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are you and your wellness partners working at cross purposes?

September 21, 2009

in wellness

this post is the third in a five-part series exploring how to provide a customized wellness experience to upwards of 20k employees and their dependents. it all began back here, when “good” made me feel bad. in the second post, i asked are you doing too much with your wellness program? this post focuses on integrating your various wellness-related programs and services.

let’s say you have a fairly traditional wellness program. it includes a health risk assessment, discounted fitness and nutrition memberships, tobacco cessation services, and incentives. operating separately are all the other health and wellness benefits you offer, including disease management programs and counseling, plus workers’ compensation, health and safety, and disability benefits.

and let’s say these are integrated in a fairly common way—which is to say, they’re not.

not to worry. thanks to recent court rulings you can procrastinate on that integration meeting you were planning. in two separate cases, a severely overweight employee required surgery due to a work-related injury. in each case, doctors counseled that for the work-related surgery to have any effect, the employee must first lose weight. much to both employers’ dismay, the courts ruled that it was the employer’s responsibility to pay for the work-related surgery and gastric bypass surgery to correct the employee’s obesity problem. This in spite of each employer’s insistence that the employee was overweight before the injury and correcting it was not their obligation. in both cases, the courts ruled that the bypass surgery was a required first step for improving the employee’s health.

this post isn’t about whether these rulings are right or wrong or how they’ll alter wellness programs going forward (compelling topics, though! what’s your opinion?). it’s about integrating your wellness-related programs without a court order catching you by surprise and forcing you to do so.

the ideal

in most organizations right now, the programs—not the person—are the focus. who’s getting the biggest bang for the buck. no one. who’s getting the best care? nobody. to achieve better health and better business outcomes, the approach needs to be inverted, with employees and covered family members at the core.

how would this be different? let’s take the cases above.

it’s not been reported what care the employees were receiving for their weight issues. in an environment where the employee was at the core, he or she would be in a disease management program for obesity and possibly for obesity-related issues, such as low back pain and heart disease. the employee would have received information about available discounted fitness programs to complement the counseling received through the disease management program. and if through talking with a disease management counselor it was discovered that depression was at the heart of it all, the employee would be connected to a counselor from the company’s employee assistance program. the employee would receive care and coordination that focused on his or her needs from the providers who could provide the best care.

integration

accomplishing this takes some doing. your health and wellness partners are not necessarily inclined to work together. most of them have competing services, and many are compensated based on enrollment numbers. your systems don’t talk to one another. and, of course, your communications may conflict or overlap. it’s incumbent upon the head of benefits or wellness to organize vendor summits where all involved parties can discuss and agree upon desired outcomes, current process and process adjustments, appropriate metrics, and service agreements.

this blog is about communication, and at this point you may be asking what does any of this have to do with communication? the answer: everything. your employee doesn’t see the back-end negotiations around the conference table, the charting of which vendor is reaching out at what point, the decisions about contracts and incentives. your employee doesn’t track the improvement in participation, satisfaction, and improved health. your employee simply experiences how well it’s done.

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[image: massenpunkt]

more on vendor summits:


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