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Uncategorized

PBMs Feeling the Heat on All Fronts

by Inoventive Solutions
May 23, 2023

While drugmakers have been assailed for years for increasing their prices and driving the cost of medications higher and higher, there is another player in the health care space that is receiving increased scrutiny: pharmacy benefit managers.

PBMs are intermediaries, acting as go-betweens for insurance companies, self-insured employers, drug manufacturers and pharmacies.

They can handle prescription claims administration for insurers and employers, facilitate mail-order drug delivery, market drugs to pharmacies, and manage formularies (lists of drugs for which health plans will reimburse patients.) 

Express Scripts, which provides network-pharmacy claims processing, drug utilization review, and formulary management, among other services, is the best-known PBM. CVS Caremark and UnitedHealth Group’s OptumRx are other major players. 

PBMs typically contract with both insurers (or self-insured employers) and pharmacies. They charge health plans fees for administering their prescription drug claims and create formularies that spell out the prices pharmacies receive for each drug on the list.

Commonly, the price the plan pays for a drug is more than the pharmacy receives for it. The PBM collects the difference between the two prices. 

It can do this because the health plan does not know what the PBM’s arrangement is with the pharmacy, and vice versa. Also, the plan doesn’t know the details of the PBM’s arrangements with its competitors. 

A PBM could charge one plan $200 for a month’s supply of an antidepressant, charge another plan $190 for the same drug, and sell it to a pharmacy for $170. None of the three parties knows what the other parties are paying or receiving.

Additionally, PBMs have been accused of pocketing the rebates that drug manufacturers offer, instead of passing them on to the end users: the patients who are prescribed the medications. Those rebates can be significant.

In the crosshairs

In theory, the PBMs should pass these rebates back to the individuals who are prescribed the medication so that they can reduce their out-of-pocket costs. However, if most of those costs are born by the insurer, those rebates would conceivably be transferred to the insurer that is paying for the drugs and the insurer could pass some of those savings on to enrollees.

But, because these arrangements are also confidential, the extent to which these savings are passed back to health plans is unknown.

As pressure on PBMs has grown, federal and state lawmakers, attorneys general in various states and state regulators have been taking action.

In 2022, 12 states enacted 19 measures that included a variety of restrictions and requirements for PBMs, according to the National Academy for State Health Policy.

A number of state attorneys general have filed lawsuits against some of the country’s largest PBMs. Ohio Attorney General David Yost has managed to wring more than $100 million in settlements with PBMs in the last three years, after filing lawsuits accusing them of violating state antitrust laws and overcharging state agencies like the Ohio Bureau of Workers’ Compensation and the Ohio Department of Medicaid.

And in Washington D.C., a bipartisan bill introduced in the U.S. Senate would require PBMs to file an annual report with the Federal Trade Commission about fees charged to pharmacies and reimbursements sought from drug companies.

The bill also authorizes state attorneys general “to conduct investigations, to administer oaths or affirmations, or to compel the attendance of witnesses or the production of documentary or other evidence.”

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Uncategorized

HDHP Enrollees Less Satisifed with Their Health Plans

by Inoventive Solutions
May 16, 2023

A new study has found that people enrolled in traditional PPOs and HMOs are more satisfied with their plans than those who are enrolled in high-deductible health plans. But satisfaction greatly increases when HDHP enrollees stick with their plan for more than three years, according to the Employee Benefit Research Institute (EBRI)/Greenwald Research “Consumer Engagement in Health Care Survey.”

HDHP enrollees enjoy lower up-front premium costs in exchange for higher potential out-of-pocket costs for copays, coinsurance and deductibles, and high health care users may experience significant outlays not covered by insurance. The sticker shock that comes with paying for those deductibles is likely partly responsible for those feelings.

But the report authors noted that there may be other reasons too:

“Lack of experience with their health coverage may account — at least in part — for this difference. Higher out-of-pocket costs may also contribute to the difference in satisfaction, but other disconnects exist,” they wrote.

