This article is the third and final in EBN's annual Open Enrollment Boot Camp series, designed to strengthen benefits practitioners with different strategies to employ during this year's enrollment season. Earlier this month, the series examined the advantages of maintaining financial, legal and physical wellness programs as a single component. The article, "Under one umbrella," as well as the first installment from EBN May, "Breaking down the wall," which outlined strategies for employers to use in increasing employee engagement and participation in retirement plans and financial planning, is available at ebn.benefitnews.com.
More than 80% of the nation's businesses with 50 or more employees have some form of health promotion program, according to the Wellness Council of America, and this trend is growing. Thus, HR/benefits professionals likely will face the task of selecting a wellness program provider, such as health coaching, incentive programs, health risk assessments, biometric screenings and/or vaccinations.
Finding the right wellness partner can be a challenge, since employers' needs and resources vary widely, as do employees' risk factors.
"There is no cookie-cutter approach," says Nancy F. Brock, MSW, chief growth officer at Provant Health Solutions. "There are a variety of data elements that you need to completely map to the employer's business objectives and what they are trying to accomplish with their program."
Making the selection process even more confounding is that providers often bundle and price their services differently - and, of course, promise different deliverables in terms of program return on investment.
"Wellness programs historically have measured utilization or participation. The real goal of a wellness program is to help someone achieve a healthier lifestyle, which ultimately has all of the benefits that we're familiar with, [such as] lowering health care costs, improving productivity," says Pam Cash, head of integrated wellness at LifeSynch. "But typically where the gap is, is not being able to measure exactly how the behavior has changed or if, in fact, it has. That whole ROI piece is not a one-year venture, it's an opportunity for companies to measure how effective they are, but that's a three-to-five year venture to pull that together."
Picking a wellness vendor potentially is a multimillion-dollar decision for benefits managers. Choose well, and the result is a healthier, more productive, less absent and less costly workforce. Making the wrong choice, however, can mean hundreds of thousands of dollars down the drain - not to mention an untold amount in lost confidence from employees and the C-suite.
With so much on the line, EBN outlines eight major points benefit professionals should consider when weighing their wellness options.
1. Program customization
Most HR/benefits professionals know wellness services run the gamut, but confusion sets in around the term "customization." Some wellness providers offer custom solutions, and others do not. For those that do, experts advise two things: Determine whether there are added fees for program customization and determine the meaning of customization with each wellness provider.
For example, is customizing limited to color options or does it mean program components can be fine-tuned to the health needs of employees, business culture and other factors? Ultimately, experts say, employers want to select a vendor who can provide these answers upfront and, ideally, one that can create a wellness strategy and programs to fit your business and the people running it, not the other way around.
Dr. Laura Ten Eyck, senior analyst/metrician at LifeSynch, says it succinctly: "I think that all employers want to know the bottom line and how their employees are benefiting and how the program is saving them money. [Still,] I think every employer is going to be different in what they need."
2. Program integration
"The trend in wellness today is about integration," notes Cash. "That lends itself to those [integrated] providers to connect the dots around metrics and outcomes in a different way, [as opposed to] a silo fashion."
For example, multisite employers may want to consider a provider that features a Web-based health risk assessment to reach employees across the country - or the globe. Other key integration features might include an incentive program, employee communications plan promoting HRA completion, and back-end capability to compile and report data in a way that's compatible with an employer's internal software.
Integrated features also help the program appear seamless to employees when they look at the wellness program along with other company offerings. "It's important for us that the wellness piece is very integrated with our benefits package. When [employees] are electing all their benefits, they're actively electing to participate or not in the wellness program during open enrollment," says Christina Fath, wellness administrator for the City of Charlotte, N.C., which launched a wellness program for its 6,500 employees in 2004. "We've got their attention because [the choice] is in front of them, and they have to make an active election."
Thus, HR/benefits professionals should go into vendor selection remembering that wellness programs are only as effective as the degree to which they are built on appropriate and targeted action.
3. Service delivery
Wellness providers offer several ways of delivering services - onsite, telephonically or via the Internet. Employers will want a provider capable of all three modalities that can develop the right mix to address the needs of their employee population.
Another consideration is whether the vendor administers services using its own trained staff. It's not uncommon for wellness providers to subcontract their service offerings. This could mean a different team of staff administering flu shots, conducting telephonic health coaching or managing a website with employees' personal health data. The addition of third parties can have implications for service quality. (See sidebar.)
4. Pricing
Another great question that a potential vendor-partner should address is whether it has minimum size requirements for its various wellness programs. Some vendors apply minimum eligible employee thresholds (e.g., a minimum of 5,000 eligible employees).
Note how each vendor prices their programs, experts say. Programs can be priced using a flat fee, per employee per month, per participant, per engaged member, per screening and more. Employers can select the common denominator that works best for their population, then ask prospective vendors to price their services accordingly, allowing for an apples-to-apples comparison. Experts also advise asking about any fees that may be associated with program customization, branding of programs, special reports, online setup fees, HRA change fees and data transfer costs per feed. Hidden fees could cause budgeting headaches down the road, so obtaining all-inclusive pricing from the start is key to a successful selection.
5. Compliance guarantees
Employers will want the peace of mind of protecting their legal interests by having wellness vendors agree to maintain compliance with all HIPAA, PPACA, ERISA, HITECH and GINA regulations. This peace of mind, experts say, is particularly vital to companies with multistate office locations, since each state may have differing regulations.
6. Company experience, reputation and structure
The wellness industry is a rapidly growing sector. There are dozens of wellness companies that exist today that did not exist five or 10 years ago. Experts suggest going beyond well-recognized names to give wellness newcomers a shot at success, as larger companies have added wellness solutions to their core business lines as a means to capture additional revenue, which may mean a divided focus.
7. Accreditation and quality assurance
HR/benefits professionals should take note whether the vendor holds itself accountable to an accrediting body, like the National Committee for Quality Assurance, National Commission for Health Education Credentialing, and Utilization Review Accreditation Committee. NCQA, for example, offers Wellness & Health Promotion Accreditation with Performance Reporting. The purpose of its accreditation is to create a standardized set of measurements, which gives professionals the ability to compare wellness providers.
Also, ask whether the vendor uses some other methods of quality control. For example, what's the vendor's success rate with its program delivery? Can the vendors cite its success ratio, defect rate and service recovery policy? (See sidebar.)
8. Health plan compatibility
While the vendor may be compatible with your current health plan, keep in mind that your company's health plan will likely change within a few years. In 2010, J.D. Power & Associates found that more than six out of 10 businesses have used their insurance carrier five years or less. This factor becomes even more important if your business has office locations in different states, which often means you are working with several different health plans. For this reason, finding a wellness provider that is health-plan agnostic is your best option.
Heather Provino is the chief executive officer of Provant Health Solutions, a national provider of health and wellness services with Wellness and Health Promotion Accreditation with Performance Reporting from the National Committee for Quality Assurance.
8 questions to ask when vetting a new wellness provider
1. What can the vendor show in terms of outcomes? Ask for ROI and other metrics discussed in the article to prove their success.
2. How many members are these results based on?
3. What types of groups were included in the analysis? Make sure they've had success with groups that have similar employee populations.
4.What time frame are the outcomes based on?
5. How do they define savings? Does this definition refer to declining out-of-pocket costs to the member or costs avoided by the employer?
6. What types of services do they offer for now and in the future?
7. Do they use third party validation of their wellness programs to ensure the validity of their data year after year?
8. Ask for contact information for at least three previous clients who terminated their program in order to gauge any gaps or weaknesses.
