Integrate a three-pronged wellness approach

January 1, 2006

While healthcare costs are predicted to rise at a slower rate in 2006 than in recent years, employers will still pay an average of more than $8,400 per employee. This amounts to an 8% increase, roughly $600 per employee; employees will pay about $155 of that increase in 2006, a 10% rise from 2005 levels, according to the 17th Annual Towers Perrin Health Care Cost Survey released in September 2005.

While healthcare costs are predicted to rise at a slower rate in 2006 than in recent years, employers will still pay an average of more than $8,400 per employee. This amounts to an 8% increase, roughly $600 per employee; employees will pay about $155 of that increase in 2006, a 10% rise from 2005 levels, according to the 17th Annual Towers Perrin Health Care Cost Survey released in September 2005.

Shifting more of the costs to employees has shown to accomplish only limited results. And, employers worry about going too far in passing these costs. "Take Care of Yourself: Employers Embrace Consumerism to Control Healthcare Costs," a new study by PricewaterhouseCoopers, showed that 62% of the 150 executives surveyed believe that increasing deductibles may only cause their employees to defer care, risking their own health and potentially leading to higher healthcare costs down the road. Eighty percent of the executives believe the most promising alternative for managing healthcare costs increases is to provide education and incentives for employees to adopt healthier lifestyles.

The National Association of Health Underwriters agrees. In the 2005 Annual Benefit Buying Trends Study, 77% of respondents see consumer-directed healthcare (CDHC) as the solution to the national healthcare inflation problem-an increase of 12% over the year before.

Of course, it is important that employees across the board have the information they need to make optimal healthcare decisions. But for this targeted group of employees, CDHC goes beyond consumerism-it means behavior and lifestyle change. They need to learn how to manage the chronic illness, how to communicate with their doctor, how to implement preventive measures. In essence, they need to be taught how to adopt a healthier lifestyle.

They also need to understand that chronic illnesses very often have behavioral health issues, and there is increasing recognition of the importance to manage an individual's health across their co-morbid conditions. In fact, a recent study by Standard University Medical Center found that people who have major depression are more than twice as likely to have chronic pain when compared with people who have no symptoms of depression.

A holistic solution that integrates employee assistance, wellness and disease management is the most effective way to give individuals the education, motivation and guidance they need to address chronic illnesses head on: Health professionals help people make modifications in their lifestyles through wellness measures, treat chronic diseases through a long-term disease management approach that aims to prevent worsening of chronic medical conditions, and evaluate and treat people for psychiatric issues through integrated health and behavioral health programs.

As an individual experiences the various symptoms associated with intertwined chronic conditions, he must be able to flow among the three prongs of treatment-tapping into what he needs, when he needs it. This way, for example, if an assessment offered through a wellness program uncovers that an individual is at risk for cardiovascular disease, every aspect of that diagnosis can be seamlessly handled through one program. He can continue to monitor his condition though the wellness program, can get information on lifestyle changes through the disease management program, and can tap into the EAP to help manage the emotional health side of the issue.

Or, perhaps a disease management counselor who is working with an employee to get her diabetes in control determines that she is highly stressed and depressed. The counselor immediately brings in an EAP counselor on board to focus on the employee's behavioral health, and taps into the wellness experts to help the employee initiate a diet and exercise program.

When these three programs-wellness, disease management and EAP-are integrated, an individual gets the full scope information and support he needs to make well-informed decisions and adopt a healthier lifestyle. As a result, the number of acute (and expensive) episodes is reduced, which lessens the number of hospital stays, lowers healthcare costs, and gets employees back into the workforce as quickly as possible.

Sean Fogarty is the director of U.S. sales and marketing for VMC Behavioral Healthcare. Based in Gurnee, Ill. VMC is the fourth largest EAP provider in the country, covering more than 4 million people with EAP, work-life and wellness services. Fogarty can be reached directly at 847-625-3516.