HDHP enrollees also were less satisfied about other aspects of their coverage, with the study finding that:

  • 47% of HDHP participants were satisfied with the cost of prescription drugs, compared to 63% of traditional plan enrollees.
  • 47% of HDHP participants were happy with the prices they pay for other health care services, compared to 57% of traditional plan members.

That said, the poll did not find any differences in terms of the perceived quality of care that HDHP and traditional plan enrollees receive.

The study authors also surmised that it is often people who are new to health insurance who may be most attracted to HDHPs due to the lower premiums. Similarly, those on a restricted budget may also gravitate towards these plans due to the lower premiums up front.

Interestingly, the survey found that the longer people stay enrolled in an HDHP plan, the more satisfied they become with it:

  • If enrolled in an HDHP for less than one year, just 32% of participants were satisfied with their plan.
  • If enrolled for one to two years, 44% were satisfied.
  • If enrolled three or more years, 55% were satisfied.

Key to HDHP satisfaction

The key to successfully navigating an HDHP comes down to educating yourself in how these plans work, the trade-off between higher out-of-pocket costs and lower premiums, and the importance of taking some of those premium savings and socking them away in a health savings account.

If you have an individual or family HDHP, you can usually qualify to put money into an HSA to fund future health care expenditures.

You can sock away $3,850 (individual account) in 2023 with untaxed income, which you can later use to pay for medical expenses you incur. For a family account, you can save up to $7,750.

HDHPs can look extremely enticing due to their low premiums, but many people jump into them without understanding the potential costs they’ll be paying for out of pocket.

While these plans are required to cover 10 essential services and preventative care, as required by the Affordable Care Act, most other services and medicines are paid for in full at the insurer-contracted rates with providers and pharmacies.

For people who have chronic conditions, and need regular medical care, an HDHP may not be the best plan. But if you are healthier and younger and don’t regularly see the doctor, you can save on your premiums by enrolling in an HDHP.

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Uncategorized

More Employers Expand Mental Health Benefits

by Inoventive Solutions
May 9, 2023

American workers are more stressed than ever coming out of the pandemic, and an increasing number of people are also struggling with mental health issues. 

Sadly, the number of people dying from drugs, alcohol and suicide hit record levels in 2022.

When someone is battling addiction or has mental health issues, it affects all aspects of their life, including work. Stress can have a significant adverse impact on business. It costs employers an average of $300 billion a year in stress-related health care and missed work, according to a Harris Poll conducted for Purchasing Power.

That’s why more employers are stepping up to provide their workers with benefits to support behavioral health and emotional well-being.

Employee assistance programs

One of the most common ways that businesses have offered support is through employer-paid employee assistance programs (EAPs), which offer a set amount of free mental health services sessions, typically topping out at five to eight per year. But for many people who are experiencing mental health issues, this may not be enough.

Some larger employers have started offering mental health benefits that cover a higher number of therapy sessions and wider range of treatment options, including therapy and mental health coaching.

Additionally, studies have found that offering a mix of online services such as digital lessons and in-person or virtual therapy can lead to lower therapy dropout rates, plus higher rates of abstinence for clients with substance abuse issues.

As a result, some employers are offering programs that cover a spectrum of behavioral health care options, such as:

  • Self-care apps for employees experiencing occasional stress
  • In-person therapy sessions
  • Virtual therapy sessions
  • Prescription medication to treat common, diagnosable conditions such as anxiety or depression.

Companies usually offer EAPs at no cost to their employees. Most employers operate their EAP through a third party administrator, which can be crucial to the success of your EAP.

Employees have to feel comfortable discussing professional and personal problems with the EAP administrator, and if your business administers your EAP, it could prevent employees from coming forward and asking for the help they require.

That said, it’s up to you to make sure your staff understands that they can talk about mental health without fear of it affecting their jobs. You should train management and supervisors on the importance of confidentiality and job protection if one of your staff asks for assistance or raises mental health concerns.

