By Scott Scanlon – Refresh Editor
When Chadd Soto started in the wellness field nearly two decades ago, most Western New York companies had just begun to dip their corporate toes into efforts to help their employees get healthier.
“Workplace wellness started when companies would give a health fair. Different vendors would show up for one day and that was their entire workplace wellness program for the year. That was in the late 1990s,” said Soto, Independent Health manager of wellness services and one of several sources in the workplace wellness package today in WNY Refresh.
“In the early 2000s, companies started to do a lot of on-site seminars about nutrition or diabetes education or exercise, and it was kind of all over the board,” Soto said.
“What’s happening going into the 2014, there’s a much more sophisticated approach to workplace wellness. ... It’s not what I call ‘fluff programing.’ Employers are much more interested in their employees being accountable for their own personal health as it relates to going to the doctor, participating in community events, knowing your numbers – whether it’s your cholesterol or your blood pressure levels – and it’s linking to how much they contribute to health insurance. It’s almost like car insurance: the greater the risk, the greater amount you’re going to pay.”
How much wellness will cost is often a question from employers looking at the bottom line of health insurance costs, Soto said.
Marie Pidanick, one of two wellness coordinators at Walsh Duffield Cos., the insurance brokerage business featured in the Refresh story, estimated that for every $1 spent on wellness, a company can expect to save $2 to $7 on employee health costs.
Because a growing number of companies now buy insurance based on the actual health care expenses of their employees – and many have gone the self-insurance route – forward-thinking companies in Western New York have begun to invest more in wellness programs and staff.
“It really has come a long way,” Soto said, “and the reason it continues to trend in that direction is because at the end of the day, it’s the only solution. Until people are accountable for their own health and doing the right things, health care is always going to be a crisis and peoples’ health is always going to be in jeopardy.”
In other words, employees themselves must be part of the solution – and that isn’t always easy.
During the last two decades, companies which decided to invest more in wellness have generally offered sweeteners to employees as a way to encourage greater health; goodies like $25 gift cards to fill out a health survey or $50 to get blood tests to screen for chronic diseases including high blood pressure and diabetes.
If rolled out appropriately, and if “Big Brother” concerns could be avoided, these types of programs have driven about one-third of a company’s employee population to take steps toward better health, Soto said. (Kind of interesting that two-thirds of Americans are considered overweight or obese, isn’t it?)
By adding more steps to wellness – a health survey, doctor visits, blood draws, exercise and nutrition classes – $50 often is not enough, said Soto, adding that boosting incentives to $250 will drive roughly 40 percent of employees to take those steps.
If employers pay $600 annually, it will drive 60 to 80 percent of WNY workers to do a “semi-complex program,” Soto said.
“When I would present that to CFOs and CEOs, they would quickly do the math. They’d say, ‘We’ll, I have 1,000 employees and you expect me to pay each employee $600 to go to their doctor? You see how expensive my health insurance is? You want to me to tack on another $60,000?”
So what has happened in health care in recent years?
Employers have asked employees to share more in terms of health insurance costs, and are learning that tying higher deductibles and penalties – the stick – is driving a higher percentage of employees toward better health.
“What’s happened – and the trend is it’s not just the carrot anymore, it’s not just the employer paying out more money – it’s the employer basically saying, ‘Look, I’m contributing 60 percent or 80 percent into your health care,” Soto said. “If you want me to continue to do that, then I expect you to do what you’re supposed to do in the health care system. If you choose not to – because you can’t make people do anything – if you choose not to, then you’re going to contribute a little bit more to your premium. That’s the true trend.”
If you do this strategically, Soto said, it shouldn’t cost more, and a health plan can track certain things and the added cost should be little to nothing.
“Where it is today is more of a shared responsibility. … If there’s a shift in the premium anywhere in that $600 to $1,000 range, you’ll drive pretty much 95 percent of that (employee) population – including spouses and dependents – to make the right choices.”
The Affordable Care Act includes some of that stick approach, too.
“There’s incentives to do the right thing,” Soto said, “whether it’s a gym membership program or offering the benefits of a smoking cessation program. Even when you look at the way health care is designed today with a high deductible, the better you maintain your health, the less you’ll pay out on your deductible.
“I think everybody’s realizing you can look at the doctors and make sure they’re doing their job, you can look at the insurance companies and make sure they’re doing their job, but now it’s time to look in the mirror. That’s where it’s going right now.”
There is a hierarchy involved in a successful program, said Karl Siebert, director of wellness program operations for BlueCross BlueShield of WNY:
“It starts with leadership buy-in,” Siebert said. “If the CEO or the leadership of the employer group isn’t engaged or interested in making it happen, it’s just not going to work.”
The second thing, he said, is operational support. “If the CEO’s engaged but the management, the director-level personnel in the company, and the setup of the company, is not conducive to a wellness program, it’s not going to work here, either.”
The third, and the most important thing, he said, is getting the buy-in from the employees. “If leadership wants them to do something and employees aren’t feeling like they’re a part of making it successful, it’s going to fall apart. So it truly is a team approach.”