Newsletter Sign-up

By JOEL BERG, a college professor and freelance writer

Despite the recession, companies and insurers are pressing ahead with wellness programs as part of their efforts to address health costs.

One of the newest tools at employers' disposal is an emerging technology called predictive analytics. It entails using software to analyze reams of health and lifestyle data to spot the looming risks in a given population.

The technology allows employers and insurers to look beyond the familiar basket of chronic conditions like asthma, diabetes and coronary heart disease, says Richard Pro, a health plans principal in the health and life sciences practice at SAS, a technology vendor in Cary, N.C.

One area where insurers might successfully intervene, for example, is joint replacement, Pro says. "Traditionally, that wouldn't fall into one of the chronic-condition categories, but it can be high-cost."

Early treatment, in the form of physical therapy and exercise programs, can delay or avoid the need for a new hip or knee, Pro says.

The challenge lies in crafting messages that convince people to seek early treatment, Pro says. Predictive analytics promises to help by customizing the pitch for each individual.

Capital Blue Cross, a health insurer in Harrisburg, Pa., continues to target wellness programs at the 20 percent of members who generate the highest claims. But the carrier also has begun to look more closely at the other 80 percent, says Marc Backon, Capital's senior vice president for sales and marketing.

Predictive modeling is one of the tools Capital is tapping, Backon says. "It's extremely valuable for members and for employers to help them understand where potential risks are."

Targeted programs do promise better results, says Jeff Munn, a principal in the health management consulting practice of Illinois-based Hewitt Associates.

"Programs that are broad-brush, that apply to everyone, that may be fairly mom and apple pie if you will, it's going to be hard to show ROI," says Munn, who is based in Washington, D.C.

Overall, only a quarter of employers plan to reduce or eliminate wellness programs in 2010, according to a Hewitt survey in January of 340 employers, representing more than 5 million workers.

"I think that's a very encouraging development when you're looking at economic times as questionable as the ones we are in," Munn says.

April 15, 2009

Copyright 2009© LRP Publications