Don’t forget your health insurance

There is an extensive list of mental health services your health plan should provide your staff. These services include outpatient and inpatient treatment, telemedicine, medication and counseling. Each of these attributes can be vital for treating mental illnesses.

Of course, there will likely be some out-of-pocket costs for your employees that use these services under their group health plans.

One service that is growing and improving success rates is the continuing evolution of telemedicine. According to the benefits news site BenefitsPro, telemedicine can make getting care anonymous and convenient, so patients can receive it where they’re most comfortable. This is especially valuable when dealing with the sensitive matter of mental health.

Other options

American workers are more stressed than ever, and some may not need counseling services from an EAP to reduce their life stress. Besides offering an EAP, there are other benefits that you can extend to your workers that can help them better deal with the ordeals of life and work, including:

Parental leave — Becoming a new parent is extremely stressful. If you don’t offer parental leave, and instead require parents to take unpaid time off, such as under the Family and Medical Leave Act, this stress is compounded. Paternal leave is paid time off for new parents, either mom or dad, after the birth or adoption of a child. It gives parents the opportunity to take care of their new child without the stress of work getting in the way. 

The benefit to the employer is that when the worker returns from their leave, they are more productive, sooner. Consider offering this to both male and female employees.

Paid time off — PTO combines sick leave and vacation time. It gives employees a set bank of time off at the beginning of each year. Employees can then choose whenever and however they want to use this time off. 

Flexible work — Flexible work is a great way to help employees with mental health issues. This benefit can include flexible hours (selecting hours they will work), flexible schedule (selecting when they work) and flexible location (like telecommuting).

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Uncategorized

Insurers Promise to Keep Covering Preventative Services

by Inoventive Solutions
May 2, 2023

Most health insurers plan to continue offering free preventative care services despite a federal judge having imposed a nationwide injunction on an Affordable Care Act requirement that these services are covered with no out-of-pocket costs on the part of patients, according to a letter by industry trade groups.

With concern growing that this important part of the ACA would suddenly be revoked, some of the nation’s largest insurers and industry trade associations penned a letter to lawmakers, stating that: “The overwhelming majority do not anticipate making changes to no-cost-share preventive services and do not expect disruptions in coverage of preventive care while the case proceeds through the courts.

“Our associations have long supported preventive care and continue to do so. By responding together, we wish to make clear our strong support for continued access to preventive health care for millions of Americans who rely on it. “

Signatories to the letter include the Blue Cross Blue Shield Association, the American Benefits Council and America’s Health Insurance Plans.

The letter was written in response to Democrats on health committees in the U.S. Senate and House or Representatives asking for information from 12 of the nation’s largest health insurers on how they plan to respond to the decision by the U.S. District Court for the Northern District of Texas in Braidwood Management Inc. vs. Becerra.

That decision struck down the ACA requirement that most health plans and issuers cover without cost-sharing the more than 100 preventative services recommended by the U.S. Preventive Services Task Force (USPSTF).

The judge in the case reasoned that the ACA requirement to cover with no cost-sharing medications for HIV prevention violates the rights of the plaintiffs who have religious objections to these medicines. The order immediately blocked the requirement nationwide to cover not only the HIV-prevention medicines, but all preventative services recommended by the USPSTF.

The U.S. Department of Health and Human Services has appealed the decision to the U.S. Fifth District Circuit Court and the Justice Department has asked that the decision be paused as the appeal process plays out.

The lawmakers also asked if the insurance carriers would honor the ACA’s rules until all appeals are exhausted, including all the way to the U.S. Supreme Court.

Fallout from the ruling

The federal court’s decision has caused panic and concern among patients’ rights advocates that insurers would immediately stop covering these services, which have become an essential part of health care in the last decade.

If the ruling stands and survives appeals, insurers could impose deductibles and copays for potentially lifesaving screening tests.

The lawmakers on April 13 wrote in their letter to the insurance industry: “We are very concerned that the decision will unnecessarily cause confusion, force consumers to pay out-of-pocket, and result in patients foregoing preventive services screenings and treatment altogether. There is evidence that even modest cost-sharing deters patients from accessing care and exposure to cost-sharing reduces the use of preventive care.”

