Health Games: A Key Component for the Evolution of Wellness Programs.

Abstract

Healthcare cost growth has been a major concern for both governments and employers. Considerable efforts have been made to "bend the trend" or find ways to control costs. At the highest levels, this has been the move from indemnity care models to managed care and then to consumer-directed health models using Healthcare Reimbursement Accounts and Healthcare Spending Accounts in plan designs. Accompanying this move in plan design has been an effort to get the consumer/patient/employee more engaged and responsible for his or her health expenditures, health decision-making, and activities. Consumers have gone through the phases of health being doctor-centric (indemnity care model), to health plan-centric (managed care models), to consumer-centric (consumer-directed health models). There is currently a need to incorporate wellness into the equation. Simply put, wellness is intended to keep people out of the health system by reducing the risk factors that would put them into the system in the first place. This includes things like smoking cessation, exercise, weight management, nutrition, and other factors over which individuals have a significant level of control over, as well as condition management such as medication adherence, and condition monitoring (such as glucose monitoring for diabetics). Wellness will become increasingly more common for major buyers, initially large self-funded employers and then health plans that will offer it as a part of their overall Plan Design and Administration services. Wellness initiatives will also be offered by Federal and State governments and will include programs for the elderly and at-risk populations as well as for the general population. The measure of success of wellness programs to actually "bend the trend" will be engagement. How large a piece of the population can be captured and retained will be the critical metric for success…and metrics require real data and will be used by the entire healthcare value-chain to measure efficacy and efficiency of "wellness spending."