Posted on 22 Nov 2011
As U.S. companies continue to ask workers to shoulder a greater burden of the cost of health care, a new survey from Aon Hewitt, The Futures Company and the National Business Group on Health, reveals that consumers want their employers to do more to help them improve their health and get the most from their employer-provided health and wellness plans.
Together with the National Business Group on Health and The Futures Company, Aon Hewitt surveyed more than 3,000 consumers (employees and their dependents) covered by employer health plans to determine their perspectives, behaviors and attitudes towards health and wellness. Under continued pressure to mitigate costs and adjust to new regulations, employers are continuing to carefully consider the future of their employer-provided health plans. However, as they adjust their plan design and wellness strategies, the survey finds that many employers aren't aligning these strategies with the goals, needs and concerns of their employees.
While a majority of consumers (74 percent) are worried about being able to afford health care now and in the future, they understand that health improvement programs, along with well designed employer-provided health benefit plans, can help them get healthier while also holding down costs.
But, the survey reveals that workers really want four simple things—programs and communication that are easy to use, motivating and meaningful to them, but that also provide personalized information and ideas.
"Employers continue to face countless challenges when it comes to offering health plans that effectively meet the needs of workers and their families, while also managing rising costs," said Helen Darling, president and CEO of the National Business Group on Health. "We hear over and over that the key to ensuring real health improvement is employee engagement, so knowing what employees want and what will motivate them is essential to success. Consumers are telling us that the one-size-fits-all approach to health and wellness isn't working for them. In order to help with their challenges and reduce costs, they want health programs that speak to their individual and families' health care needs."
Make it Easy
Faced with rising health care costs and new regulations, more employers are introducing health care plans that require workers to take more responsibility for managing their health and the related costs. In fact, a recent Aon Hewitt report shows that 51 percent of employers now offer a Consumer Driven Health Plan (CDHP), up from just 9 percent in 2005.
The good news for employers is that consumers are willing to try CDHPs if the immediate cost savings are apparent. Among those with a choice, most employees (63 percent) select a CDHP because of the lower premium costs. Additionally, 39 percent choose this plan option because their employer contributes to an associated account—Health Savings Account (HSA) or a Health Reimbursement Account (HRA). In fact, among those enrolled in a CDHP who have a choice, over 90 percent will definitely or probably re-enroll. While CDHPs are, in part, intended to encourage workers to take a more active role in their health, the survey findings indicate that they are having a mixed affect on behaviors. Encouragingly, 42 percent are getting more preventive care and 40 percent are looking for lower cost health services options since choosing this plan. More troubling, a sizeable number of workers (35 percent) are sacrificing or postponing care (28 percent) to avoid out-of-pocket costs.
"While an eye towards cost is certainly a valid and reasonable reason for consumers to select a certain health care plan, choosing a plan that fits a worker's lifestyle and needs also ensures that people are getting the most appropriate coverage for their needs," said Cathy Tripp, managing principal Health & Benefits at Aon Hewitt and project leader for this study. "However, employers need to make sure workers aren't sacrificing health and the future costs of poor health for lower costs today. Giving employees the tools and advice to decide what is the most appropriate plan for them is critical."
Make it Personal
When it comes to tools to help them make health decisions, consumers want information that is tailored to their specific situation. Half of participants (50 percent) want a personalized plan that recommends specific actions they can take to improve their health based on their health status, up 9 percentage points from 2010. Workers are also looking for convenient, one-stop access to information with 40 percent expressing a preference for a wellness website and more than a third (35 percent) want personalized health tips and reminders. Cost is still not far from the minds of consumers though. Fully 44 percent would like cost savings tips and a third (33 percent) want cost estimating tools.
