Many population health management programs face closer scrutiny when a company is faced with difficult budget decisions during a tough economy. But health and health care costs are a strategic priority for every business whether they acknowledge it or not — and most readily do.

In times of economic downturn, companies might want to consider increasing their spending on health and wellness initiatives. Why? Because in an economic downturn, maximizing productivity and reducing costs are more important than ever.

The true cost of poor health includes indirect costs, as well as the more obvious direct cost of medical claims. The more bad health habits or risks employees have, the lower their productivity; and health risks directly equate to higher health care costs, both direct and indirect. A number of medical conditions, if left unmanaged or poorly managed, become catastrophic, ending in hospitalization and reduced functioning, thereby reducing productivity. Lastly, health and wellness programming is a relatively low cost and important item. It decreases disease, but also influences whether employees like their jobs and feel cared about by an employer, which in turn affects productivity and absenteeism.

There are some key preventive measures a company can take that help keep people from slipping into a high risk, high-cost category. First, know what the most common or costly conditions are in your population and offer programs targeted to help your people manage these conditions. Encourage the local medical community to be an active partner with innovative management tools and strategies. Also increase the employees’ stake in the equation, but not regressively. Again, making disease management easy and affordable will likely save money. Lastly, look for quality in the medical care your employees get. Help your employees find quality care for catastrophic, high-cost conditions, and make helpful, quality information easy to access. There are now a number of good Web-based sources of quality medical information, such as the Centers for Disease Control and Prevention (CDC), National Library of Medicine, and mayoclinic.com.

When prioritizing program elements during tough economic times, companies can minimize downstream health costs and productivity impacts if they focus on initiatives that prevent the onset of high-cost, productivity-lowering diseases such as diabetes. In most health promotion and disease prevention programs, we know there is a three-to-one return on your investment, and you get the pay back in one to two years.

For mild conditions such as high blood pressure, high cholesterol, and Type 2 diabetes, company policies should make it easy to treat these conditions, and encourage medication and behavioral approaches. Make common medicines cheap to the end user, and encourage regular use of prescribed medications. Back it up with multimodal messages throughout the year. Make talking to a human easy when people have questions about their condition or medications with telephonic coaches, disease management professionals, group classes, or an onsite nurse.

Online personal health managers are a new consumer tool that will likely play a key role in helping people take their medications and manage their conditions. Using an online personal health manager also forms a bridge to doctors, and can give personalized day-to-day support and guidance to people via the Internet.

Keep healthy people healthy to prevent downward risk migration that can make health costs jump, and engage as many of your employees as possible in something positive. The first step is to get their attention. A health assessment tool provides a teachable moment and a jumping off point for engaging people in the wellness options you may offer.

Tracking data can often represent a significant time and dollar investment that may be difficult to keep up with during lean budget times. But the old adage of you can’t manage what you don’t measure is true in population health management. Maintaining a database of health status and trends is critical for making informed decisions on what interventions will have the most impact for your particular population. It also helps you justify the expenditure by showing whether you’re making a difference over time.

Use a health assessment as your baseline data set. It allows immediate feedback to the individual and gives group data for needs assessment and program development. It allows tracking of change over time, an early warning system and modeling of pay back from various program options. And it’s low cost, especially the online versions.

When faced with difficult budget decisions, if you are contemplating cuts to your health and wellness programming, stop and think about the downstream implications. Preserving these programs not only will help you keep your bottom line healthy, but also may improve your employees’ health, productivity and morale.

Arizona Business Magazine

February 2010