Is Workplace Wellness the Engine That Can Fuel Value-Based Care?

There are few things everyone in healthcare can agree upon, but one exception is the fact that fee-for-service payment models are no longer sustainable. It is almost universally accepted that we must reward providers based on outcomes, not activity, if we want to dramatically improve healthcare in the U.S.

The COVID-19 pandemic unleashed decades of pent up demand for change. And now, we’re seeing an explosion in interest and innovation in value-based care. A recent study by Willis Towers Watson showed that nearly three-quarters of employers (73%) intend to adopt and expand different types of health care delivery models, such as centers of excellence (COEs) and high-performance narrow networks, over the next three years. As we continue to redefine the next normal, value-based care continues to gain momentum. We are quickly reaching an inflection point.

But what does any of this have to do with the wellness industry?
Only everything.

The Center for Value-Based Insurance Design at the University of Michigan was one of the first organizations to examine the link between value-based care and workplace wellness. The Center has suggested that combining value-based design with wellness programs “allows businesses to maximize their investment in employee health” while creating long-run return on investment.

The synergy between value-based care and wellness creates aligned incentives for all stakeholders – employees, employers, health plans and providers – while also removing or reducing both financial and non-financial obstacles for healthy behaviors and outcomes.

A well-designed value-based program increases the ability for providers to care for the whole patient and to focus on prevention and health improvement. It creates a clinical on-ramp for workplace wellness programs which typically lack physician engagement and collaboration.

On the other hand, when providers are rewarded, and held accountable, for the total health of their patients, they quickly realize that they must dramatically change their overall approach to patient care. They must rely on outside resources to support them in achieving the very best clinical and financial outcomes. Workplace wellness programs can do just that. A well-designed workplace wellness program engages employees in their health and results in more educated and activated healthcare consumers. Basically, a good wellness program can produce better patients.

By integrating wellness and value-based care, organizations can increase their ability to effectively identify and stratify specific health risks as well as their ability to target resources and interventions more effectively. They can leverage the dual engagement of providers and employees to fuel deeper, stronger relationships between physicians and their patients. And they can create 24/7 surround sound for healthy behaviors and decisions, with physician care plans reinforcing wellness participation, and wellness participation reinforcing physician care plans.

At the end of the day, physicians need engaged patients. And patients want to interact with a physician who is rewarded based on whether they have positive outcomes. The symbiosis between wellness and value-based care will open doors of opportunity for wellness professionals and solutions providers in the wellness space.

For wellness professionals

This is your opportunity to level up. Value-based initiatives require healthier employees. As we just discussed, providers can’t achieve high-quality outcomes if employees are not in good health and aren’t taking steps to maintain and improve their wellness practices. By more closely integrating with value-based care, workplace wellness programs can have a more powerful, and measurable, impact on the bottom line. If your company is engaging in value-based strategies with its health plan or provider partners, you need to make sure workplace wellness is seen as part of the broader solution, and as a key to success for any value-based efforts. Explore all avenues, including:

• How can data from your wellness efforts help inform providers?
• How can you escalate employees to connect with healthcare resources in a timely and appropriate fashion?
• How is your wellness programming helping drive desired behaviors, such as avoiding unnecessary ER visits or achieving certain quality measures?
• How are you helping employees understand the connection between wellness and their healthcare benefits?
• How are you reporting back to senior management to showcase the impact wellness is having on value-based care initiatives?

For wellness solutions providers

You have the opportunity to increase your relevance and impact for the employers you serve. Or you can miss the boat and be left behind. There is unprecedented competition and consolidation in the health benefits space. The digital health revolution, coupled with the industry’s rapid transition to both virtual and value-based care, have blurred the lines and led to chaotic redundancy in service offerings. Employers who are trying to improve the health and wellness of their employees have never had more choices, or had to sort through so much noise. The companies who clearly define their value proposition will win in this environment. The solutions that can support new delivery models will rise to the top. If you provide wellness services but haven’t considered how you fit into the value-based care equation, I would encourage you to do so, quickly.

The stars are aligning for employers to take major steps forward in improving the health and productivity of their workforces. We’ve never been so close to achieving true collaboration and engagement of all healthcare stakeholders. There is still a lot of work to be done to ensure a successful shift from fee-for-service to value-based care. But for those of us who spend our days in the workplace wellness space, this is our moment to shine. If done correctly, wellness can be the engine that fuels value-based care. It will require thoughtful design, innovation and a dose of courage. But we can be the change we need to see in healthcare.

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