Tailor-made initiatives meet needs of employers

Factor employees’ conditions, other issues

Recognizing that employee groups are not all the same, Blue Cross and Blue Shield of North Carolina offers customized health and wellness programs for its employer-group customers.

"We’re not a one-size-fits-all employee wellness program. We go to the employee to find out their needs and design a package for them," says Sarah Weiser, PhD, director of employer health partnerships.

For instance, some groups have told them that the printed materials are likely to end up in the trash because the employees don’t read well. In those cases, the Chapel Hill, NC-based health insurer may set up a slide presentation on a health issue in the company’s break room or bring a speaker on-site to discuss a particular condition.

In one company, where 30% of the employees speak Spanish, the company brought in Spanish-speaking staff for a presentation.

The company started its health and wellness promotions with employer groups two years ago, based on requests from some companies who wanted help in keeping their employees healthy.

"We realized a need to work more closely with employer groups to help address rising health care costs at the group level. The companies know that instead of cutting benefits, the best way to address increasing costs is to keep employees healthy in the first place," Weiser says.

When the insurer begins working with an employer group, the company conducts a two-hour interview and develops a group assessment profile that includes what has worked in the past, how they reach out to employees, any employee publications, and buy-in from senior and midlevel management.

"We have different kinds of employee populations and employers that are in different places on the continuum. Some are providing only a health fair. Others have fairly sophisticated wellness programs. When we meet with them, we look at ways we can partner with them to leverage their resources," she says.

For instance, the company ascertains whether the supervisors will let people off for wellness activities at the work site and whether they have an occupational health nurse or wellness coordinator on-site. Employer groups are interested in return on investment and often want to know what they can do that will make the biggest impact in the shortest time, Weiser says.

"We show them research that indicates wellness activities do pay off but it is over two or three years. We know that a health fair doesn’t magically save costs but that incentive programs and changing behavior does make a difference, and a health fair is a good place to start," she says.

Before Weiser’s team suggests a wellness strategy to an employer, it conducts an in-depth analysis of the company claims data to determine which conditions are driving the company’s health care costs and compiles a list of the five top conditions affecting employees along with key opportunities for improvement.

"We look at conditions that are cost-drivers but can be impacted at the work site. If there are a lot of people with back problems, there is an opportunity to do something about that. If there are a lot of employees with asthma, we would recommend a workplace asthma initiative," she says.

Weiser suggests that the company offer incentives that encourage their employees to sign up for a program, pointing out that a $50 initiative can drive participation in a program.

The first step in the insurer’s employer health and wellness initiatives is to suggest programs that already exist but that the employees may not be using.

"We want to leverage existing Blue Cross programs and work on ways to increase employee participation in the programs," Weiser says.

For instance, if diabetes is a significant issue, the company mines its data to determine what percentage of employees already are in the diabetes disease management program.

"We advise the employer about the program and work with them on educating the employees about the program at the work site. If the situation with the employer group is appropriate, we will bring a presentation to the site," Weiser explains.

The health plan often brings a display of materials about a particular program and sets it up outside the company cafeteria, supplementing the company’s materials with information from sources such as the American Diabetes Association.

In other cases, the company’s case managers and diabetes educators have presented a 30-minute program on diabetes for employees, handing out free glucometers or, in some cases, pedometers to emphasize the importance of exercise in keeping diabetes under control.

"We can put together a whole campaign on diabetes, including an information session by a clinical person, information about our disease management program, newsletter articles, posters, fliers, and tools for a Diabetes Awareness Day," she says.

The efforts begin with resources already being offered by Blue Cross and Blue Shield of North Carolina and are supplemented by other resources, such as information provided by a pharmaceutical company, or community resources, such as smoking cessation courses provided by the American Lung Association.

The programs are tailored to the individual needs of the companies.

For instance, when claims at a textile company showed that migraine headaches were a big problem, the company sent a representative to the break rooms at five plants to talk about the BCBSNC migraine disease management program and help people enroll.

When appropriate, the company reaches out to the family members of employees.

For instance, as part of the men’s health program, Blue Cross and Blue Shield of North Carolina sends information home addressed to "Someone Who Loves . . . John Doe."

"We know that women tend to drive health care decisions more than men. We use these techniques in a couple of groups so that the women will encourage their spouse to participate," Weiser says.

The on-site programs represent a good opportunity to educate employees on disease management and case management programs for which they may qualify, she notes.

"Many people are either not aware of the program or they don’t understand how helpful it can be. We offer members with chronic diseases the opportunity to work one-on-one with case managers on a personalized plan," Weiser says.

Many times, the employees don’t understand disease management or case management and suspect that they’ll have to pay for the program.

"These on-site presentations are a very effective way in getting employees engaged. We allay their anxieties and reinforce the ways their health plan can benefit them," she says.

Bearing in mind that family members of the employees also may be big consumers of health care costs, Blue Cross and Blue Shield of North Carolina encourages employers to invite family members to health fairs and presentations.

"When we do a health fair or mini-booth on specific topics, we make it clear that family members are eligible for the program. The employers recognize that family members do drive some of the costs. Most start with their own employees and move on to the family members," she says.