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Wellness in Iowa – Not as Expensive as You Might Think (Part II)

Healthy lifestyle concept.Continuing with last week’s blog – much was learned from the 2012 Capital Crossroads Wellness & Community Study. Iowa employers cite these key reasons for not offering wellness programs:

  • Too expensive or no budget – 45 percent
  • No staff to administer program – 40 percent
  • Their organization is too small to offer wellness – 39 percent
  • Difficult to manage program – 23 percent
  • Never considered offering wellness – 23 percent
  • Unsure how to start program – 18 percent
  • No time available to start program – 17 percent
  • Lack of management support – 13 percent
  • Employees are healthy/no need to offer program – 5 percent

Understanding these perceptions can provide a wonderful opportunity to educate employers, regardless of size, on just how easy and inexpensive many basic wellness programs can be. Employer location also appears to determine whether wellness programs are offered. Employers in urban areas (60 percent) are more likely than their rural counterparts (40 percent) to offer at least one wellness program.

In addition, the distribution of wellness offerings varies widely by industry. Over 60 percent of organizations in Finance, Insurance and Real Estate are most likely to offer these programs, while only 21 percent of employers in the Construction industry offer wellness.

Also within this extensive survey of 913 Iowa employers, wellness programs were divided into three categories:

Education and Health Management – of the nearly 70 percent of employers who offer wellness programs, Workplace Safety is the most commonly-offered education program, with more than six in ten employers providing workplace safety education. Education programs that are expected to grow the most in the next year, include managing:

  1. Obesity and cholesterol (about nine percent may offer program in the next 12 months)
  2. Tobacco cessation (8.3 percent)
  3. Hypertension and diabetes (almost 8 percent each)

Preventive and Screening – of the nearly 60 percent of employers who offer Prevention and Screening programs, offer the following:

  • Cold & Flu prevention (50 percent)
  • Blood Pressure Check (34 percent)
  • Cholesterol Check (29 percent)
  • Blood Sugar Check (29 percent)
  • Health Risk Management (29 percent)

Fitness and Nutrition – 57 percent of employers who offer Fitness and Nutrition programs, offer the following:

  • Nearly 40 percent promote healthy eating programs
  • 31 percent include healthy choices in on-site vending machines
  • 25 percent provide fitness memberships
  • 23 percent have on-site exercise programs

Other Findings:

Larger employers reported being most familiar with the Healthiest State Initiatives (HSI), a statewide program that aims to make Iowa the healthiest state in the nation by 2016. There is a clear trend of familiarity with the HSI and the size of the employer. There is also a clear relationship between an employer’s familiarity with the HSI and their willingness to offer a wellness program. Only one in five employers unfamiliar with the HSI offer wellness programs, while four in five employers familiar with HSI do.

The 2012 Capital Crossroads Wellness & Community Study contains many great nuggets of information to assist Iowa employers on implementing and enhancing quality wellness programs.

To learn more, we invite you to subscribe to our blog.

Positive Perceptions on Wellness (Part I)

Last year, our firm (along with Data Point Research and Yogesh Shah, MD) was hired by the Capital Crossroads Wellness Committee to undertake a state-wide survey of Iowa employers to determine:

  • the extent employers have embraced wellness initiatives
  • their desires for future assistance in offering and maintaining such programs

The results from the 2012 Capital Crossroads Wellness & Community Study were both extensive and revealing!

Generally, Iowa employers believe wellness programs are beneficial for their workplace environment – whether they currently offer wellness programs or not. Over 15 percent of Iowa employers statewide offer some type of wellness program to their employees, and this offering greatly depends on the size of the employer. Only 13 percent of employers with 2 to 9 employees offer wellness programs, while nearly all (94 percent) of employers with 1,000 or more employees offer at least one wellness program.

Larger employers (250+) are significantly more likely to offer incentives for participation in wellness programs (55 percent) versus employers with 2 to 49 employees (24 percent) and employers with 50 to 249 employees (39 percent). The most common incentive offered by both large and small employers? Cash or gift cards. In addition, some employers offer “lower insurance premiums” as an incentive for employees who participate in programs, with larger employers being twice as likely to offer this incentive.