The trade associations that responded to the lawmakers’ request to continue honoring the ACA rules said that preventative care is popular and effective, and that the decision from the federal judge likely is just the start of a lengthy legal process.

If the decision were to stand, there are still some preventative screenings that are not covered by the ACA, and it would not affect all states. There are 15 states with laws requiring insurers to cover with no patient cost-sharing the same preventative services that the federal law requires.

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Uncategorized

Smallest Firms See Largest Health Insurance Hikes

by Inoventive Solutions
April 25, 2023

A new report has found that small businesses that purchase their group health insurance online or through payroll vendors saw the largest premium hikes in 2022, significantly higher than those that went through brokers.

Overall rates for employers with 10 or fewer employees saw their family plan health insurance premiums jump 12% from 2021, compared to just 5.4% for all small to mid-sized businesses with up to 250 employees, according to the report by HR and benefits software company Ease.

The cost for individual group health plans increased 6.7% for the smallest SMBs, compared to just 4.3% overall between 2021 and 2022. As stated, the numbers for smaller companies were the most pronounced for those who buy their coverage online or via payroll vendors.

Meanwhile, employees’ share of premiums increased at a slower rate overall of 4.15% between 2021 and 2022, meaning that employers were not passing on the full increases in group health plan premiums to their staff.

Since 2018, individual premiums have increased by 21% while family premiums have increased by 18%. To put it into dollar signs, that’s an extra $104 for individuals and $231 for families each month for medical insurance.

The Ease report notes that those higher premiums are likely hurting those small employers more than larger SMBs with between 51 and 250 workers. The latter have seen an increase in health plan enrollment among their employees between 2018 and 2022, while those with one to 50 employees saw overall decreases. Overall, more than half of SMB employees opt out of their employer-sponsored coverage.

The HDHP effect

The report found that health maintenance organizations and preferred provider organizations continue to dominate the landscape in group health benefits for SMBs. While high-deductible health plan (HDHP) enrollment grew at an astounding 68% between 2021 and 2022, they only accounted for 6% of group health plan enrollment.

Some employers have gravitated towards HDHPs to reduce their and their employees’ overall premium spend, but these plans come at a cost: more out-of-pocket costs for workers.

In those cases, Ease CEO and co-founder David Reid recommends pairing an HDHP plan with other voluntary benefit plans that can “insure” gaps in coverage, such as short-term disability plans and group supplemental health insurance plans called Gap plans. They are similar to the Medigap supplemental insurance plans millions of seniors purchase each year to fill in holes in Medicare parts A&B.

Gap plans can help by providing coverage when employees have not met their health care deductible. These plans may cover most inpatient and outpatient services that are covered by the underlying primary health care plan and applied to the deductible or coinsurance provision.

Plans differ and employers may choose a variety of coverage options, including varied inpatient and outpatient benefits. Deductibles can be added to the plan to manage premium costs.

Coverage can often be configured to be compatible with HDHPs using health savings accounts.

Importance of your broker

Reid said that the report’s findings illustrate the importance of employers working with brokers and consultants to purchase their employee benefits.

“[SMBs] getting good advice are using more innovative solutions that allow them to make their dollars go as far as a large corporation’s dollar-spend on benefits,” he told the trade publication BenefitsPro. “Those who are bypassing a consultant and purchasing benefits through, say, their payroll vendor are generally seeing fully insured, off-the-shelf plans that increase in cost more quickly.”

As your broker, we have access to plans from different carriers and can work with you to put together offerings that will best accommodate your employees.

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Uncategorized

Making Your Voluntary Benefits Program a Success

by Inoventive Solutions
April 18, 2023

Both employers and employees have much to gain from a solid voluntary benefits program. 

For employees, being able to enroll in an insurance product through a workplace voluntary benefits program offers them the advantage of group pricing, the convenience of paying through payroll deduction, and perhaps access to insurance that would be difficult to get on an individual basis.

