My teenager is never separated from his cell phone. Never. Yet, sometimes when I dial his number, he doesn't answer. I envision his phone, buzzing merrily in his right front pocket. I imagine him fishing the phone from his pocket, seeing that it's me, then going back to whatever it was that I've interrupted.
So then I send him a text message and, if I word it carefully, without too many direct questions, he might respond. It's a mother-son dance we do.
Over the last several years, I've seen a similar dance between my company's health management vendor and our employees. It goes something like this:
A representative from our health management vendor calls Ella Employee because her health claims data indicate that she's being treated for diabetes, a condition for which we've purchased their disease management services for health plan participants.
Ella doesn't recognize the number that shows on her caller ID. She lets the call go to voice mail. The vendor rep leaves a cheerful, but cryptic, message. (The Health Insurance Portability and Accountability Act limits how much they can disclose to anyone other than the diagnosed patient, of course.)
Ella doesn't call back. Even though the rep used our company name, and she vaguely remembers a wellness program brochure, she's not 100% convinced it's legit.
In addition, she's in the middle of making dinner for her family, and the cable box is on the fritz. She's got more important things to worry about.
A few days later (per the contracted methodology), the health management vendor rep calls back. Nobody is home, so they leave another message.
Ella returns and, partway through unpacking her groceries, notices that she has a new voice message. She listens to the first few words, and deletes the call, thinking it's just a solicitor. By the time she's put the last of her groceries away, she's forgotten about it.
Some time later, the vendor calls again. This time they get Jon, Ella's husband. They explain who they are, who hired them and then ask him to have Ella call back, giving him the callback number.
Jon forgets until bedtime, when he remembers to tell Ella about the "odd" call he took for her and shows her the phone number.
The next day, Ella tries to call back but doesn't know which number to press in the call menu list. (Jon didn't catch that part.) She gives up. The vendor doesn't. And Ella grows exasperated with their persistence.
Later that year, when she's completing her year-end survey for the company's wellness program, she shares her frustration: "Why do these people keep calling me?" Unfortunately, she's also shared her frustration with several of her co-workers and her supervisor, too.
Have you witnessed this dance? If you've implemented any opt-out wellness programs (like we did for disease management and health coaching) chances are that you have or you will.
Learning the steps
I didn't know the steps in 2007 when we launched the program, and I've learned that most of our employees don't enjoy this particular dance number very much. (Read more on page 16 from Contributing Editor Ed Bray on how to dance with grace when it comes to health care reform.) Here are a few tips to help you and them:
* Meet objections head on. Acknowledge that you know that some of them are not fans of phone calls and messages from the vendor but that the vendor is actually doing what you pay them for. Remind them why the programs exist. Be honest about why you've chosen an opt-out program.
* Explain who's getting calls and why. Remind employees which programs have opt-out enrollment features, for which conditions and health risks, and how they (or their eligible family members) might qualify.
* Acknowledge that false positives do occur. Explain that the vendor may sometimes discover something in your medical history - such as a prescription you took or treatment you received - that makes it appear to them as though you have a disease or condition that you never really had.
* Reassure them that you take their privacy seriously. Demonstrate that you are aware of important privacy regulations (like HIPAA) and assure them that all of your programs comply.
(Then make sure that they actually do!) Reinforce that the vendor does not share any of their personal information with you and that, as an employer or plan sponsor, you just see the aggregate information.
Let them know that their privacy is the very reason these calls can seem mysterious on an answering machine or highly cryptic if somebody other than the diagnosed person is taking the call. The vendor reps are actually trying to protect your privacy by not sharing too much with somebody other than you.
* Partner with your vendor to ensure that return call instructions are clear. Automatic call distribution systems are terrific for efficiently getting callers to the right place within your vendor's support structure.
However, don't assume your employees are highly familiar with program services and terminology.
Make sure to leave callback instructions that are specific enough to help them successfully navigate a call distribution system ("press 2 for nurse line, press 3 for disease management").
* Tell them how to make the calls stop if they aren't interested. Your vendor may not be wild about this, especially if they are paid based on enrollment.
But it's not good for your participants or for your program (as it's perceived across the covered population) if it's seen as nothing more than a nuisance. It may seem obvious to you, but you need to explain how to opt out - and do it in such a way as to equip (but not encourage!) them to do so.
* Hold eligible participants accountable for opting out if that's what they want. I've been amazed by several conversations in which a participant was venting about receiving outbound calls from our health management vendor or pharmacy benefit manager. When asked "Have you returned their calls and asked them to stop?", the answer is usually a sheepish "no."
Make sure your participants know that you pay your vendors to be persistent, and that there is no reward for waiting them out.
Then it's up to you as the plan sponsor to hold your vendor accountable for honoring participants' wishes. When somebody says "please stop," the vendor must to be able to follow through quickly and consistently.
This dance is a relatively new one for me and for our participants. Not everyone likes it. Our learning process has been awkward at times.
We continue to evaluate whether or not opt-out is the best approach for our disease management and health coaching programs. For now, we're on the floor. Someday, we may choose to sit it out. Opt-in may be a beat we like better over the long haul.
Contributing Editor Cindy Bucher is the benefits and compensation manager for a Midwestern financial services company and has been in her current role since 2004. She and her staff serve more than 2,500 active employees and 650 retirees, as well as their families. She can be reached at
