Wellness Programs Expected To Surge

Expect wellness efforts to explode in the next few years as companies, federal and local governments, unions, not-for-profit organizations, and others that sponsor benefits increasingly adopt the theory that poor lifestyle decisions that people make contribute greatly to health care costs. This is according to the Express Scripts report “9 Leading Trends in Rx Plan Management [1].”

“The concern with health behaviors is reflected in the programs that plan sponsors intend to implement in the coming years,” the report states. “For the first time in the [five-year] history of our survey, wellness programs were cited as the most effective measure to control overall health care costs, garnering 25 percent of the first-place mentions in a field of 11 strategies. The intended use of wellness programs in the next two years is 23 percent higher than current use, the single highest increase of any measure intended to control overall health care costs.”

Timothy C. Wentworth, Express Scripts president for sales and account management, says that “Clinicians and benefits managers know that behavior — poor diet, lack of activity, smoking and alcohol abuse — are the big factors that influence health care use and spending, but they are now realizing that people also need to listen to their doctors and stick to a treatment plan, including their prescriptions.”

The report is based on an online survey of “318 individuals with pharmacy decision-making responsibilities — such as benefit managers and benefit directors” at employers, not-for-profit organizations, and public sector unions representing 9 million covered lives. The survey, taken in the fourth quarter of 2011, includes benefit packages at companies with 5,000–50,000 covered lives. The other trends are:

• Plan sponsors will look to online tools and mobile apps to lower costs.
• Health care reform will raise questions about future coverage options, but only a small number of plan managers consider it the biggest challenge.
• Employer Group Waiver Plans may soon outnumber Retiree Drug Subsidy plans as a tax advantage expires in 2013.
• Consumer-directed health care will gain momentum.
• Mail strategies will grow and deliver results.
• Comprehensive management will become key to curtailing spending on specialty pharmaceuticals.
• Drug coupons will raise cost concerns.

But it’s the attitude toward health care behavior, and the planned response, that registers with employers.

“Our employers are increasingly using online and mobile tools for employee engagement and these have a great potential to help meet goals around keeping our workers healthier and more productive,” says Tom Croyle, president of the Lehigh Valley Business Coalition on Health Care, which represents over 100,000 employees in Pennsylvania. (See our Q&A with Paul Terry, PhD [2].)