Addressing obesity—asignificant risk factor for chronic disease—will continue to be atthe forefront of employers' health and wellness initiatives thisyear. (Photo: Shutterstock)

In my meetings with benefit managers and consultants over thepast few months, they have emphasized several wellness themes again and again. Makingprogress on these issues, they told me, will be among their toppriorities for 2019.

Here's an overview of those priorities.

1. Measuring engagement.

Vendor A claims that its wellness coaching program engages 80 percent ofemployees on average, while Vendor B's engagement rate is 25percent. Clearly, Vendor A's program is superior, right? Notnecessarily. That's because an employer considering both optionsmay essentially be comparing apples to oranges. For example, VendorA includes mail contact, telephonic outreach and possiblyenrollments in its definition of engagement, but Vendor B takes amore conservative approach by only measuring active two-wayengagement with a coach or platform, or achieving behavioral goals.

Related: Wellness participation: How data drivesengagement

Employers and vendors have been immersed in how to ramp upemployee engagement in health and wellness programs, but not enoughthought has gone into how to measure it and for which populations.Employers will push hard this year to define the term moreprecisely and to begin standardizing engagement measurement. Thiswill allow them to create a consistent basis of comparison acrossvendors, products and performance.

Employers understand that all engagement is not equal. Theamount of engagement required to drive value varies by product.There are also different levels ofengagement—administrative (such as enrolling in aprogram, measuring how often a participant is in contact with hercoach) and value-based, which is the degree ofinteraction required to achieve key health, behavioral or costoutcomes. I expect employers to increasingly demand moregranularity regarding these issues.

2. Promoting health literacy.

Employers want their employees to be more savvy and confidentwhen interacting with the health care system. Too many of thecurrent solutions attempt to solve a specific issue in time, butdon't help develop employee skills so that they can address theissue on their own in the future. In furtherance of those goals,employers will be asking vendors to incorporate simple terms andeasy-to-use instructions in multimedia formats into their productsand services.

Enhancing the workforce's health literacy is critical because it is apredictor of deeper patient engagement and better health outcomes.Conversely, low literacy drives high health costs through less useof preventive services, poor treatment plan compliance and moreemergency room visits, hospitalizations and readmissions.

Unfortunately, health illiteracy has reached epic proportions inthe U.S. According to the National Assessment of Adult Literacy,only 12 percent of adults have proficient health literacy – theskills needed to manage their health and prevent disease.

How can health literacy be improved? Some ideas: integrateorganic opportunities for learning through video and chat withrobust consumer tools such as plain language glossaries, costestimators, telephonic and written reminders and alerts, providerquality ratings and written materials that are culturally andlinguistically sensitive. Communications should also minimize theneed for high-level numeracy skills.

3. Rethinking obesity.

Addressing obesity—a significant risk factor for chronicdisease—will continue to be at the forefront of employers' healthand wellness initiatives this year. Despite widespread efforts tomanage obesity, adult obesity rates remain stubbornly high – 39.6percent, the highest rate ever documented by the State of Obesity2018 report by the Trust for America's Health and Robert WoodJohnson Foundation. Obesity costs our health care system $147billion annually, according to the Centers for Disease Control.

While traditional solutions—providing healthy weight programs,promoting nutrition and offering incentives for physicalactivity—have achieved some success, employers view this challengemore broadly. They understand that, in addition to being a medicalissue, obesity has social, psychological and environmentalimplications. Thus, employers will seek new approaches thatleverage lessons from the public health sector as well asbehavioral and nutritional science.

This strategy might include, for instance, subsidizing healthyfood in corporate cafeterias, offering discounts for buying healthyfoods at local supermarkets, educating employees about theconnection among metabolics, nutrition and physical health, andoffering mindfulness programs on moderate eating habits. Thisrepresents a shift to a wider social-cultural perspective incombination with established medical and behavioralinterventions.

According to the Optum Wellness in the Workplace study, 56percent of employers have already made changes to their physicalwork environment, such as providing healthier food in cafeteriasand vending machines, on-site fitness centers, ergonomic programsand standing desks.

4. Personalizing the health experience.

Conditioned by the likes of Amazon, Netflix and other high-techinnovators to receive offers for goods and services tailored to their interests and needs, today'semployees expect their experience with the health care system to besimilarly personalized and relevant.

To be blunt, the industry can't continue to limp along onoutdated data and analytics infrastructure. That's why employersare encouraging health plans and wellness vendors to leverageartificial intelligence to make that goal a reality. Advancedanalytics, for example, can help health plans better understandemployees and identify gaps in care, thereby enabling care managersand wellness coaches to provide support and resources that willhave meaningful impact.

Providing that personalized experience requires the integrationof all available data associated with a particular employee,including claims and clinical data, plus non-medical data such asengagement history, channel preference, psychographic needs andpurchasing behaviors. Using AI and analytics, relevant, actionableoffers can then be made to the employee.

Suppose, for example, the analytics indicates that a middle-agedmale has diabetes, hasn't refilled his prescription medication,recently saw a doctor for back pain and has a high propensity toenroll in wellness programs. He might receive prioritizedrecommendations – based on clinical hierarchy and consumer behaviordata – to provide a reminder to fill his prescription, an offer tojoin his health plan's healthy back program and a discount couponto a local fitness center.

Ultimately, by applying smart data and analytics, the goal is tobe able to predict which employees might develop diabetes or othercommon chronic conditions, thereby enabling early, relevant andpersonalized interventions.

Employers are realistic. While they don't expect all thesepriorities to be fully realized this year, they will push theindustry to make considerable progress as part of their ongoingeffort to keep their populations healthier and more productive.

Read more:

• 3 questions to ask when assessing wellnessvendors
• 4 trends in employee wellness programs for2019
• Workplace wellness: The employeedisconnect

Seth Serxner is Chief Health Officer atOptum.