Innovation and integration
More payers embrace value-based models
Value-based care payment models are becoming more common. Commercial payers–such as accountable care organizations–are increasingly adopting value-based care payment protocols, care coordination strategies, bundled payments, etc. But experts point out it’s a long-term effort that becomes more successful over time. (Health Payer Intelligence)
ACOs look beyond clinic walls
Accountable care organizations are increasingly acknowledging the importance of what happens beyond the doctor’s office or hospital, according to a new Robert Wood Johnson Foundation-funded report. They are expanding services to include more preventive support for patients; they also work with social service organizations to improve the health of their communities rather than just focusing on assigned beneficiaries. (report)
Employers need actionable data
Many employers struggle with managing data to make informed decisions about benefits. Cited as most useful data: employees who regularly visit the ER; pre- diabetic employees who haven’t seen their primary care doctor in the last year; and an evaluation of their company’s health care spend against comparable companies. (National Alliance of Healthcare Purchaser Coalition)
Michael Thompson, president and CEO of the National Alliance of Healthcare Purchaser Coalitions and former PwC principal, discusses bending the cost curve, employee engagement and rebooting wellness.
What needs to change?
It’s become clear that a total focus on the demand side—the employees—will not be enough. I think we’ve started to hit the wall in terms of how far we can shift costs. Many employers are starting to pay attention to how care is delivered and its value. Employers need to get behind delivery-based options that reward systems committed to value-based care, and integrate them into their broader benefits strategy.
What can employers do?
It’s time to reframe wellness in terms of supporting workers’ wellbeing—moving from a health care issue to a people issue. When you do that, it changes how you approach almost everything else. Don’t punish bad risk—start supporting people to improve wellbeing.
Approaches that engage employees in real time—that look at employees more holistically, and not disease by disease—have the most traction. These tend to be more advocacy-oriented and less education-oriented. It’s personalized health—meeting people where they are and supporting them in their journeys.
We can’t just throw programs and tools at people. We need to find ways to facilitate, to provide guidance and real-time support, that steers them to things that can be helpful.
Start looking beyond the benefits program and the workplace. Look at the communities employees live in and, frankly, at the care and support you provide. Link to community health initiatives. Focus on root causes and total wellbeing. Ask yourself: Are you simply focused on getting them out of bed and into the office, or are you helping make them the best they can be?
Employers, employees and community
Innovative benefits drive health
A list of 10 employer innovators includes Michelin, which provides family health centers, on-site gyms and free medication for condition management; it reduced metabolic syndrome by 12 percent in three years. La Macchia Enterprises built a culture of wellness and has more than 95 percent participation in its wellness program. (Employee Benefit News)
Make wellness fun
Drive engagement by making wellness fun. A Forbes contributor offers eight ideas, including starting or ending meetings with a group exercise, encouraging lunch breaks and bringing back recess. But he offers this warning: “You can’t guess what your employees define as fun, so be sure to ask your employees what they want before you get started.” (Forbes)
Competition motivates exercise
Want to get employees to exercise? Competition is great motivation, according to new research. “Competitive groups frame relationships in terms of goal-setting by the most active members. These relationships help to motivate exercise because they give people higher expectations for their own levels of performance,” says lead author Damon Centola, PhD. (Preventive Medicine Reports; announcement)
Tools and Information
What is a CIN? Watch the consumer-friendly two-minute video from Monument Health: How a Clinically Integrated Network Works for You answers that question: (video)