The reasons are
1. PHM companies understand insurance-based risk transfer: they understand that this is ultimately about reducing health care costs in the short as well as long run. In contrast, many wellness providers see this as a "retail" product and simply want to sell their services.
2. They can offer their programs at little incremental cost: this is a situation where size matters and if the employer has a preexisting relationship involving a program for chronic conditions, wellness can typically be tacked on for a very reasonable amount.
3. These vendors have a track record of managing within of "risk corridors": if there are performance guarantees, expect these companies to work with you on the upside and downside caps that can limit the exposure of both parties.
4. Cafeteria versus a “total solution” approach: hand-offs between programs are very important since, for example, persons with chronic illness may benefit from wellness and persons screened for participation in a wellness program may have a previously undiagnosed chronic condition. Smooth and offs between programs are more likely to occur if both the chronic care management and wellness are working for the same company and share the same leadership.
5. Prevention already active in programs: don't believe those allegations that "disease management" programs only focus on a single condition. These companies have been offering an interlocking suite of services for decades and that includes wellness. They already know how to engage patients with chronic illness in prevention and wellness while simultaneously helping them to better manage their condition.
6. Depth and width market expansion: PHM companies are broadening the number of services that they can bring to market. As a result, within any wellness offering, these vendors are constantly working to increase the number of approaches and program options. Many retail programs have a one-size-fits-all approach.
7. Resists commoditization: sure, you may think it's just a matter of giving employees health club memberships and emails reminding them to eat their veggies, but good PHM companies know that's a lot of bunk. If that's all you want, they may ask you to go deal with one of those retail outfits. If you want quality, be prepared to pay for it.
8. Bariatric surgery costs: frightening! As the threshold for bariatric surgery continues to drop and more and more patients become candidates for this expensive procedure, PHM vendors understand that there are ways to give patients other options short of getting an abdominal scar.
9. Remote interventions for tobacco & obesity “as effective as traditional face to face.” There is an emerging body of evidence that suggests that telephonic coaching has a role to play for many patients, depending on their disease burden and personal preferences. There are many patients in any population who would respond to telephonic coaching, and the PHM vendors know how to navigate that.
10. You're in a hurry. If you want to build this yourself with your own employees, perhaps with the help of the local medical center, you can expect the planning to take many months, and then you'll need to wait additional months before anything gets launched. If you want to do this in a hurry, why not call in the experts that can get this going within 4 to 6 months? You'll have some preliminary data within a year.