"If companies truly want to move the needle in terms of overall health and cost, they have to stop looking at employees as one group, and start looking at the individual," stressed Joann Hall Swenson, principal and health engagement best practice leader at Aon Hewitt. "Employers can customize health information and related programs to address the specific health conditions and risks of their workers as well as offer specific tips and actionable steps they can take to improve their condition. In addition, offering tools that allow individuals to see and understand the cost of their health care services goes a long way in helping workers make the most of their health care dollars."
Make it Move Me
In addition to shifting a greater share of the cost to employees, companies are also looking at ways to get employees and their dependents healthier. According to consumers, the best way to motivate them to participate in employer-sponsored health plans is by using rewards. More than half of consumers would prefer either non-cash or cash incentives to encourage them to take part in wellness (60 percent), condition management programs (50 percent) or respond to a health risk questionnaire (58 percent).
For employers, getting workers engaged in their health is critical to health improvement and cost containment. However, the survey finds that there is a disconnect between how healthy people think they are and how healthy they actually are. The Centers for Disease Control and Prevention reports that approximately one-third (33.8 percent) of U.S. adults are obese, though only 24 percent of survey participants say they are obese. Similarly, the survey found that more than three-quarters (76 percent) of consumers rated their health as "very good" or "good," while just 15 percent considered their health "fair" or "poor." While employees may think they're healthier than they likely are, they do acknowledge that their health isn't perfect.
Approximately 60 percent of consumers report having at least one health condition with obesity, high blood pressure and back pain most often mentioned.
"This lack of awareness between real and perceived health is a huge problem since we know that concerns about risk factors can help overcome our natural tendency to put-off making the tough life changes needed to significantly reduce health risks," stressed Darling.
Despite the potential disconnect between real and perceived health status, consumers do understand what it takes to get and stay healthy. When ranking what matters most to their health, many (85 percent) say that good health is a result of making smart health choices each day, over two-thirds (68 percent) say that getting regular preventive care ranks in the top three, while 40 percent rank living and working in a healthy environment in the top three. While people know what it takes to be healthy, there are still often barriers to reaching health goals. Most people cite lack of time (42 percent), cost (40 percent) and unwillingness to sacrifice (35 percent) as the leading obstacles to getting and staying healthy.
Consumers do acknowledge that there are people and things in their lives that may help move the needle when it comes to improving their health. Nearly three-quarters (72 percent) are influenced by advice from a doctor, almost half (47 percent) from friends or family, and 41 percent from general health websites. Just 13 percent consider health information from their employer a trusted source.
"It's clear that when it comes to improving their health, knowing what to do and acting on it are two vastly different things for consumers," explained Swenson. "They have made it clear that they don't need employers to focus a lot on explaining to them why they should change their health behaviors. Instead, they'd rather that their companies provide tools, programs, and perhaps most importantly, time, to help them make positive health choices despite the barriers in their lives."
Make it Meaningful
To improve health and productivity, employers are increasingly offering programs to both workers and their dependents such as biometric screenings, health risk assessments, onsite clinics/pharmacies and Employee Assistance Programs. However, many employees and their dependents don't seem to be aware of many of these programs. In 2011, more than one-third (36 percent) of consumers did not participate in any health program or service offered by their employer. Among the programs that workers did participate in, blood tests or biometric screenings were the most popular (61 percent participation), followed by health risk assessments (57 percent participation).
Despite low participation, when workers do take part in these programs, satisfaction is extremely high. Almost all (97 percent) of consumers who took part in blood work/biometric screening were satisfied, 97 percent were happy with their on-site clinic or pharmacy, and 92 percent were satisfied with the health risk assessment.
In addition to lack of awareness, and despite the availability of health improvement programs, many consumers don't feel their employers are fully supportive in helping them get and stay healthy. A majority of workers (60 percent) think their company is only moderately-to-not supportive when it comes to their efforts to be healthy.
"Employers may be missing the mark when it comes to health improvement programs being offered to workers," said Tripp. "Workers need to see that their efforts to become healthy are supported by the company. Developing a culture where leaders care and support healthful living communicates to workers that this matters to the company."