Evolution Man


It’s an exciting time to be part of healthcare in America. Like most major changes, about half of America thinks health reform is a great idea while the other half seems to think it’s the end of civilization as we know it. Of course, the truth lies somewhere in between. There are desperately needed provisions and features that will make healthcare more affordable and accessible for many who need it. There are also mandatory features and layers of new bureaucracy that is adding excessive new cost to people who were previously very content with the coverage they had. Undoubtedly, it will take several years for us to all settle in to a new “normal.”

Early adopters are testing the waters and identifying questions, unknowns, and pitfalls. Over time, I believe we will see an emergence of more private healthcare exchanges, a movement toward defined contribution plans and a continued increase in models that equip employees to make the best choices for their individual needs.
We see a very relevant role for wellness programs in the private exchanges and all defined contribution models in that the amount of money allocated to each individual to “spend” in the exchange will be a variable amount, based upon their participation in, and the results of, an annual wellness screening. This reflects a growing movement toward “shared responsibility” in the healthcare program available to employees, rather than the powerless role that employees have traditionally held as they learn what their benefit plan design and per-pay contribution is every open enrollment.

You will also see a move away from “pass/fail” and “all or none” incentive designs tied to a fixed goal (such as BMI under 25 or blood pressure under 120/80) in favor of rewards being tied to marked improvement over time or even to those simply maintaining current health. Coaching and education programs will become optional resources to help people achieve improvement, rather than the sole condition of a reward which again shifts the responsibility for a person’s health away from the employer and onto the individual.

I believe that individuals will become increasingly hesitant to wear a device, track what they ate for breakfast, and check in routinely with a distant health coach as they realize the correlation between their health results, their well-being and their paycheck. Employees will demand to be rewarded based on their accomplishments, rather than mass prescribed methodologies for their personal health. Much like we’ve seen with the movement from fixed employee pension plans to 401k plans that empower individuals and let them make investment choices based on personal objectives, we will see employees demand to be rewarded for results achieved rather than their adoption of employer provided games and contests. Although the programs, games and contests will still be requested by employees and add a bit of “fun” to the options available to them if they choose to engage, rewards will not be based solely on participation or the completion of an activity.

Individual mandates, health promotion campaigns and accountable care organizations are all aligning to encourage and equip individuals to take the reins for their health. Numerous self-funded captives and consortiums that are allowing smaller employers to band together, but requiring them to engage wellness programs that promote personal accountability for the individual, are rapidly emerging. Bravo Wellness is energetically excited to support these innovations and evolve with our customers as the new “normal” is defined. There are certainly unknowns, but rest assured that the future is bright and together we will continue to identify and expand the strategies that demonstrate the most success and value.