Health plans update: wellness programs and health plan options address ways to control costs.

• Author: Held, Shari
• Position: HEALTH CARE

WELLNESS PROGRAMS remain at the forefront, but all health plans and programs are evolving to meet the demands and needs of employers and provide them with a broad spectrum of choices.

"It is very gratifying to see that wellness is finally begin recognized as a critical tool for helping stabilize health insurance costs," says Sally Stephens, president and CEO of Indianapolis-based Spectrum Health Systems and a long-time advocate for wellness and prevention. "The trend we are seeing consistently now is that employers are moving to the next level in wellness programs."

For some companies that means a model that rewards employees and spouses. For others it means eliminating barriers to primary-care access.

Health hurdles. Smoking and weight management are two of the biggest health hurdles Indiana employers face. Every state's population increased in terms of incidence of overweight and obesity in the latest survey, and although Indiana improved its rank slightly, that isn't necessarily cause for celebration. "It's not because we've gotten healthier, it's really because other states got unhealthier," Stephens says. "From my perspective as a registered nurse and diabetes educator, if you can impact stress, weight and smoking you are going to be able to affect every single other condition that's out there.

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According to Stephens, many Spectrum clients are emphasizing weight management from a cultural perspective--holding contests, health action campaigns, walking campaigns and other opportunities to engage employees. "Those who do are more successful in slowly inching their risk downward," she says.

Vicki Perry, president and CEO, Indianapolis-based ADVANTAGE Health Solutions, sees a demand for wellness programs and chronic disease management programs that can be integrated with the payer Side. "Rather than fragmented wellness ... we are seeing interest in aggregating both of those so that claims data can be an early driver for those initiates with outreach to those identified populations."

According to Chris Reef, CEO of Welborn Health Plans, the average rate increase on Welborn's entire book of business was 4.6 percent in 2007. He credits integrative prevention and wellness programs, at least in part, for those results and notes that the company's WellCare Department has nearly doubled in size in the last 18 months. "I don't think it is a silver bullet," he says, "but prevention and wellness is going to go a long way toward helping."

Another trend Stephens notes is an increased emphasis on coaching, one-on-one contact with individuals at the workplace. "We take a hands-on approach with high visibility at the worksite," she says. "You want the 'signs and symptoms' of a wellness program. It has a bigger impact on the culture of an organization." Spectrum also offers a 24-hour nurse line to provide support for client's employees after hours.

Welborn places nurses onsite to act as health care advocates at no charge to clients. "Ultimately it's about educating...