Audit Wellness Progress with Data You Have

Performing a Wellness Audit is easy and inexpensive, but there are two concepts that must first be grasped:

  1. The direct result of employee wellness initiatives is improved employee population health; the indirect result of employee wellness is lower healthcare claims, usually years later.The bad news is that focusing on claims analysis in the short term will not work as an auditing mechanism. The good news is that your wellness progress can be audited with data already available—the results from your employee biometric screenings.
  2. Don’t ask the student to grade his own paper—there is a conflict of interest in the normal wellness value chain. Employers typically depend on those responsible for improving employee population health (coaching vendors, lifestyle management providers, insurance carriers, etc.) to tell them how their employee population health has or has not improved.A typical scenario goes like this:

    You ask your wellness vendor “Did our blood pressure improve?”

    The wellness vendor hears “Did you do the job that I paid you to do?”

    Voilà! A conflict of interest is born. Integrity aside, the wellness vendor is biased to analyze the data in such a way that they can say “yes” because they want you to remain a customer.

    There is a better way—and leading Fortune 500 companies are pursuing it as we speak. It’s a little nerdy, but inexpensive and fast.

    The first step is make sure your biometric screening data is in the hands of a company who is not making money from your behavior change efforts. Importantly, this does not necessarily mean you have to add a new vendor to perform an audit. If you have hired your biometric screening company directly, and they are not also providing you with telephonic coaching or other wellness services, they can perform this analysis, provided they know how.

    The process they should undertake is simple, yet more scientific.

A Simple, yet More Scientific Approach to Auditing Wellness Progress

Step 1—Establish a scientific basis for claiming success

To trust an improvement in population health, there must be a scientific basis. To simply count how many people improved their cholesterol status from high to borderline or from borderline to normal is not sufficient. That result may have happened if you did nothing. Or any improvement you see may have been due to random chance.

A scientific conclusion is obtained by using statistical science to perform what is called “hypothesis testing.” The hypothesis testing of cohort data of a specific biometric test (we will use Total Cholesterol here) will yield one of 3 results:

  1. The distribution of cholesterol scores moved to the left (improved).
  2. The distribution of cholesterol scores moved to the right (worsened).
  3. The test was inconclusive so No Change is assumed.

Unless the data supports conclusion number one above, there is no scientific evidence to support that the efforts of your wellness vendors are working and you should be asking more questions as to why.

At Onsite Health Diagnostics, we have performed this analysis many times, and we can happily tell you that many times we find statistically valid improvement! — a scientific basis to claim success.

Step 2—Quantify the magnitude of the change in business practical terms.

A scientific basis to claim success is mandatory, but it is not enough. For example, cholesterol scores may have statistically improved by a magnitude .001. That’s not going to help your business. To draw business practical conclusions with a scientifically sound foundation, the next step is to calculate Net Lives Improved.

Net Lives Improved = Number of Cohort that Improved in Status—Number of Cohort that Worsened in Status.

Too many times, the data presented to employers claims “500 people lowered their blood pressure risk!” and the hand clapping begins. It’s necessary to understand that in any population, some people will improve, some people will worsen and some people will stay the same. To only report on the improvements is not sound.

Net Lives Improved takes into account all changes in status and provides a metric that companies can set goals to and hold their wellness vendors accountable for. When you understand that on a NET BASIS you have improved over 300 lives; now that is worth celebrating. To take it even further, you can assign a dollar value, using your claims as a guide, to the value of an improved life with respect to cholesterol, blood sugar, etc.

In conclusion, don’t settle for normal wellness reporting and don’t get wrapped around the axel trying to make claims data do something it cannot do. Perform a simple wellness audit with a trusted source. If you don’t know where to start, give us a call. We perform audits even if we are not your biometric screening partner, and our interactive, online aggregate reporting has wellness audit data built in.


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