Wellness has become one of the hottest health care topics for employers. Companies are looking to what appears to be a logical solution–keeping employees healthy–as a way to reduce the unsustainable cost increases related to health care benefits. So how does a company decide on what they really need and which vendor best meets their requirements?
This is the first in a series of articles that will discuss some of the key issues that will help you make a choice that’s right for your company.
The Wellness Industry
There are literally thousands of wellness companies in America today. In fact, any nutritionist, fitness specialist, nurse, doctor, health professional or administrator can set one up. It’s just not that hard to hang out your shingle to offer an HRA, conduct a few classes, mail a few brochures, offer some coaching, and call yourself a “wellness” program.
The first thing to recognize is that a fitness program or a diet/weight loss program or a smoking cessation program or even all of these combined with an HRA and biometric screenings are not necessarily a comprehensive program. These programs focus on people who already have an identified risk. While this is needed, it is not the answer, as the founding father of the wellness field, Dr. Dee Edington, points out in his most recent book, Zero Trends: Health As a Serious Economic Strategy. Dr. Edington’s decades of research reveal that in order to bend the health care cost trend you have to not only manage those individuals with a risk, condition and/or disease, more importantly you also need you keep the healthy people healthy. More on that later.
Furthermore, these individual or bundled risk reduction programs are but a subset of a comprehensive wellness program. Now I am going to throw a curve into your thinking: is “wellness” what a company really needs?
There is an entire industry that calls itself “wellness,” and that must be what employers need to keep their employees healthy, right? Most RFPs ask for a wellness program, benefits consultants discuss wellness, and there are big conferences on it. However, here is where the nomenclature as established by the early entrants into this space is leading us astray.
Wellness was established to fill a need for the large number of companies that knew they required outside help. These wellness programs are not like their more intensive; more established and highly focused brethren, disease management programs. As the “wellness” industry develops, it is in many ways like disease management was in its infancy: there are low barriers to entry, few or no clearly defined standards, and little or no science behind the majority of programs. And that’s just for starters.
The science of keeping people healthy
When you have a health issue, you look to the expert who is trained to solve your problem. For instance, if you have a primary care need, you go see a practitioner in family practice, internal medicine or pediatrics. You see an orthopedist for your bones, joints and muscles, a cardiologist for your cardiovascular issues, or other specialist and sub-specialist for the myriad of other diseases or conditions you may have.
So where do you look within the science of medicine for prevention? Is there a specialty in wellness? Well, no, but there is a specialty that focuses on prevention and the science of keeping people and populations healthy. That medical specialty is preventive medicine, a relatively small but very important segment of the medical profession. In the next post I will discuss preventive medicine, what it is, how it looks at the world, and how that should impact your decision-making in evaluating which vendor offers the most beneficial program for your company.