Pilot program leads to a successful rollout
Pilot program leads to a successful rollout
Incentive yields participation rates of 70%
Laying the proper foundation can make a significant difference when your wellness program is rolled out to the entire population. And when that population is 93,000 employees, a 70% participation rate will make anyone sit up and take notice.
That’s exactly what’s been achieved in the state of Wisconsin, where Madison, WI-based WEA Insurance Trust, and the St. Paul, MN, office of the StayWell Co. have partnered to deliver a health promotion program for Wisconsin school employees and their spouses who participate in a Trust health insurance plan. An incentive program used in a two-year pilot program achieved those 70% participation rates, and the full program rollout, launched in fall 1999, is nearing those rates, as well.
Focusing on prevention
WEA is not a Johnny-come-lately to wellness, notes Renae Sieling, MS, health management program coordinator. "We have been involved in health promotion for our members for many years," she says. "But we were looking for a program that would deal more with prevention, rather than just medical care.
"We had other program components in place, but we were looking to expand our services to prevent health problems in the future — maybe many years down the road," she continues. "We looked at many companies that provided health risk assessments [HRAs], lifestyle education, and disease management, and we chose StayWell because they provided all of them."
StayWell saw both an unusual challenge and a unique opportunity in the assignment. "This is a bit of a new population," explains David Anderson, PhD, vice president for programs and services, "and a unique program for this type of population. WEA was trailblazing; I don’t know of any program of this scale in a teacher’s organization, or with any educational group."
The rationale for a pilot program
There were two reasons the partners decided to begin with a pilot program, says Anderson. "First, we wanted to offer an incentive to maximize participation. The question was, what level was right to get to the participation goals we had set? Second, because the population was set across a wide geographic area, and the specific populations were small in any one area, we knew it had to be delivered in large part at home or by mail."
The typical response rate for this type of delivery is in the 20% to 30% range, Anderson notes, if the material is simply sent with an explanation of what the program is and how to participate in it. "We and the WEA wanted a much higher response rate, because we were very focused on meaningfully improving health. We wanted participation in the range of 70%," he says.
Sieling notes that there were actually two test programs — the first using a population of 7,000, the second with 10,000. They tried several different levels of incentives, and $25 got them to the level of participation they were looking for.
This was an encouraging finding. "I’ve seen organizations use very large incentives, as high as several hundred dollars, but we didn’t feel that was necessary," explains Anderson. "This is a modest incentive, but it really jumped participation rates, providing a really terrific return on investment."
The pilot program also proved valuable in working out the kinks in the program, as it was. "We worked through how to best deliver the various aspects of the program; we made a number of adjustments on how to promote and package it," Anderson recalls. "And we’ve seen the results of that in the full rollout."
"In the second pilot, we tested out the implementation changes to see how they played out," adds Sieling. "We had a different communication plan, decreased some aspects and increased others; we increased some of the work site promotion. With 335 school districts, we felt it was important to increase visibility on site. We also looked at the education program, where follow-up was a big concern, and we changed the look and text of the invitation. We also then chose in the statewide rollout to offer a choice of either a telephonic or a mail-based program to increase completion rates."
In fall 1999, the statewide rollout began. StayWell’s HRA is the program’s starting point. It provides participants an overview of their "modifiable" health risks — risks that can be improved through lifestyle changes. It also identifies members who can benefit from education programs, which link high-risk participants with professional health educators and personalized education materials for lifestyle improvement support. (For a closer look at the HRA and program components, see chart, left.)
All 93,000 employees received the HRA. "Right now, we’re looking at a 65% participation rate," says Sieling.
"We’re closing in again on that 70% rate, which is our goal," notes Anderson. "I’m thrilled with the level of participation."
In fact, he adds, Staywell hopes to take some of the things it has learned from the program and put them to use in other programs. "The opportunity to learn through the pilot program was a really helpful exercise for us," he notes.
Only the beginning
The rollout is just the start of the next phase of a multiyear process. In three years, an independent team of researchers from the University of Michigan, Ann Arbor, will evaluate and analyze the program to determine if employee health has been improved and health care expenditures have been reduced.
How in the world do you keep track of so many participants? "We have a database on all employees who are eligible to become participants," Anderson explains. "Once an employee is in the program, we use it to determine how to segment them through the programs most appropriate for them. Then, we can also use the database to track participation, and continue to go back to the people who have not yet participated, to try and target them at the right time with those methods that are best for them."
Anderson notes that the data will be "scrubbed" in such a way that no individual identification will be possible. "All the data will be linked for analysis, and there will be absolute confidentiality," he insists.
A database, Anderson asserts, is a must, given such a large population and the complexity of today’s programs. "You really need strong technological support to manage a program like this."
The methods by which the university will measure program effectiveness are still being fine-tuned, says Anderson, "But primarily, they will be using health care claims experience to determine changes in costs over time of those who participate vs. those who don’t. We will have considerable data available to do that."
He adds that it is extremely important to have an outside party evaluate the program. "It’s important both to StayWell and to WEA that an independent third party determine whether we’ve achieved our objectives," he says. "And the University of Michigan has done a number of these evaluations."
Both StayWell and WEA are extremely pleased with the process to date. "This really has been a partnership," says Anderson. "WEA came to us because we had certain expertise, but they really know their population; they’ve delivered wellness services to them for a long time. All of the decisions that have been made were joint decisions. The key was we both knew that some sort of incentive was necessary, but we wanted to minimize the dollars spent on those incentives. After all, it is the number of interventions that will determine who will make long-term changes and what savings will occur."
"We’re doing this because WEA is a nonprofit insurance company looking at ways to meet our overall goals: to help school employees be the healthiest employees in Wisconsin," Sieling adds. "This partnership with StayWell is one important piece of that puzzle."
• Renae Sieling, WEA Insurance Trust, 45 Nob Hill Road, Madison, WI 53713. Telephone: (608) 661-6649. Fax: (608) 276-9119. E-mail: [email protected].
• David Anderson, The StayWell Co.,1340 Mendota Heights Road, St. Paul, MN 54512. Telephone: (651) 905-6973. Fax (651) 454-4062. E-mail: david.anderson @staywell.com.
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