A couple of weeks ago the Health Enhancement Research Organization, also known as HERO held its bi-annual Think Tank meeting and Forum (the HERO version of a conference) in Phoenix Arizona. After having some time to reflect on both of those meetings, I would like to share some of my reactions with you. Let me start with the Think Tank.
The Think Tank brings employee health management (EHM) experts together bi-annually to exchange ideas, expertise, and recommendations in an effort to solve problems and react to opportunities. Members of the think tank have a major role in the creation and dissemination of national EHM policy, strategy, leadership and infrastructure. During the most recent session we addressed three subjects: (1) the role of consumer directed initiatives and personal responsibility in health care, (2) the impact of an aging workforce and actions that must be taken both domestically and internationally, and (3) the role of financial incentives in the health management industry. As you might imagine, the use of incentives drew significant debate so let me expound upon that discussion.
Overall the field is fairly supportive of the use of financial incentives to drive participation in health management programs. However, we also agree that while financial incentives can drive participation, little evidence exists to show that financial incentives alone change behavior. The lightning rod seems to be the use of incentives to reward “health outcomes” as it is defined in The Patient Protection and Affordable Care Act. Such incentives reward people for keeping biometrics such as cholesterol, blood pressure, and body fat within reasonable limits. The opinions on this issue varied widely at the HERO Think Tank.
From my experience I know that all employers are different. As the result, I believe America’s employers need the latitude to put in place the incentive programs that work best for them, based on their cultures and their business environments. We do not need further regulation regarding incentives. Instead, the pros and cons of various incentive programs should be evaluated so that employers can make discriminating choices that support the needs of their people and culture. Others may disagree with my perspective. For instance, American Heart Association has distributed position statements taking the view that outcomes-based incentives tied to health plan or self-insured company premium costs are unfair and discriminatory, instead advocating for ‘‘participation-based’’ incentives. Their fear appears to be that such incentives could lead to the mistreatment (including greater cost burden) of people with existing disease. While an understanding view points, current law already provides many safeguards and people who take good care of themselves already pay a disproportionate amount of the health care cost burden.
Regardless of our individual views, the one thing that the think tank fully agrees on is that as an industry, we must speak with a united voice. Articles by Michael O’Donnell, and by Paul Terry and David Anderson have done a nice job of advocating for the “one voice” approach.
The HERO Forum was also an enlightening experience. Highlights were the following:
- Many companies are going back to the basics. Part of the format at the HERO Forum is to have “How To Do It” workshops where best-practice health management programs are highlighted. This year many of the professionals guiding these programs described how they were getting back to the basics of superior program planning, setting clear objectives, communicating their programs effectively, generating engagement through creative approaches, and measuring outcomes effectively.
- People were networking and discussing some of the most timely topics in health management. Many good ideas were discussed in areas like the broader view of well-being, program integration, and the impact of work culture on health management success.
- The research showing the efficacy of health management is continuing to advance and HERO is leading the way.
- There are many breakthroughs in the area of participant engagement that involve superior communications, incentives, program positioning, and the ability to use new media and technology in the effort.
- The use of small actions and social media in effectively advancing behavior change was addressed by Chris Cartter, General Manager of MeYou Health, in the closing keynote. Chris provided deep insights into this topic.
Both the HERO Think Tank and the Forum were well attended and the sessions and debate were provocative. If you are not a member of HERO, I urge you to consider getting involved. If you were there, what were your impressions and biggest takeaways?What are your thoughts on the incentive debate? Please share.