Beyond workout apps: The ROI of well-crafted wellness programs

Both health insurers and employers have a stake in driving down healthcare costs for their member populations--especially among patients with expensive-to-treat chronic conditions. Increasingly, businesses are turning to payers to design wellness programs to aid in the effort.

But it's not as simple as handing out activity trackers or launching a member wellness portal. Every company is different, and there are many ways to measure success.

There's the CFO who wants proof the cost of the program will drive a financial return on investment (ROI) for the company. The HR director who wants to ensure engagement while also protecting employee privacy. The employees themselves, who want the programs to be useful, rewarding and fair. And everyone wants a program that will produce sustainable results.

FierceHealthPayer spoke to three health insurance executives to find out how they're designing wellness programs--and how they're demonstrating their value to customers.

Many ways to measure success

"We like to meet with customers to consult where they are in their wellness plans," says Amy Turner, director and COO of Innovation Health (right). "We can either offer packages that are pre-set in the form of fitness challenges or employee engagement, or we customize a program depending on where they are in the process, since many companies are in different places for their wellness needs."

You have to really want your customers to succeed, she says. "We want to impact their bottom line as well … Helping customers reduce costs and improve employee quality is one of our goals."

Rhonda Toole, vice president and national account executive at Cigna Healthcare, adds that it's important to look at the long-term benefits of wellness programs. "By focusing on improving engagement, health and the bottom line, companies are saving millions a year by reducing risk factors and getting people to achieve coaching goals to reach long-term behavior change," she tells FierceHealthPayer

Humana, meanwhile, aims to focus on "purpose, belonging, security and health," Kristine Mullen (right), vice president of wellness leadership, tells FierceHealthPayer.

"Humana builds programs and services that look at multiple dimensions of wellness--not just physical activity," she says. "When we measure outcomes and results, we really think about it in those four dimensions and our solutions support and drive results in those ways."

Distrust hampers engagement

From the employee's standpoint, privacy is one of the biggest concerns when it comes to wellness. They want to control who sees their data, and they're wary of vendors who might sell their information or worry that their employers will use their personal health information against them.

That can sink a wellness program before it even gets underway.

Turner says addressing mistrust over wellness programs starts at the very top. "If the higher-ups are not on board with employee health and wellness, it will be very difficult to get everyone else inspired as well," she said. "Those in charge need to know what motivates their employees, and they need to encourage everyone from the company getting involved."

Getting employees involved is not always easy, but it is not as hard as it may appear, Turner says. One way of achieving this is to establish a "wellness committee," where every department or division can have one or two representatives attend, who express the health needs of the group they are speaking for; the committees can discuss anything from fitness challenges to space improvement.

"Wellness committees that are staffed and run by all different employees who represent everyone makes each group feel as though they have a voice," she adds.

Payers must ensure employee privacy, Toole says. "Individual numbers cannot be shared with employers; that should be between the individual and their doctor." Companies have a right to take steps that will improve their employees' health, but they have to establish "cultural trust" and "change the social network" where open discussion is encouraged surrounding health in the workplace, she adds.

That said, sometimes biometrics are necessary in order to put actual numbers with reward benefits, she notes. Employers must identify the most meaningful goals they want to achieve and find specific biometric measurements that will display those achievements. "Seeing increased in engagement coaching, for example, is a good biometric measurement," she said. "That's when you get into real monetary numbers, especially surrounding chronic conditions."

Convincing the skeptical CFO

While privacy might be the main concern for employees, employers are often wary of the complex rules and regulations surrounding healthcare reform and employment laws. And financial leaders, in particular, want to know that their budget dollars are being put to good use.

"I have always wanted to sit down in a room full of skeptical CFOs," Toole tells FierceHealthPayer. "They have to understand it's a long-term play, and it's not going to be fixed overnight. They need to look at wellness as a value return investment rather than just an immediate return."

Mullens says CFOs and other leaders must look through a long-term lens that focuses on overall improvement rather than only dollar signs. "But if leaders are focused on their monetary bottom line, we have found that engaging employees in overall wellness ends up saving actual dollars," she says. Last-minute time-off requests decrease and efficiency can increase when staff are engaged in overall wellness programs.

"U.S. businesses lose anywhere between $450 and $500 million every year to reduced productivity," Toole says.

Steps to sustainability

Once a company finds that perfect program and gets a taste of success, the next step is to keep that good vibe going.

It starts at the top, Turner says.

"If the executive team doesn't support a company's culture of wellness and lead by example, it will probably fail," Turner says. Everyone--from the CEO down--must be enthusiastic about wellness and participate openly.

Toole says complex tiered programs often fail because people don't understand them. If employees think the rewards are not attainable, it can create a hostile environment. "Keep it simple, be very clear and make it a single monetary amount on an annual basis by doing just two or three things."

Mullen says constant employee engagement around wellbeing is crucial. "There needs to be champions and influence within the department to spark a culture of health and well-being," she says. "Offer choice and variety and think of it in different multi-dimensional environment and financial wellbeing parts."

All three women emphasize the importance of both payers and employers making wellness a lifelong commitment, and approaching wellness from a holistic point of view. Treat not just the situation, but the people themselves, and look at other things beyond numbers and dollar signs, they say.

"Holistic perspective is better for sustainable results," Mullen says. "If everyone feels involved and important in the culture, it will be everyone's business to create a movement of wellbeing."