Value-based designs use data to invest in incentives that change behaviors to reduce financial and health risk.
Benefit managers are important for the model to succeed, as they must identify those populations that are most at risk for health events.
Assembling medical, prescription drug, disability, performance, absenteeism, workers' compensation and presenteeism data can create a more robust picture than claims alone.
While direct costs can indicate that some management function is not going well, the total picture created by looking at indirect and productivity costs helps benefit managers identify what is driving costs of unidentified or undermanaged conditions.
Recent research from the consulting firm Towers Perrin shows that high-performing companies (those with annual cost increases averaging 5% or less) tend to provide employees with more resources, including health care information and decision-support tools.
In their commitment to actively managing service providers, high-performing companies create a mix of strategies and tactics that benefits the company and employees:
- A clear focus on and commitment to supporting employees' health and health care decisions.
- Well-articulated strategies and rigorous metrics for evaluating program effectiveness.
- Benefit designs that encourage transparency and accountability.
Therefore, understanding risks, creating programs and services to manage risks and deploying them for employees can deliver value.
First, though, benefit managers must engage employees in the solution.
In our experience, successful behavior-change strategies include:
- Asking employees what is important to them about their health.
This question puts the employee in the driver's seat, asking, "What would you like to work on?"
It's an important question because it tells employees that they are important and that their concerns are important to their employer.
- Identifying commonalities between groups of employees.
For instance, one group may be focused on weight control, while another is most concerned about stress management.
- Looking for linkages between employer and employee priorities.
- Identifying benefits -usage patterns.
For example, some diabetic employees have noted they want more nutritional information, and your benefits package provides diabetes education and counseling. Yet these employees are not using the available resources.
Benefit managers must ask, "What incentives could drive the employees to use the very services they are seeking?"
Employee engagement does not begin by imposing rules and regulations. Understanding motivations for behaviors, identifying access barriers to better behaviors and creating early success for employees are the first steps to engagement and creating success for both employee and the employer.
In a short period of time, the success of early achievers builds a social network that inspires the viral expansion of the improved health behaviors that link personal and employer-based improvements.
Hence, identifying the levers within the employee population, providing access to programs and services that meet the population segments' needs and lead to the employer's desired outcomes, publicizing the successes of the emerging employee leaders and encouraging future success are the steps to employee engagement that will ensure the value of health-improvement strategies.
The success is in developing grass-roots change that creates competency for improvement and safety for new ideas to emerge.
These steps lead to the success of value-based designs for health improvement and health-cost reduction, as employee-consumers begin to make choices that improve their health and the health of the organization.
David Hom is vice president of strategic HR initiatives at Pitney Bowes and a strategic advisor for the Center for Health Value Innovation.
Greg Judd is CHVI director and leader of Benefits Information Group, a provider of employee benefit plan market intelligence.
Cyndy Nayer is CHVI executive director and leads River City Partnership on Health, Inc., a national employer health strategy company.
Ardis Belknap is the director of human resources for the city of Springfield, Ore.
For more information about CHVI, visit www.vbhealth.org.