For employers, offering a range of voluntary insurance products can help increase employee satisfaction – along with loyalty and morale – and make the business more competitive in attracting and retaining the best talent.

These advantages alone, however, do not ensure that a voluntary benefits program will be a success. Careful planning, including the selection of benefits to offer, choice of vendors and well-crafted communications, are keys to program success. Consider the following:

Get the right mix – Bring in the kinds of benefits that employees want and will enroll in. Survey employees as to what types of additional benefits they would participate in if given the opportunity. Depending on your employee demographics, these could include additional life insurance options, long-term care – or even pet insurance.

Voluntary benefits enable employees to self-customize an individual benefits package that is uniquely appropriate to them.

Look for gaps – Look for gaps in your company’s current benefits coverage, and consider how voluntary benefits plans can be used to fill them. 

For companies that have had to scale back on their regular benefits package, voluntary benefits can be particularly helpful. If your benefits budget is tight and, for example, needs to be dedicated to helping fund medical benefits, offering dental and vision on a voluntary basis gives employees easy and affordable access to these benefits.

Get the word out – While we can often supply some communications materials, your internal communications concerning the program will help to incorporate it into your overall benefits program in the eyes of employees, making it more likely they will enroll. 

Consider announcing new voluntary benefits offerings in a communication from top management, which will demonstrate the company’s commitment to the program.

Make voluntary benefits enrollment a part of your annual enrollment process, and incorporate descriptions and information on voluntary benefits offerings into the communications materials for your core plans.

Work closely with us – We are here to help you make a selection that best fits your company’s needs, and to help you communicate with your employees and enhance enrollment.

This will be particularly important if any of the voluntary benefits have minimum participation requirements. We can come in for presentations, individual meetings or enrollment sessions, all of which can be very effective in increasing participation in these programs.

The takeaway

Voluntary benefits can be a great add-on to any company’s benefits program. Careful planning and consideration of the various issues that can affect participation can increase the chances of program success.

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Uncategorized

Insurers Make Changes to Prior Approvals Ahead of Rulemaking

by Inoventive Solutions
April 11, 2023

After the Centers for Medicare and Medicaid Services proposed new rules aimed at streamlining the prior approval process for most health plans in the U.S., a number of the country’s largest insurers announced their own steps to improve the process.

UnitedHealthcare announced in late March that it would cut the use of prior authorizations by 20% for some non-urgent surgeries and procedures. Starting in the third quarter of 2023, the insurer will remove many procedures and medical devices from its list of services that require prior approval, and continue through the rest of the year for most commercial, Medicare Advantage and Medicaid plans.

Meanwhile, insurance giant Cigna said it has been in the process of reducing the prior authorization for about 500 services and devices. And Aetna is working to automate and simplify prior authorizations.

Market experts expect other insurers to follow suit as frustration over the long wait times and horror stories of patients dying while waiting for approval mount. The bad press and resulting lawsuits, in conjunction with the new rule making is likely to prompt more health insurers to revamp their prior authorization procedures.

The proposed rule

The rule is aimed at tackling one of the biggest headaches for patients and practitioners alike. Waiting for prior authorizations for care, pharmaceuticals or medical devices can lead to delays in care and increased risk of hospitalization from those delays.

The goal of the proposed rule, which would take effect in 2026, is to reduce the bureaucracy around prior authorizations and cut wait times for responses that some providers say sometimes take weeks to get approved.

