Creating a culture of health in the workplace isn’t easy, but the results that can be obtained — both a personal benefit to the individual and a cost and productivity benefit to the organization — are making value-based health care an appealing initiative for employers across the country.

VBHC is a holistic, consumer-centered approach that focuses not on the dollars being spent but on how the dollars being spent work to improve employees’ health. Recent focus groups conducted by the International Foundation of Employee Benefit Plans examined VBHC strategies among multiemployer and public employer health plans and found that many organizations are making strides in building a healthier workforce and reducing health care costs.

“Value-based health care is not an initiative that happens overnight,” says Sally Natchek, senior director of research at the IFEBP. “For many organizations it’s something that is accomplished one step at a time over the course of several years.”

A common theme that emerged was the challenge of engaging employees in their own health. To overcome barriers such as geographically dispersed populations, culturally diverse workers and lack of motivation or interest, plans identified the need for all levels of leadership to “buy in” to the VBHC concept.

“It has to start with a commitment from the top. You just can’t say you’re concerned about it. You have to have policies and procedures that back it up. It starts with a strong commitment, and you must make sure your policies are aligned,” says Natchek.

Plan representatives discussed communication and education techniques to engage employees: Carefully select the sources and vehicles for delivering messages, try to engage all levels, motivate people to take action by using a variety of techniques, and begin educating early in a worker’s tenure. They stressed the need to think creatively and to use personalized communication methods such as one-on-one communication through champions at the worksite.

“A conglomeration of different types of communication is needed and sometimes throwing stuff at the wall to see what sticks. This is what we have to do, and if it costs a little more initially, in the end it will help us get through to folks.”

 Although using health care data is important, few organizations are proficient in gathering and monitoring data and measuring outcomes to help them develop health care strategies. As a starting point, focus group representatives suggest preparing a general picture of a plan’s health status to understand where costs are originating and the issues that have the greatest impact on worker health.

“Our health care costs were growing just like everybody else’s and a lot of it was in the area of certain diseases. Ten percent of the population was driving 90% of the costs,” one responder said. “So we introduced a disease management program to target cost-driving diseases, and we have done a ton of analysis of our data that shows we have bended the curve in our health care costs.”

Annual health screenings are viewed as an important first step to building a healthier and more productive work environment. Additionally, many focus group representatives report using value-based benefit design to encourage participants to manage chronic conditions so emergency room visits and hospitalization can be avoided.

Forty-six representatives of multi-employer and public employer health plans participated in the focus groups. For more information on the project, visit

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