Larger employers are also more likely to assume the majority of the wellness costs (62 percent), while only 46 percent of the smaller employers do so.

When offering a successful wellness program, large and small employers alike agree that these three items are inexpensive to administer:

  • Communication about programs
  • Strong internal leader
  • Top management support

Perhaps one of the biggest findings from this Study is the most encouraging of all. There is strong agreement by Iowa employers that wellness:

  • Reduces healthcare costs
  • Increases productivity
  • Reduces absenteeism
  • Increases the quality of life for employees

In fact, less than three percent of those employers who do not currently offer programs feel that wellness programs do not work!

The findings within this Study certainly suggest that having a strong workplace culture committed to wellness with a healthy dose of senior leadership support is critical for any wellness program to be successful.

The results reflect some very positive feedback to Capital Crossroads and to the Healthiest State Initiative – employers are looking for guidance from their respective communities on how to make wellness programs inexpensive to begin (and continue)…and easy to administer. As they say, “If there is a will…there is a way!”

To learn more, we invite you to subscribe to our blog.

Our ‘Health Care River’

'Our Health Care River'

‘Our Health Care River’

I am both intrigued and baffled by the ongoing public dialogue that occurs about rising health insurance premiums. The recent Wellmark rate request for individual policyholders is a case in point. Last November, Wellmark requested a 12.2 percent rate increase for three blocks of their individual health insurance business, in addition to the Wellmark Farm Bureau block of business.

No one wants to see health insurance premium increases of any amount, let alone annual increases that are a multiple of the general inflation rate. However, insurance companies should not be the general villain – but they are. Why?  They represent a very easy target for many – they are large, appear to be very profitable, have nice buildings, provide generous pay to key executives, and so forth. With the naked eye, public umbrage may be understandable.

The mainstream mentality is to reform the big and bad insurance companies.  By doing so, we will have more reasonable health insurance premiums in the future…or so we think.

Now it’s time to add a good dose of reality into this discussion.

Health insurance premiums are nothing more than a derivative of health care costs. If health costs move up, so will your premiums that you pay to insurance companies. If medical costs consistently go down or become more stable, your premiums will also be favorably impacted. The true cost drivers of “Our Health Care River” fall into two general buckets:

  1. Fragmented Delivery System
  2. Unhealthy Lifestyles

Our fragmented delivery system is really not a “system,” but rather a concoction of multiple temporary or expedient remedies that attempt to solve our problems as we confront our health care needs. No one is at fault, yet we ALL are.

For decades, we have allowed our legislators (both federal and state) to cobble together laws and regulations to combat the immediate issues of the day without really understanding the repercussions of how these actions will ultimately impact long-term societal goals. We are always developing short-term solutions to long-term problems, and, by doing so, creating a fragmented delivery system that resembles more of a ‘Frankenstein’ health care system.

Unintended consequences are typically an unwanted by-product of both good and bad legislation. The consequences we have in our fragmented delivery “system” include:

  • Misalignment of payment incentives to health care providers
  • Recommended care is only delivered about 55 percent of the time
  • Little transparency in cost and medical outcomes
  • Poor coordination of care
  • Deficiencies in clinical information systems
  • Lack of accountability in care delivery
  • Medical mistakes harm about 25 percent of all patients – costly both in dollars and in lives
  • About 30 percent of all funds expended for health care are wasted

Much like chemicals in a farm field, the unintended consequences of our fragmented delivery “system” runs off into the “health care river,” causing further problems downstream. This ultimately results in higher insurance premiums, medical mistakes and, unfortunately, premature mortality.

On the other side of the ‘health care river,’ we have unhealthy lifestyles – which has been well documented. Unhealthy lifestyles include:

  • Lack of physical activity
  • Poor dietary habits
  • Smoking & alcohol consumption
  • Aging population (just a fact of life!)
  • Emotional & spiritual needs are unmet
  • Overweight and obesity issues
  • About 70 percentof the factors influencing our health are lifestyle issues

As both cost drivers flow into our health care river, the consequences become unsustainable. Trying to fix health insurance premiums downstream will first require innovative activities and solutions UPSTREAM. We all have a part to play in this new ‘system,’ a very meaningful part. This is the type of public dialogue we need to have as we continue to confront future health premium increases.

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