Promoting Healthy Choices through Wellness Programs

Chronic disease is a monumental health issue in the United States. Approximately six in 10 adults in the U.S. have a chronic disease, while four in 10 have two or more.

The most prevalent chronic diseases are diabetes and obesity. An estimated 34.2 million people, or 10.5% of the U.S. population, have diagnosed diabetes, costing the country around $327 billion annually. Worldwide obesity has nearly tripled since 1975, with approximately 93 million Americans affected by it. According to the Centers for Disease Control and Prevention (CDC), the annual nationwide productive costs of obesity-related absenteeism range between $3.38 billion and $6.38 billion ($79 to $132 per individual with obesity).

Enter wellness and preventive health programs from health plans. These are designed to promote healthy living and prevent diseases before they occur, as well as educate members and reduce healthcare costs. These programs typically require health screenings and risk assessments at the outset. They then provide participants with educational materials, exercise and nutrition plans, smoking cessation tools, stress reduction resources, mental health assistance and more.

Prevalence of wellness programs

The Kaiser Family Foundation (KFF) 2019 Employer Health Benefits Survey contains a wealth of information on wellness programs in the employer-sponsored health insurance market. Here is a summary of some of the results:

• Among firms offering health benefits…
• 36% of small firms and 72% of large firms offer programs to help workers stop smoking or using tobacco.
• 31% of small firms and 60% of large firms offer programs to help workers lose weight.
• 39% of small firms and 71% of large firms offer some other lifestyle or behavioral coaching program.
• 28% of small firms and 68% of large firms offer disease management programs.

• Among large firms offering health benefits…
  • 65% offer workers the opportunity to complete a health risk assessment.
  • 52% offer workers the opportunity to complete a biometric screening.
  • 84% offer workers wellness programs, such as programs to help them stop smoking or lose weight, or offer lifestyle and behavioral coaching.

• Among firms with wellness programs…
  • 41% of large companies and 15% of small companies offer employees a financial enticement to participate in, or complete, the program.

An important note in the report is that many employers believe improving the health of their workers, and their family members, can improve morale and productivity, as well as reduce healthcare costs.

Positive proof from published studies

There are differing reports on the advantages of wellness programs from health insurers; however, benefits to these programs have been proven by a number of respected studies.

The Journal of the American Medical Association (JAMA) found that 8.3% more employees in workplaces with a wellness program reported exercising regularly and 13.6% more were actively managing their weight.

A Health Affairs case study of large companies reported that total medical spending at a company with an employee wellness program experienced slower growth in health costs than companies without one.  

The Journal of Occupational and Environmental Medicine reported that employees who participated in a health promotion program and improved their healthcare or lifestyle regained an average of 10.3 hours in productivity annually and saved their companies an average of $353 per person per year in productivity costs.

These studies aren’t the only evidence that wellness programs can work. The Office of Disease Prevention and Health Promotion lists the following five reasons employee wellness is worth the investment:

• Healthy, active employees incur lower health costs.
• Employees who take advantage of wellness are more productive.
• Physically active employees are healthier.
• Wellness programs inspire important behavior changes.
• Small business owners may be able to take advantage of tax incentives for workplace wellness programs.

Programs in progress

On the federal level, in October 2019 the Centers for Medicare & Medicaid Services (CMS) invited states to take part in a demonstration project to employ wellness programs in their health insurance markets. The program was created to enable a total of 10 states to implement wellness programs that are health-contingent, which is prohibited under the Affordable Care Act (ACA). 

One report found that more than 60 percent of consumers in the U.S. are interested in sharing personal data collected by devices as part of health insurance rewards programs. The following two health plans are among many that have established their own wellness program initiatives:

AllWays Health Partners

As part of Partners HealthCare, the AllWays Path to Lifestyle Change program was developed by Massachusetts General Hospital (MGH) to help members at risk for type 2 diabetes. The goal of the program, which was announced earlier this year, is to encourage eligible members to reduce their weight by seven percent and increase their time spent exercising to a minimum of 150 minutes per week. There are no additional out-of-pocket costs for members who have been identified as being at risk for developing type 2 diabetes.

Aetna

This health insurer’s health and wellness programs include a focus on women’s healthcare, personal health and wellness coaching, mindfulness and workplace wellness. Called Aetna Health Connections, these 70+ wellness programs are comprised of solutions such as a disease management initiative, the 24-hour Informed Health® Line, the Aetna Health^SM app and an online health assessment for targeted strategies for weight loss, stress reduction and smoking cessation.

How health plans are addressing mental health

Mental health is a prevalent issue in the United States. The National Alliance on Mental Illness (NAMI) reports that one in five U.S. adults experiences mental illness each year. However, the average delay between the onset of mental illness symptoms and treatment is 11 years. An increasing number of health plans are implementing programs to make it easier for members to receive treatment. These are examples from America's Health Insurance Plans (AHIP):

1. Cigna is collaborating with MDLIVE to make mental healthcare more convenient by enabling patients to schedule virtual visits (by secure video or phone) with providers. This benefit is in addition to other behavioral health solutions Cigna has in place, including a 24/7 crisis line and digital platforms to help people cope with stress, anxiety and depression.
2. Through its Resilience in School Environments (RISE) initiative, Kaiser Permanente – along with partners Discovery Education and Alliance for a Healthier Generation – is providing training and resources for teachers and administrators in schools around the country to help them combat stress and anxiety for students and staff alike. According to the CDC, one percent of children have diagnosed anxiety, and 3.2 percent have diagnosed depression.
3. A 2019 study from the PEW Research Center found that 70% of U.S. teens identified anxiety and depression as major problems among their peers. Blue Shield of California launched its BlueSky program to provide mental health awareness and resources to schools in California, focusing on middle and high school-aged children.

Health insurance providers including Cambia Health Solutions and Centene Corporation are making investments in Quartet, a healthcare technology company that connects with primary care providers to match patients to in-person or virtual mental health resources depending on their needs.

MLS Group of Companies partners with many group health plans who have rolled out wellness programs to its members. Nicole Long, General Manager of MLS, explains, “As one part of the vast healthcare industry, we understand that valuing health and wellness is an important way to connect us with other healthcare entities. Not only do we share these values, but we also share a commitment to improving the quality of healthcare. In our own offices, employees have access to resources offered by our human resources department that assist staff with navigating their healthcare choices and finding support to make sustainable, healthy choices.”

Learn more about MLS’s leadership and our commitment to quality on our website. 

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