The specifics of the rule are as follows:

  • Insurers would be required to render a decision within seven days after a request for a non-urgent service or item (compared to the current 14 days).
  • If the requested care or item is urgent, the insurer must render a decision within 72 hours.
  • If the insurer denies the request, it must include a specific reason for doing so.
  • Most group and individual health plans, Medicare Advantage, Medicaid managed care and state Medicaid agencies would be required to build and maintain a system for electronically approving prior authorizations, known as a “fast health care interoperability resources application programming interface.”
  • The interface must be able to ascertain whether a prior authorization request is required and “facilitate the exchange of prior authorization requests and decisions” from the provider’s electronic health records or practice management system.
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Uncategorized

Judge Deals Blow to Preventative Care Coverage under ACA

by Inoventive Solutions
April 4, 2023

A recent decision by a federal judge in Texas to issue an injunction on a pivotal part of the Affordable Care Act requiring insurers to offer certain types of free preventative care, has raised concerns that some health plans will stop paying for these services.

However, since most employer-sponsored plans are on annual contracts, the decision is unlikely to affect policies in 2023, but beyond that, it’s uncertain how things will play out. The Biden administration has appealed and called for a hold on the ruling until the decision is settled by higher courts.

If the ruling by Judge Reed O’Connor of the Federal District Court for the Northern District of Texas sticks, it would roll back the health insurance market to the days prior to the ACA when health insurers decided which preventative care services they would cover with no cost-sharing.

The ACA changed all that, requiring insurers to pay for preventative services, such as: 

  • Cancer screenings, like breast cancer screenings and colonoscopies 
  • HIV screenings
  • Diabetes screenings
  • Heart disease screenings
  • Pap smears
  • Depression screenings
  • Statins
  • Immunizations and PrEP for HIV and HPV.

Judge O’Connor in 2018 issued a decision striking down the entire ACA, which was later reversed by the U.S. Supreme Court. 

The most recent ruling is really two decisions: 

  • That a panel of volunteer experts that issues binding recommendations on what preventative care must be covered under the ACA violated the Constitution because its members are not appointed by the president or confirmed by the Senate.
  • That the ACA requirement that insurers must cover PrEP and HPV vaccines as well as certain HIV/Aids-prevention drugs violates the religious beliefs of Christians, which in turn violates the Religious Restoration Freedom Act.

The fallout

The consequences of the ruling are unlikely to be felt immediately, particularly for group health plans, the annual contracts of which include coverage for preventative services. 

Matt Eyles, president and CEO of the trade association America’s Health Insurance Plans, issued a statement saying that: “As we review the decision and its potential impact with regard to the preventive services recommended by the United States Preventive Services Task Force, we want to be clear: Americans should have peace of mind there will be no immediate disruption in care or coverage.

“We fully expect that this matter will continue on appeal, and we await the federal government’s next steps in the litigation, as well as any guidance from relevant federal agencies.”

That said, if the Biden administration fails in convincing higher courts to put a hold on the injunction while the appeal of the decision plays out, changes could come over time. 

In this continuing tight job market, many employers would likely be reluctant to roll back these preventative services in their health plans. And if insurers plan to make changes to their plans’ benefits, they are required to give advance notice. 

Other pundits have said that the preventative care provisions of the ACA have become so ingrained in the health care system that employers and insurers would have a hard time rolling these benefits back, and many may not consider it.

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Uncategorized

Moves Afoot to Improve Prior Authorization Times, Efficiency

by Inoventive Solutions
March 28, 2023

The Centers for Medicare and Medicaid Services has proposed new rules aimed at streamlining the prior approval process for most health plans in the U.S.

Under the proposal, starting in 2026, insurers would be required to render a decision within seven days for a non-urgent service or item (compared to the current 14 days), and 72 hours if it is urgent.

It would also require most group and individual health plans, Medicare Advantage, Medicaid managed care and state Medicaid agencies to implement electronic prior authorization systems by 2026 and streamline their processes for approving care.

The rule is aimed at tackling one of the biggest headaches for patients and practitioners alike. Prior authorization can sometimes take time to receive, often delaying much-needed care. Waiting for approval can have serious consequences, with studies finding:

  • It often leads to delays in care for serious conditions like cancer.
  • It often leads to more people being hospitalized as their condition worsens as they wait for care or medicine to be approved.

Prior authorization rules can also be confusing, time-consuming and frustrating for both patients and doctors, with the latter often feeling as if the insurer is questioning their expertise.

