| Potential Downside to Insurance Company
| |
| | nurse lines to assist with
|
| Sponsored Wellness Programs
| |
| | self-diagnosis, discounted gym
|
| Employers struggling with the
| |
| | memberships, discounted access to
|
| ever-increasing costs for healthcare are
| |
| | complimentary and alternative medicine
|
| wisely turning to worksite wellness
| |
| | and advertising incentives that reward
|
| programs in search of a solution. For
| |
| | people for tracking activities.
|
| convenience, many employers are looking
| |
| | Most insurance companies, however, fail
|
| to their health insurance carrier to
| |
| | to offer simple and effective programs
|
| provide the appropriate wellness program.
| |
| | that could have a greater impact on
|
| However, the convenience of a health
| |
| | improving member health. For example,
|
| insurance provided program may not
| |
| | there are highly effective online
|
| outweigh the risks. That decision could
| |
| | nutrition programs that can be offered
|
| come back to haunt them.
| |
| | for pennies per eligible member per
|
| At issue is an insurance carriers ability
| |
| | month. Instead insurance carriers are
|
| to use information gathered during a
| |
| | opting to increase claims cost, and
|
| wellness program as justification for
| |
| | ultimately premiums, by covering visits
|
| increasing an employers rates at renewal.
| |
| | to a Registered Dietician.
|
| Since no laws prevent an insurance
| |
| | Though most health insurance carriers
|
| company from using voluntarily provided
| |
| | actively encourage members to complete an
|
| information for rating purposes,
| |
| | HRA, few insurance carriers share the
|
| employers should be cautious about the
| |
| | group-level risk profile with the
|
| information they provide.
| |
| | employer and even fewer provide
|
| Employers should be particularly
| |
| | group-based, onsite wellness programs.
|
| concerned with how their insurance
| |
| | How is an employer using an insurance
|
| company uses data collected during a
| |
| | company sponsored wellness program able
|
| Health Risk Assessment (HRA).
| |
| | to objectively determine the best way to
|
| Health Risk Assessments
| |
| | assist their employees without this
|
| Health Risk Assessments are sophisticated
| |
| | crucial information?
|
| survey tools designed to identify
| |
| | So, why do insurance carriers encourage
|
| preventable health risks on both an
| |
| | HRA completion among their members?
|
| individual and a group level.
| |
| | Insurance carriers generally contend that
|
| Individual participants who complete the
| |
| | collecting HRA data allows them to more
|
| survey receive a custom health profile
| |
| | quickly identify candidates for Disease
|
| that outlines specific health risks and
| |
| | Management (DM) services.
|
| makes recommendations for modifying
| |
| | Health Risk Assessments are not completed
|
| high-risk behaviors. This information
| |
| | at initial enrollment and therefore it is
|
| can serve as a catalyst for individual
| |
| | highly unlikely that many, if any,
|
| change, but more often than not it takes
| |
| | candidates for DM will first be
|
| incentives and customized, individual and
| |
| | identified through HRA data analysis.
|
| or group-based intervention to encourage
| |
| | Instead, most will be identified when
|
| people to modify these high-risk
| |
| | they incur claims related to that
|
| behaviors.
| |
| | disease. For example, candidates for a
|
| Data gathered from individual
| |
| | diabetes management program are easily
|
| participants HRAs is compiled into
| |
| | identified when they purchase insulin,
|
| aggregate or group-level, health risk
| |
| | test strips or any other diabetes-related
|
| profile. This information then provides
| |
| | products.
|
| benchmarks for ongoing measurement,
| |
| | Health Risk Assessments are backed by
|
| assesses wellness program effectiveness,
| |
| | years of research and can be highly
|
| and forecasts future healthcare costs.
| |
| | predictive of future healthcare costs.
|
| HRA data also serves as a roadmap for
| |
| | As the cornerstone of most worksite
|
| intervention on both an individual and a
| |
| | wellness programs the value of an HRA is
|
| group level.
| |
| | not at issue. Instead, the issues
|
| By way of example, assume that a companys
| |
| | surround the use and control of HRA data.
|
| group-level risk profile reveals that few
| |
| | Without laws to prevent an insurance
|
| employees exercise on a regular basis.
| |
| | carrier from using voluntarily provided
|
| Using this information, an independent
| |
| | information for rating purposes employers
|
| (non-insurance) wellness vendor could
| |
| | would be well served to confirm in
|
| customize an effective workout that does
| |
| | writing exactly how HRA data will be
|
| not require a gym membership.
| |
| | used. At minimum employers should
|
| To further enhance results the wellness
| |
| | confirm that HRA data will not be used
|
| vendor might also provide a group-based
| |
| | for rating their individual company or
|
| seminar about starting and maintaining an
| |
| | for rating the insurance carriers overall
|
| exercise program. By offering an
| |
| | block of business, because that also
|
| incentive for exercising and/or attending
| |
| | indirectly impacts an employers rate.
|
| the seminar the level of participation
| |
| | To eliminate any possible conflict of
|
| should increase, thereby increasing the
| |
| | interest, many employers are avoiding
|
| overall effectiveness of the program.
| |
| | insurance company sponsored wellness
|
| Often a wellness vendor will assign a
| |
| | programs and are opting to utilize the
|
| health coach to each individual to assist
| |
| | services of independent wellness vendors
|
| them in setting and maintaining their
| |
| | instead. This decision easily prevents
|
| goals. The health coach also increases
| |
| | wellness data from being used against an
|
| the effectiveness of the program.
| |
| | employer by an insurance company.
|
| Insurance carriers, however, take a
| |
| | Employers should remember that Health
|
| different and varying approach to
| |
| | Risk Assessments are tools designed to
|
| providing a wellness program. Many
| |
| | measure risk, plan interventions and
|
| health insurance carriers offer a limited
| |
| | measure results. Health Risk Assessments
|
| number of individual level interventions
| |
| | do not improve employee health; it is the
|
| including; Employee Assistance Programs,
| |
| | programming that results from the
|
| online health information, toll free
| |
| | assessment that makes the difference.
|
