Selecting The Right Tool and Vendor For Health and Wellness Programs

Voluntary program for better health

Having the best-suited health and wellness vendor with the right technology tool to support your health and wellness plan design, strategy, goals, and wrapping it all into a well-crafted member experience is the primary need for every plan administrator. And, on its surface, finding that correct, total solution appears to be an easy process to many because of the large number of vendors in the marketplace.  From large named vendors to smaller ones, choices are everywhere.  But, finding the best fit for your organization requires planning and thoughtful attention to ensure that promises will actually turn into reality.

I.  Strategy and Program Selection

Before embarking in a selection process, you have to evaluate your plan design’s overall strategy in order to determine which strategy you will be choosing. The three main types are:

1) Full Voluntary, a “nice to have” program that is designed to simply promote better health, building morale and add to the value of your overall benefit portfolio to attract and retain employees;

2) Wellbeing -Activity with incentives, also designed for voluntary member participation but with the nuance of money and/or prizes to entice higher engagement rates; and

3) Outcomes-based (health-contingent), which ties healthy member outcomes on an annual basis to such things as rewards and/or premium contribution rates.

Some points to consider when determining which approach is more relevant to your organization are:

    • Your population’s age range, gender, and cultural requirements
    • The type of industry your company occupies
    • Your population’s overall health status and related needs
    • Your population’s claim data and what indications it shows related to needed risk reduction(s) for chronic, non-accident-related conditions
    • Leadership engagement level

Once the above information has been collected and is known, then, you are ready to select the type of corporate wellness programs that is aligned with your population’s needs.

An example of how the aforementioned factors are used in determining program strategy could be: A population age group between 30-55 that has a noticeable claims occurrences of back pain diagnoses and a need to proactively address and prevent this specific condition risk.

There are several programs out there to tackle this risk, ranging from standing desk mechanical configurations, to building healthier habits through exercise and more. Select the program of your choice and assign an associated goal with success criteria to measure the outcome of the program.

As part of the wellness program implementation, the following components are very important:

  • Communication and Marketing
  • Program implementation and measurement (engagement, completion, impact on health, culture, and meeting the success criteria that were establish when selecting the program.)
  • Incentives
  • Reporting and insight
  • Revision of the program and adjust as needed

II.  Creating a Capabilities and Features List

With the example above, and when selecting the vendor, list all the features and functionalities that will help you achieve the success criteria for your program.

When selecting a vendor, you should:

  1. Evaluate the vendor’s technology strategy in direct parallel with your wellness strategy, e.g. incentive management program and the type of reports you need
  2. Establish a list of mandatory modules, a functionality features list that the successful vendor must have
  3. Establish a list of non-essential but nice-to-have features that are geared toward enhancing the program’s overall member and administrative user experiences
  4. Detail a list of program legal compliance requirements that are essential to the delivery of your wellbeing program, e.g. EEOC, GINA, DOL, IRS regulatory notifications. Ex. wearable fitness tracker devices giveaway, how alternative standards are addressed for member’s unable to meet the primary requirements, etc.

Compile the above points in an excel sheet and drive the selection from there. This will help you to ask the vendor and document the relevant questions during the demo phase, which will finally be embedded in the contract. This will put you in the driver’s seat to achieve your goals. The vendor can show and demonstrate their corporate wellness technology. From this perspective, you are placing the vendor in a position to physically demonstrate their capabilities in relation to each needed requirement versus a global picture in which some of your detailed needs may be lost and not realized until after the contract is executed.

III.  Vendor Vetting

After obtaining all the information from your Excel sheet, you should take each proposal and compare the listed functionalities and capabilities presented and cross-reference them against your requirements. This basic check-and-balance, while very simple, will ensure no detail has been missed and that you will receive all elements of your documented requirements.  This simple step can be easily overlooked, creating pain after contracting because of missed detail that makes the technology offering incapable of fully supporting your total program needs.  This method also provides the most objective analysis of all vendors by creating true clarity during the evaluation process and ensures you are comparing “apples to apples”.

If you have a broker that is assisting with this process, you should ask them for the raw spreadsheet-results to confirm your own review of the details. Sometimes, the results are summarized or just a recommendation of the vendor-of-choice are returned.  This is not to say that your broker may have missed your requirements or is promoting a vendor with which they have a preferred relationship, regardless of the ability to match to your needs.  Rather, it is a final, personal sign-off from you that gives you peace of mind and confidence in the chosen solution before moving into a contracting phase, after which you will be the accountable party for the delivery and performance of your new partner.  .

Your final review of the vendor submissions also ensures you not only have a clear picture of how their capabilities align with your needs.  It also gives you insight on total costs to launch and operate the program.  For vendors that may be missing features that you have to have or would like to have, they may be capable and willing to build these into your solution.  But, a large question arises related to cost.  Vendors may see a common application of your requirement(s) that may be missing and decide to incorporate them at a reduced cost or free of charge in order to enhance the experience of all customers.  Otherwise, there will most likely be full charges associated with these changes to their existing technology configuration to accommodate your needs.  It is highly advisable to know your financial exposure before any contract is signed.  And, on the note of contracting, you should consider two critical elements that will help ensure your overall satisfaction.  First, you should have performance guarantees (PG’s) written into the contract in which the vendor agrees to be bound by certain standards, per your requirements, and places a percentage of fees at-risk that will be payable to you should they not meet them.  Second, you should push for the inclusion of a cancellation clause that allows you to terminate the contract for-cause in the event of performance dissatisfaction.

IV.  Implementation and On-Going Support

One element that is equally as critical as assessing capabilities is determining how the vendor will support you during the implementation phase, as well as, on-going support you will need during active day-to-day performance. Vendors have a wide range with respect to their account support practices.  You have to determine your tolerances in terms of workload that you can accommodate during both phases.  You should ask for a copy of each vendor’s proposed implementation plan as part of your vetting process.  This helps you in the decision making process two-fold:  1)  It ensures that all items are accounted for and incorporated in a timeline that can be monitored through to completion; and 2) It should include assigned responsibilities for the person or entity to carry out the task.  This second component will allow you to make workload assumptions based on your schedule and time allocation capabilities, who else within your organization may have to assist, and, if integrating with such features as the import of claims, being able to conceptualize the external organizational tasking that will be required to bring the implementation to a successful end on-time.

Finally, a good question to understand is how much time you and/or your staff will have to support the program via the technology and what items the vendor sets as those falling within their role and which fall to the customer. For example, are Levels 1, 2, and 3 help desk support the full responsibility of the vendor; does the vendor’s account manager become involved in the daily needs like setting and launching challenges, setting up and helping manage the integration of scheduling biometric screenings, etc.?

V.  Ongoing Measurement, Feedback, and Improvement

The last component to consider is that your program and strategy will always be evolving in order to improve performance, member experience, and alignment with your corporate goals. The configuration set in place through the technology at the inception of the program won’t remain the same in following performance years.  These needed changes will be based on measurements related to member performance.  This leads to an important question during the vetting phase that ensures the vendor is capable of capturing and reporting on metrics/drivers for you to analyze that show both featured successes, as well as, those that may reflect underperformance.  A subset of this metrics question is how easy is it to change metrics as needed in the future and what sort of access and ease you as the plan administrator have in accessing them either through direct extracts or reports coming out of the technology.  Routine review of effectiveness as compared to goals and the incorporation of multi-stakeholder feedback to refine the program over time are necessary to optimize performance and success.  You want to ensure the vendor’s solution is flexible to meet your near- and long-term needs, while assessing any potential charges associated with those change related needs.