- Engaging employees. Diabetes is among the most prevalent health conditions that drive employer healthcare costs, and there are effective programs that can help prevent or better control this disease. However, employers often have trouble encouraging members to participate in these programs.
- Higher costs. The cost of caring for individuals with diabetes is 2.3 times higher than non-diabetics, and over 20% of total U.S. healthcare spend is attributed to people with diagnosed diabetes.
- Improving outcomes. Some suggestions to improve employee engagement and outcomes for members with diabetes or at risk of diabetes include providing easy access to affordable programs, crafting communication and using social networks.
Employers are expecting rising
healthcare costs and report that cost management (67%) and affordability (42%)
are their top priorities over the next three years.
Diabetes
is among the most prevalent health conditions that drive employer healthcare
costs, and there are effective programs that can help prevent or better control
this disease. However, employers often have trouble encouraging members to
participate in these programs, which only save costs if they successfully
engage members.
The
cost of caring for individuals with diabetes is 2.3 times higher than
non-diabetics, and over 20% of total U.S. healthcare spend is attributed to
people with diagnosed diabetes. Diabetic complications such as heart disease,
nerve damage vision impairment and kidney failure represent large costs to
health plan sponsors and productivity loss for employers. Most importantly,
these complications lead to a significant decline in quality of life for
diabetics.
Employers
are cognizant of these facts and a majority (70%) report that they will focus
on metabolic syndrome and diabetes in the next three years as a means of
improving member health.
WTW
has six suggestions for employers to increase program engagement, decrease risk
and improve outcomes for their members with diabetes or at risk of diabetes.
1.
Provide Easy Access to High Quality, Affordable Programs
Humans
are conditioned by evolutionary biology to make decisions that take the
smallest amount of energy. Employers can use choice architecture to make it
easy for their members to participate in diabetes and metabolic syndrome
programs.
Employers
can offer programs free of charge, and simplify enrollment with single sign-on,
a QR code, or a single number to call for those who are more comfortable with
phone versus digital methods. They can prioritize programs which provide
complimentary supplies to decrease logistical roadblocks to test blood glucose,
and they can offer a value-based formulary with no or low out-of-pocket costs
for diabetic medications.
Programs
that allow virtual participation through asynchronous applications are more
convenient and can increase engagement. Many diabetics also have high blood
pressure or other chronic diseases. A single, integrated program offering that
addresses multiple needs can simplify navigation.
2.
Communicate the Value of Participation
Behavioral
economics research shows that people hate losses more than they like gains, and
employers can use this loss aversion to encourage initial and persistent
participation in diabetes programs.
For
those enrolled in diabetes management programs, consistent engagement may be
supported by communications that focus on the loss that is avoided through
action. For example, employer or vendor communications can focus on avoiding
the complications of unmanaged diabetes, including vision loss, nerve damage,
heart disease and stroke. Communications can encourage members not to let the
time they’ve already committed go to waste and avoid missing out on activities
members love.
3.
Craft Communications That Leverage Optimism Bias
People
who qualify for diabetes prevention or management programs may think they can
address their health issues on their own without an employer-sponsored program
or professional help.
Communications
can point out that even the most successful people need help at times. Employer
communications can also focus on positive messaging on accomplishments and
milestones. For example, digital solutions that celebrate members throughout
various milestones during a weight loss journey can encourage continued persistence.
4.
Utilize Stories to Motivate
Compelling
statistics that demonstrate the health and cost impact of diabetes diagnoses
and complications alone don’t drive substantial behavior change; people are
more moved to action by powerful stories than by impressive statistics.
Both
employer and vendor communications can take advantage of narrative preference
by using storytelling to nudge members to engage in medical management
programs. Communications can make
it real by sharing a story about how a pre-diabetic member was empowered by a
Diabetes Prevention Program to make lifestyle changes and has since avoided a
diabetes diagnosis. Diabetes management programs can include stories around how
a vendor helped a member manage diabetes and maintain their quality of life.
Communications
that leverage data should clearly tie to the broader narrative.
5. Use Social Networks to Nudge Behaviors
People
want to emulate the behaviors of their friends and those they respect, so an
employer can report on how many colleagues have been helped or are currently
engaged in a program. Successful programs often have a social media element
that allows participants to share their success, and support or affinity groups
can help encourage ongoing participation.
Employers
can encourage leaders who engaged in programs to share their successes to
inspire employees to model their behavior.
6.
Appeal to Intrinsic Motivation to Drive Change
Focus
attention on the goals of individuals, which can be highly motivating. Within
program design, members should be empowered to help craft their care plan and
set goals in partnership with a coach or clinician. Coaches can help users to
uncover their personal motivations for keeping diabetes in check.
Employers
can identify what really matters to members through surveys, focus groups and
other data gathering methods. Craft communications to demonstrate how
participating in employer-sponsored programs can help members achieve their
goals.
More
member engagement in effective programs to address increases in obesity,
metabolic syndrome and diabetes can lead to lower costs, less disability, and
increased quality of life. Investing in helping employees avoid or manage
diabetes not only enhances employee wellbeing but can improve employers’ bottom
lines.
Employers
should understand their employee population’s unique needs, challenges, and
preferences, and apply behavioral economics to choose and communicate programs
that will promote risk reduction, decrease the incidence of diabetes
complications, and help control healthcare costs.
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