Wellness Programs & Risk Assessment

Risk management and cost control also concerns pinpointing who will be high cost proactively. Insurance companies will often use public data, such as census data, to understand what can become a pertinent issue.  Things such as wellness programs are being used by insurance companies proactively, but are also being used for damage control. The methods of damage control vary from insurer to insurer. However, employment and basic wellness programs are available through many insurance companies to incentivize risk-reducing behavior, and hopefully create a long-standing relationship with the consumer. This  type of relationship could have long lasting benefits.

Example: Obesity

To have a tangible example of how risk managers leverage data, let’s use obesity as an example. For health care providers, obesity is a concern as it is closely tied with other health problems. This table provided by the Centers for Disease Control that covers obesity can be leveraged by risk managers in several ways: obesity statistics From this graph, we understand that based on gender, obesity is equally an issue in both males and females. However, we can ascertain that a serious issue with obesity (and many other widespread health issues) is an educational divide.  It is important to note that healthcare companies have some clarity as much statistical data is  available to the public, and many government organizations call attention to health epidemics/issues. The final role in the cost control process is to take a diligent role and actively change the behavior that increases cost of care and claims.  This involves being proactive and reaching people who may not be affected by their risky behavior yet. For example, in the midst of the ACA, more companies are screening children for obesity since it will allow healthcare companies to educate and provide resources to them early. ther measures involve reaching people who may already be affected by their risky behavior and giving them incentives to improve their health. Insurance companies are increasingly turning to wellness programs to improve overall health, and obtain data about patient’s habits.

Wellness Programs

The purpose of wellness programs is to offset potentially dangerous lifestyles (eg. obesity, smoking) by implementing incentives or provide an interactive  outline to healthy living. Here are some examples of programs initiated by insurance companies  and what they entail:

Wellness program

 Many of these wellness programs have online portals that allow users to keep track of their progress. These programs often allow insurers the chance to communicate and cross-sell to consumers due to the open communication they establish.