Insurers use prior authorization as a cost-containment tool that requires providers to seek approval from them before referring a patient for certain services and prescribing some medications. Studies have found that the number of prior authorization requests has exploded in the last few years, straining the system and delaying care.

The proposed rule

The goal of the rule is to reduce the bureaucracy around prior authorizations and cut wait times for responses that some providers say sometimes take weeks to get approved.

The proposed rule — a revised version of a similar one floated by the Trump administration that was withdrawn due to cost concerns — applies to all Affordable Care Act-qualified health plans, Medicare Advantage plans and state Medicaid programs.

As mentioned above, the time insurers have to approve a prior authorization request would be reduced to seven days, and 72 hours if it is urgent. Additionally, if the insurer denies the request, it would be required to include a specific reason for doing so.

Under the proposed rule, insurers will be required to build and maintain a system for electronically approving prior authorizations, known as a fast healthcare interoperability resources application programming interface (FHIR API).  

The FHIR API must be able to ascertain whether a prior authorization request is required and “facilitate the exchange of prior authorization requests and decisions” from the provider’s electronic health records or practice management system.

Some doctor’s groups have said the new rule doesn’t go far enough and that seven days is still too long.

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Uncategorized

Wellness Programs Grow in Wake of Pandemic

by Inoventive Solutions
March 21, 2023

Employers have often long struggled to boost participation in their wellness programs, but the COVID-19 pandemic changed that as people started looking for ways to better care for themselves both physically and emotionally.

The pandemic added fuel to the country’s mental health crisis and more people than ever are seeking out counseling to cope with the stresses of life.

Others stopped taking care of their overall health, by exercising less and drinking too much and putting off regular checkups, leaving them worse off health-wise than they were before the pandemic.

Wellness programs can bridge the gap between employees’ overall health and your group health insurance. While the latter covers their medical and pharmaceutical needs, these programs can help them maintain healthy lifestyles, and can also help them better deal with stressors in their lives.

On top of that, they can improve employee satisfaction and boost their productivity.

The benefits to your organization

A five-year study by Go365, a personalized wellness and rewards program, found that highly engaged participants:

  • Paid an average of $116 less in health care than low-engaged members.
  • Compared with low-engaged members, reported 55% fewer “unhealthy days,” which can be an indicator of reduced productivity, absenteeism or presenteeism.
  • Had an average of 35% fewer emergency room visits and 30% fewer hospital admissions than low-engaged members.

Wellness programs continue growing in number and you may want to put together a list and survey your employees about which of the programs they would most like to see. Some are more expensive than others, and some costs are negligible.

These programs typically aim to promote mental and physical health and fitness, and run the gamut. Some of the most common wellness programs include:

  • Gym memberships,
  • Smoking cessation programs,
  • Diabetes management programs,
  • Weight loss programs, and preventative health screenings,
  • Stress management,
  • Parent coaching and support,
  • Recreational programs such as company-sponsored sports teams,
  • Nutritional and food guidance programs, and
  • Financial security programs, which can include access to budgeting resources, debt management tools, student loan counseling, emergency savings plans, and more.

You can also provide incentives such as premium discounts and cash rewards for participating in a program or achieving certain health goals, like for weight loss or stopping smoking.

Getting it started

Since the pandemic started, more employers have started offering virtual wellness sessions for their employees, while those with existing programs have bolstered them with new ones, such as financial wellness.

But to succeed, the programs need adequate levels of management and employee buy-in. Make sure you are choosing programs your employees actually want and will use. Don’t waste time and energy on wellness initiatives that they don’t find engaging or beneficial.

Instead, survey your staff to find out which wellness plans they find the most appealing.

Also, it’s important to stick to your budget and not to overpromise what you can deliver to your employees. Be realistic as you explore your choices.

The expense can be worth it if it’s tailored correctly. Employees who are healthy and happy have higher levels of productivity than those who are not. Wellness programs also lead to increased engagement, improved morale and retention, and reduced health risks.

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