Tuesday, November 16, 2010

A Business Plan For Wellness: How One Company Does It (Gaming?)

Interested in checking out the business model behind an honest-to-goodness wellness company? Well, look no further than this supplement to the latest issue of the Population Health Management Journal titled “Preventive Medicine: a Ready Solution for a Health Care System in Crisis.” Written by Janice Clark R.N., it instructively describes in considerable detail how one company sells its wares. The Disease Management Care Blog thought this was interesting because there were some wrinkles to this wellness business that it had not considered before.

The product consists of a “suite” of services that include general wellness and prevention, screening/early detection, chronic condition management, senior wellness, children’s prevention and an “executive” care. Each module includes an assessment (a health risk appraisal, labs, personalized summary with recommendations and assistance with planning that includes an on-line personal health record) that ultimately generates a “personal risk analysis” with a “customized” “road-map plan.” This plan, in turn, is paired with other interventions such as access to on-line learning resources, instructional videos, telephonic coaching, access to a nurse “advocate” or, if preferred, a physician. Participants are then targeted by “Action Programs” that prompt participants to “connect” to individualized and ongoing prevention activities.

There is also the option of gaming. The games consist of “challenges and contests” that earn "points." Examples include on-line calculators that convert self-recorded activities into “miles” on a virtual Iditarod or Pony Express. As the miles build up, points can be earned that earn entry into random drawings for shopping sprees or cruise packages.

Even if gaming is not your thing, the points still count. Signing up for wellness earns a minimum of one point. As additional testing, activity participation and lifestyle changes accumulate, persons can look forward to achieving a maximum of 1000 points. They can also form teams that combine their points with other individuals in competitions that also lead to rewards such as taking possession of the coveted “Prevention Cup.” This can be intra as well as inter company.

The DMCB suspects this business is really aimed at self-insured entities, though there is little to prevent a commercial insurer from offering it to its customers on a "pass-through" basis. The company charges a fee per participant that is apparently adjusted to the service offerings described above. While all persons are automatically enrolled in its programs (which earns that one point), the company only gets paid when individuals actually participate. This gives the company an incentive to sign up as many persons as possible. While self-insured companies may be reluctant to take on the additional cost of a wellness program, there are ways around this. For example, the article describes “mid-Atlantic care dealer” that surcharged non-participating employees’ health insurance premiums that went to pay for wellness. This made its costs “budget neutral.”

So what pointers did DMCB find interesting?

When it comes to wellness, offer a lot of stuff, make it look scientific and be retail, not wholesale. While the DMCB believes it all comes down to eating less, exercising more, taking your pills and being personally engaged, the notion that this can be packaged as an individualized and sophisticated offering appears to have a special luster in the marketplace.

Turn-key scalability helps. While there may be some health insurers, CEOs, human resource managers and unions that have unique notions on how wellness should be delivered, there are other buyers who simply want the equivalent of a plug n’ play service contract. This is their answer.

At lot can be done on-line. That being said, if customers want to buy-up to human interaction (including docs), no service is too small and no fee is too big.

Gaming? Last but not least, the DMCB is intrigued by the notion that grown-ups would be actually be ensnared by the “Iditarod,” the “Pony Express” and competitions. Surely, thinks the clinically grounded DMCB, all adults should believe that wellness is for wellness’ sake, but that seems not to be the case. If this company has invested in such silliness, maybe it’s not so silly after all.

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