I recently came across an article titled “Insurers blame doctors for their losses”. 12 out of 21 medical insurers (57%) in Kenya sank into losses due to rising claims, fraud and high cost of drugs. The medical insurance firms claim that doctors are to be blamed for over prescribing, unnecessary procedures and diagnostics. Invariably such losses are passed on to the consumers.
Protecting your company through the purchase of various forms of insurance is a risk-management necessity. But the coverage on its own, without efficient management can prove to be expensive. There are a few bigger picture issues that can be considered to lessen the likelihood of expensive payouts. These issues tend to fall under the broad category of employee wellness. A properly designed, consistent employee wellness program, which is regularly reviewed and measured, can help lower, or at least control medical insurance costs.
Employee Wellness Programs typically focus on the following:
- Health screenings to identify medical risks – to be conducted with employee consent.
- Disease management to support people with existing chronic conditions
- Lifestyle management to encourage healthier behavior – for example, exercise, diet or smoking cessation.
- Employee Assistance Program – a voluntary and confidential way to connect employees to third party professionals to help manage mental and emotional health issues.
While Employee Wellness Programs call for an upfront investment, they can lower costs over the long term by discouraging lifestyle choices that tend to lead to absenteeism, poor productivity and performance.
With the high prevalence of non-communicable diseases nationally, we have a ticking time bomb with huge health risks amongst the employee population with risk factors such as:
- Heart diseases
- Diabetes
- Asthma
- High blood pressure
- Overweight and obesity
- Tobacco consumption
- Alcohol addiction
- Lack of sufficient physical activity
- Lack of adequate nutrition
- Stress and stress related disorders
- Depression, anxiety and other mental disorders
Of recent, we are seeing the trend where insurance companies are beginning to offer wellness coverage as a “free of charge” value add service entailing basic screenings and/or periodic health talks and fitness activities to their corporate clients. A question we have to ask is if this is sufficient to address the above risks adequately? Is the impact measured? Isn’t it time to invest in and insist on consistent, comprehensive wellness programs?