by Jack Bucalo, Columnist & Featured Contributor
[su_dropcap style=”flat”]I[/su_dropcap]N GENERAL, there are two key points to remember about wellness programs: (1) a company’s financial management typically does not view any generalized wellness program as a means of reducing or containing medical claims cost, while H. R. management simply wants to install some kind of easy and cheap wellness effort, and (2) wellness consultants and, to some extent, H. R. management have not demonstrated in dollar and cents that medical claim costs can be reduced or contained year over year by such programs. Think about it! In today’s business environment where medical costs are rising, don’t you think that a company would be more than happy to implement a wellness program IF such a program would have a meaningful effect on reducing or containing such costs?
If H. R. management wants to conduct an effective wellness program that will, at the very least, have a fighting chance of reducing or containing medical claim costs, I would suggest the following three part program that can be implemented with a relatively small amount of administrative cost.
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PART 1 – Employee Medical Insurance Cost
After several years of using incentives that reduce the dollar amount the employee pays for such coverage by living in a healthy manner, the evidence is clear – it doesn’t work. To be effective, the company must utilize disincentives to comparatively unhealthy employees who are costing a disproportionately larger share of its medical claims cost. Here, the employee who uses tobacco or is overweight by his/her body weight index would pay more for their coverage, with a 20% surcharge for each, being a logical starting point to determine the exact amount. Also, changing your hiring policies to ban people who use tobacco or are overweight from employment, or at least give preferential treatment to people who are not, is needed. Such tough practices should be established by legal counsel based on current state and federal law, though they should be utilized wherever possible.
PART 2 – General Health Fairs
These fairs, which employees attend during working hours, cover such subjects as Blood Pressure Reduction, Stress Reduction, Good Eating Habits and Nutrition, etc, and can typically be covered in one hour. Smoking Cessation fairs may take longer, but they are the most important one by far. Outside fitness center discounts may be appropriate, but like an inside fitness facility, the cost-benefit analysis typically suggests it is not a worthwhile expenditure, as mostly healthy employees tend to utilize these benefits.
PART 3 – Specific Health Fairs
For each geographic company location where employees use the same set of hospitals and doctors, the company should analyze the medical claims costs over the past two or three years by diagnostic category (heart, neurological, cancer, lungs, diabetes, etc.) to determine which diagnostic categories are contributing to 80% or more of the claims cost. Typically, there are three or four categories that do. In an effort to drive down these costs, you should conduct health fairs on each of these categories. Actual preventative physical tests (blood test for sugar intake, heart checks, colorectal tabs, blood pressure, etc.) and paper & pencil tests can be given to employees in an effort to identify potential major medical problems before they become problematic.[/message]
Regarding the cost of implementing this program, the administrative H. R. cost to do so typically can be covered by your existing staff as an ancillary duty. The administrative cost of the general and specific health fairs can be almost negligible if you utilize the services of appropriate outside associations, such as the American Heart Association, the American Cancer Society, American Lung Association, American Diabetes Association, etc., whose personnel bring skill, expertise and information on the subject. The biggest cost of the program is the employee time to attend the health fairs. However, with an overall wellness approach suggested by this three part program, you will have a better-than-decent chance of convincing finance and top management to approve its implementation in an effort to reduce or contain medical claims costs. Also, the statistical results of the preventative physical tests (such as, 10 of the 113 employees tested had high blood pressure readings and were advised to see their doctors as soon as possible) should be communicated to employees and management in an effort to market the effectiveness of such fairs.
In sum, the general health fairs help emphasize the company’s desire to have a healthy work force by creating a health conscious culture, while the specific health fairs help attack the primary cost drivers of your medical claims cost. Increasing the cost of employee coverage for employees who create a disproportionately larger part of the cost if allowed by state and local law, should motivate them to change to a healthier life style while letting all other employees know that they will not have to carry a heavier-than-needed burden.
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