link to peak body health promotion activities.
• Encourage risk factor screening (people with chronic disease still need to address risk factors).

7. Target Subgroups

• Obtain and analyze population health data.
• Gather and provide information from local agencies.
• Plan appropriate interventions.
• Build on health promotion initiatives with at‐risk and “hard to engage” populations.

8. Plan for Success

• Build on past success.
• Skills and experience of partners.
• Language—do we mean the same things?
• Outcomes and timelines.
• Communication back to/within organizations.

In tomorrow’s Advisor, more of Ahlrichs’ wellness tips, plus an introduction to the new guide, HR Playbook: HR’s Game Plan for the Future.