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The current economic slowdown has claimed a number of casualties, but employee health promotion and management programs do not appear to be among them. That’s one of the major conclusions drawn from a recent survey by Lincolnshire, IL-based Hewitt Associates, a global management consulting and outsourcing firm specializing in human resource solutions.
Hewitt surveyed 1,020 companies. The study, "Health Promotion/Managed Health Provided by Major U.S. Employers in 2000," showed that 92% of U.S. companies currently offer some kind of health promotion program, up from 88% in 1995. The survey’s other findings include the following:
• 71% of companies now offer employees some kind of health or lifestyle education or training, a 5% increase since 1995.
• Financial incentive and disincentive programs held steady at 40% — still up from 32% in 1995.
• 27% of companies administer health risk appraisals (HRAs).
• 74% of employers use health screenings.
• 77% of corporations offer employees special programs such as disease and medical management, flu vaccinations, well-baby/child care and prenatal care, compared with 71% in 1996.
• 71% of employers report that they are considering or already have some type of disease management initiative in place.
• The majority of employers offer disease management (77%) and wellness programs (67%) as part of their benefits design, while some companies self-administer wellness (34%) and disease management (10%) programs.
This upward trend in the face of a slowing economy runs counter to historical corporate attitudes about health management programs, which were traditionally viewed by upper management as "nice to have" as opposed to "need to have" initiatives. Why the change?
"We’re seeing the impact of a rapidly maturing marketplace," explains Camille Haltom, MS, a Hewitt health care consultant. "A couple of years ago, employers said they were very skeptical about disease and medical management programs, but providers are much better at measuring the impact of their programs and the cost savings that might result from better medical management."
The codrivers behind this shift are a growing body of literature and more available data on the positive impact of these programs, says Haltom. "Many companies have put programs into place within the last year, so they themselves don’t have the history," she explains. "But providers have a process to measure impact, and there is a more substantial body within the literature that point to financial savings. Health plans as well have embraced disease management and have used such programs to attract employers," she adds.
While some wellness programs, such as smoking cessation, may take decades to demonstrate savings, disease and medical management programs have a shorter-term window for positive returns, notes Haltom. "Still, health promotion enjoys and maintains its popularity, as do prevention programs, because they have been around longer," she notes. And, after all, "All of these programs are points along the continuum of medical management," she asserts.
The percentage of companies that offer HRAs, however, is surprisingly low — 27%. "Actually, that’s held steady for many years," Haltom says. "I would observe that while employers may not put HRAs in place as stand-alone tools, they may be used as part of an integrated health management program, which may not show up in the survey. Also, the growing use of on-line services will increase the ease with which HRAs can be administered, and we may see that number jump."
What is also significant about the survey, says Haltom, is that "it really speaks to how well third-party providers or even health plans are delivering or administering health care programs — how efficiently they are identifying people who have certain conditions." While there has been an influx of new providers in this area, she notes, "We’ve also seen some fall by the wayside that couldn’t keep up with the need to show ROI [return on investment] and savings."
The survey also has an important take-home message for occupational health professionals, says Haltom. "These programs integrate very nicely with disability programs," she asserts. "This would be considered the disability prevention arm, if you will, as well as a program to help people get back to work sooner. This is really based on good clinical practice — helping people self-manage their conditions more effectively and efficiently, and improve their interactions with providers."
[Editor’s note: Additional information about the survey, "Health Promotion/Managed Health Provided by Major U.S. Employers in 2000," may be obtained at the Hewitt web site: was.hewitt.com/hewitt.
Or, contact Kelly Zitlow at Hewitt Associates, 100 Half Day Road, Lincolnshire, IL 60069. Telephone: (847) 442-7662.]