Health care costs have been rising for several years with no sign of slowing in the near future. In 2007, health care expenditures in the United States surpassed $2.2 trillion. Stemming this growth has become a major policy priority, as the government, employers, and consumers increasingly struggle to keep up with health care costs. 

The current health care climate represents an ideal opportunity for businesses to reevaluate their worksite wellness and disease management program offerings.  Worksite wellness and disease management programs have the potential to decrease overall health care costs; however, the potential of these programs to achieve cost savings depends on thoughtful and systematic benefit design and implementation.

As a health and wellness consultant, I always advise my clients to take a data-driven approach to worksite wellness and disease management programs. The first step to developing an effective wellness and disease management program is to conduct a needs assessment and gap analysis. Synthesize data from multiple sources such as health care and disability claims, pharmacy claims, hospital utilization, and health risk appraisals to arrive at a high-level understanding of the conditions and risk factors that are driving health care costs for your business and identify “gaps” where there is a need to address specific cost drivers (e.g., asthma, diabetes, tobacco use).

Because there are so many vendors in the marketplace offering wellness and disease management programs, businesses must take a very systematic approach to identifying the vendor and programs that will best meet their specific needs. When I am asked by my clients to develop a Request for Proposals (RFP), I always draw from the business’s data sources to describe the employee population, prioritize the health conditions and risk factors that should be addressed, and propose the outcomes and metrics to be used to design and evaluate the programs.

The bottom line is that worksite wellness and disease management programs hold tremendous potential to help businesses and employees to reduce health care costs. But with so many health improvement programs, approaches and vendors in the marketplace it is critical to take a data-driven and systematic approach to developing and implementing the programs that hold greatest potential to improve health and reduce costs in your own business. 

Carol McPhillips-Tangum, MPH is a health research consultant with specific expertise in the design and evaluation of health improvement and disease management programs. She is a Principal at Experion Healthcare Group, LLC (www.experionhealth.com) and can be reached at ctangum@experionhealth.com