Wellness is a Marathon: Train for it with Outcomes-Based Contracts

Wellness is a Marathon: Train for Results with Outcomes-Based Contracts Value-based benefit designs succeed when they are built on a platform of prevention and wellness. Payers and purchasers must focus on the current and emerging risk, and the biggest indicator of danger is lack of engagement by the consumer, the payer and the purchaser (who is typically the employer). Paying for outcomes as a part of the service contract holds everyone accountable for both engagement and outcomes. For over 5 years and across numerous surveys, 87% of companies large and small offer incentives for prevention and wellness services Health is the Goal Outcomes-Based Contracts Doubled from 2010-2012 for Prevention and Wellness Health and Financial Risk Improved with Participation OBC use for chronic care OBC for Prevention and and guidance Condition Mgt Risk Management services, in order of % usage Care Coordination Reduction in ER Use Chiropractic Services Data Registry in Medical Records But companies that do not link incentives for employees with incentives for services do not achieve minimum thresholds of participation. Average Participation in Annual Exam Average Participation Average Participation in Flu Shot in Biometric Screen Minimum Threshold is 60% Minimum Threshold is 70% Minimum Threshold is 80% 38% 63% 68% *not achieved even when offered free and onsite $1.00 A survey of 36 peer-reviewed studies of wellness programs in large firms found that average employer medical costs fell $3.27 for every dollar spent on wellness programs, and average costs of unscheduled absences fell an additional $2.73. $3.27 $2.73 So if employees don't participate, there's a lot of money going to waste What to do? My Biz Outcomes-Based Contracting Outcomes-Based Contracts (OBC) align incentives for employees and services providers for engagement and goals. More participation or more risk reduction means higher reimbursement. References: Nayer, C. Meta-analysis of employer surveys. 2001-2013. Health Policy Brief:Workplace Wellness Programs," Health Affairs, May 10, 2012. All rights reserved. www.cyndynayer.com (a division of River City Health) 2013 12345678910