We have reported many times in the past on the offerings, study results, interviews, etc., offered by Welcoa - The Wellness Council of America.  This source has been around for more than 20 years and continually produces information and resources which are of high quality, and oftentimes free, for employers seeking to improve employee health and productivity.  You can check out all their offerings at www.welcoa.org. 

In one of their "Interviews," Dr. David Anderson (VP and CHO of StayWell Health Management) discussed his views on "the art and science of demonstrating outcomes."  He was interviewed by Dr. David Hunnicutt, President of Welcoa.  To read the entire interview, log onto their Web site, click on "Free Resources" at the top of your screen, and then choose "Interviews."   You'll find this interview there, along with many others of potential interest.

Dr. Anderson advocates a balanced approach to applying your health management dollars - not focusing exclusively on high risk employees alone where the cost savings can, of course, be dramatic on a per employee basis, but also on those at low risk to maintain their healthy life styles.  He indicated that ". . we found in a recent study that best-practice programs reduced overall risk in their population by about 5% in a one-year period compared to about 2% reductions in a standard practice group."    So, it is possible to significantly impact risk and costs in a relatively short period of time. 

Further, Dr. Anderson and his group have found that it is extremely realistic to achieve an ROI of 2:1 ($2.00 for every $1.00 spent) by the end of your third program year, but that means an investment of real dollars over a period of three years.   You have to take the long view and really put the dollars to work in programs that work. 

But how do you figure out what really works?  Among all the other things you are doing, try these links:

Well Workplace Checklist

The Health Enhancement Research Organization (HERO)

and, Welcoa itself at www.welcoa.org

One last comment about this interview.   Dr. Anderson pointed out that "The unfortunate irony is that the relatively small wellness investment [$300-$500 pepy] is being held to a much higher standard of proof - a positive return-on-investment - than the over $10,000 per employee being spent each year on sickness care."   This really puts the investment in any wellness initiative or on-site service clinic in perspective, doesn't it?  But, I guess there are still those out there who  can't see the forest for the trees.

Cyndy Nayer, CEO of the Center for Health Value Innovation, wrote a white paper based on the Innovators' Summit held in February of this year.  The title is "Outcomes-Based Contracting(TM), The Value-Based Framework for Optimal Accountability."   

Again, we realize how busy you are, and this paper runs a full 16-pages in length, so you need to sit down in a quiet spot with a cup of coffee to go through it.  Take your time, I think you will find it thought-provoking and something you will want to share with others in your firm.  This is the type of approach that works best in an on-site environment and which is "lost" on most standard benefits coordinators.

Our summary:

One of the major goals of employers (with respect to healthcare for their employees) should be to supply the tools and create an environment in which each employee can become "the engaged and accountable individual who uses the information to manage his or her own health and economic improvement through engaged, accountable providers."   In order to achieve this goal as quickly as possible, employers can use Outcomes-Based Contracting to accelerate the positive effects of value-based benefits design.

Further, as employers move along the Health Value Continuum(TM), they go from being "reactive" to a point where their programs should become fully sustainable, impacting the entire workforce (and, ultimately, the community at large).   In order to do this, a key concept must be the alignment of goals of all participants, from the employee, to the employer, to the provider/vendor.  Everyone has to win.  It makes sense.    This means focusing on outcomes, a long-term commitment, and the at-risk population (however, see the comments of Dr. Anderson above, who believes you must truly focus on everyone, even those at low risk). 

So, when you are looking at programs, suppliers, physicians and other providers, and hospital and pharmacy arrangements (all your potential agreements and, don't forget, your employees and their dependents), you have to figure out how to reduce the friction that naturally occurs when one element is out of sync with the others (one benefits more than the others) to achieve maximum employee engagement and outcomes.  This improved engagement drives the behavior change needed to get the outcomes desired.

How do you support behavior change?  By employing what Nayer calls the "Five Cs" (Commitment, Concern, Cost, Communication, Community).   For those of you working at the design level for your program, or those vendors who are constantly seeking ways to improve the services they provide, this article should be helpful, and it is the first in what is anticipated to be a series on how to achieve results more quickly.