Time to move past initiatives around health awareness, education

Employers not focused on reducing health risks, costs: Aon Hewitt
By Sarah Dobson
|Canadian HR Reporter|Last Updated: 02/27/2012

When it comes to improving workers’ health, most employers aren’t focused on initiatives that will actually reduce risk and lower costs, according to a recent survey by Aon Hewitt.

While employers are keen to have integrated workplace health programs that focus on addressing health risks and related costs — and to measure results — most are focusing on awareness and education, not activities designed to reduce those risks and costs, it said.

“Awareness and education-based programs, they’re easy to do, they’re relatively inexpensive to do, they’re often free — through public health or through your insurer or EAP provider,” said Mike Kennedy, vice-president and national lead of health strategies and solutions at Aon Hewitt in Calgary.

“For those employers who are looking for low-cost programming, doing something, starting somewhere, they’re fantastic places to start. However, you shouldn’t confuse them with being aligned to produce outcomes such as lower risk, lower cost.”

In looking at the most popular wellness program components, employee assistance programs (EAPs), newsletters, lunch-and-learn sessions and health-spending accounts (HSAs) came out on top, found the survey of 120 employers.

“You can’t expect lunch and learns to produce a significant behaviour change and reduction in cost. That’s sometimes where the disconnect is — expecting a certain program to have a different result than it’s designed to produce,” said Kennedy.

“If looking for a return that is reduction in risk, reduction in cost, improved productivity, then you also have to expect to put the program in place that’s going to achieve that.”

However, education and awareness-type initiatives could seem more popular because they are commonly offered by providers and insurance companies, as seen in the 2010 Buck Survey of Health Promotion and Workplace Wellness Strategies, said Sandra Pellegrini, Toronto health and productivity practice leader at Buck Consultants.

“That’s almost an automatic,” she said. “I wouldn’t draw a line to say employers are more focused on that — it’s just part and parcel of what’s available today.”

However, almost one-third (32 per cent) of the employers surveyed by Aon Hewitt said they are unaware of which health issues are driving costs. There could be a couple of reasons behind this, said Kennedy. For one, reports from providers can have different start dates, such as the start of the calendar year or a contract, which can make it a challenge to compare apples to apples.

Secondly, employers want context, which means understanding how their costs compare to other populations and industries such as theirs. Those benchmarks typically haven’t existed, he said, but they can ensure employers spend dollars on a program that offers the greatest potential for return on investment (ROI).

“It really comes down to understanding not just what’s driving your costs overall, it’s not just tallying up the mental health claims for your drugs, for disability, for absence, it’s also looking at, ‘What is the cost of mental health claims to our organization compared to what we should expect it to be based on our demographics?’”

Currently, 54 per cent of employers analyze data to establish the top cost drivers while 19 per cent plan to do so in the next two years, found the survey. Almost one-half (45 per cent) are also determining whether health and benefits costs are higher or lower than peer groups and 22 per cent plan to do so in the next two years.

Among those employers that see cost reduction as a desired outcome of their wellness programs, 32 per cent are focusing on disability, 26 per cent are focused on drugs and 25 per cent are looking at absences, found Aon Hewitt. That’s because these costs are significant and Canada’s health-care system makes it difficult for employers to measure all components of health-care costs, unlike the United States, said Pellegrini. But they can measure the data they have, such as days off, lost time, longer absences in the form of a disability claim, and detailed drug claims.

Online health-risk assessments (HRAs) are provided by 39 per cent of employers and 28 per cent plan to introduce them in the next two years, found Aon Hewitt. On-site biometric screening is offered by 11 per cent, but 23 per cent plan to bring it on board in the next two years. Coaching to support high health-risk behaviour change is offered by 17 per cent and 29 per cent plan to introduce it in the next two years.

HRAs can introduce a shared accountability model that brings any issues to the attention of individuals so they are in a position to take control of their personal health, said Pellegrini. The assessments also allow employers to establish a baseline to measure down the road.

“If you’re not measuring it, you’re not managing it. That’s a long worn-out statement but it’s very true.”

Using tools to follow, track and measure is really important, said Josée Thibodeau, manager of online health-risk assessment service Health & Wellness Companion at MD Physician Services, a Canadian Medical Association Company. “Because you cannot just invest anymore, left and right, into programs that won’t necessarily have an impact.”

Organizations have realized, for example, on-site gyms are largely popular among employees who already are physically active, so they don’t necessarily make people more active, she said. It’s about segmenting and understanding demographics, along with employees’ willingness to change.

“It’s all about their internal motivation — you have to find that little button to push,” said Thibodeau, based in Montreal.

A lot of corporate wellness programs also neglect culture, said Peter Dehais, marketing co-ordinator at Loszach Report in Montreal, which helps employers implement wellness programs. Organizations might focus on flashy offerings that attract people but don’t make them want to stick around.

“Most people look at the benefits costs and try to implement physical activity measures or nutritional aspects and there’s a lot of the education and awareness that happens there to try and get people to live a healthier lifestyle but there’s sort of an overlooking of internal factors that are creating heavy costs.”

Companies should take an in-depth look at the way things work inside a company and how to make jobs healthier by looking at issues such as job satisfaction, perception of workload, autonomy at work or stress levels.

“Those are things that can make a big difference in day-to-day productivity,” said Dehais. “It’s much more difficult to calculate than benefit costs but those have a huge impact on the overhead a company will have every year.”

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