Personal health management takes wellness to new level

by Bernard J. Sullivan

for the Business Journal

In the 1980s, American businesses eagerly adopted wellness programs in an effort to integrate healthy living habits into the day-to-day workplace routine and to reduce health care costs.

The programs often focused on encouraging employees to start exercising and stop smoking. They were well-meaning in the truest sense of the word but their results were hard to measure.

Today, personal health management is taking the wellness concept to a new level of effectiveness and accountability.

What is personal health management? It's a comprehensive risk-management approach that attracts both employees and employers.

Employees take action to improve their health and productivity, make wise use of health care services and limit health-related benefit expenses.

Employers provide employees and their dependents with information and plan coverages, incentives and intervention programs, as well as a work environment that supports positive health practices.

By working together, employees and employers both benefit. Employees are healthier, more productive and report higher morale; employers document savings of 3 percent to 8 percent of their health care expenses.

Those cost savings aren't surprising when you look at the statistics. Seventy percent of health care expenses in America are associated with preventable conditions. These expenses are typically generated by less than 10 percent of the work force.

For American businesses, another statistic comes into play. Research conducted by William M. Mercer Incorporated typically finds that 30 percent to 32 percent of claims are linked to preventable conditions.

According to the Mercer data, the top 10 preventable conditions found most often in organizations are:

?Coronary heart disease

?Back problems

?Mental illness

?Lack of self care

?Hypertension

?Stroke

?Bladder cancer

?Alcohol abuse

?Cardiovascular disease

?Head injury

Treating these and other illnesses after they occur now accounts for 97 percent of health benefit expenses. Only 3 percent of benefit expenses go toward health promotion and disease prevention.

Fortunately, that's starting to change. Companies across the country are beginning to see the benefit of proactive personal health management, in terms of personnel and profit.

They're seeing proof that a comprehensive health management program helps prevent conditions or delays the onset of disease; detects disease and provides early intervention; encourages the appropriate use of care; and enables employees to manage their illnesses.

And, companies are realizing that the effectiveness of these programs can be tracked in the short-term, mid-range and long-term unlike the "feel good" wellness programs of the '80s.

Personal health management differs from wellness in two key aspects. First, because it is research-based, it can produce measurable results. Personal health management can answer the question: What financial impact does this program have on our company and our health benefit costs?

For example, Mercer recently conducted a study with the WEA Insurance Trust, which insures more than 115,000 school employees and dependents throughout Wisconsin.

The scientifically valid study was designed to measure the impact of a self-care program Mercer had developed for WEA. Adjusted for inflation, Mercer found that WEA yielded nearly $5.50 in savings for every dollar invested in the self-care program.

What's more, the evaluation showed that WEA saved more than $1 million in health care costs simply by offering the self-care program.

Second, personal health management specifically targets the "at risk" portion of an employer's employee population. One of the main problems with many wellness programs was that they attracted people who were already healthy.

For instance, on-site fitness facilities tended to be used by the company's most fit employees, rather than the least fit.

Personal health management, on the other hand, identifies a company's specific problem areas, based on a thorough analysis of health claims and costs. Then, specific "interventions" are created to address these problem areas and to motivate the right people to participate in the health management programs.

With this scientific approach and bottom-line appeal, personal health management coupled with expanding managed care is becoming a top health care cost-management strategy for American businesses.

How can you decide if a personal health management program would benefit your company? Ask yourself these questions:

?Are benefit expenses exceeding budget, and has it become imperative to reduce the rates of increase?

?Is senior management focusing on productivity, morale and retention?

?Are management and employees demanding more health promotion/disease prevention initiatives?

?Are you required to prove results or improve performance of existing programs?

?Would you rather invest in prevention, when cost-effective, than pay to treat illness later?

If your answer to any of those questions is "yes," it is time for your company to investigate personal health management. When you do, remember this: Personal health management programs are based on a simple, sound idea healthy people make healthy organizations. And healthy organizations are more likely to have healthy profits.

(Bernard J. Sullivan is a principal in the health care and group benefits consulting practice in the Kansas City office of William M. Mercer Incorporated, the world's largest human resources consulting firm.)

INSET CAPTION:

Personal health management programs are based on a simple, sound idea healthy people make healthy organizations.

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