Traditionally, the role of a benefits plan provider has been purely to provide a financial safety net in case a covered member goes through a disruptive health event. But as Donna Carbell, head of Group Benefits at Manulife notes, there’s an opportunity for carriers to do so much more.
“Historically, benefit programs have really boiled down to being quite transactional: pay claims, pay them fast, pay them accurately, and don't make any errors,” Carbell told Life and Health Professional. “Looking forward, we have the privilege of being able to engage with millions of people on a regular basis and work with them as they're embarking on a health journey.”
That approach, which she said Manulife had been working on for a decade, is called Health by Design, which works either by providing members with critical pieces of information, or nudging them toward a particular product or service. Whatever the case, the goal is always the same: to maximize the amount and quality of time that people spend at work by helping them maintain or return to their optimal level of health.
“We kind of think about this in three buckets,” Carbell said. “The first is prevention; the second is intervention, really disrupting an illness; and the third, which has traditionally been our bread and butter, is recovery or helping people that have had to go off work for a short time return to a state of health and wellness where they can work productively.”
Over the years, Manulife has been rolling out Vitality, an app-based behavioural program to inspire healthy habits and mitigate the risk of chronic conditions, across various aspects of its individual life and health insurance businesses. That program, Carbell said, was further expanded at the end of 2019 when Manulife declared Vitality would be embedded in all its health benefits plans at no cost to plan sponsors.
“We started rolling that out this year, though we’ve seen a bit of disruption because of COVID-19 as employers dealt with significant challenges,” she said. “But now we’ve got over six hundred thousand members and ten thousand plan sponsors on the platform, and we’re on a regular cadence to roll out around 200,000 members monthly for the rest of the year.”
According to Carbell, wellness has always been a challenge for employers looking to manage additional costs. Whether it’s with respect to rising expenses related to health claims or lost productivity due to absenteeism, the financial challenges related to poor worker health are well reported. By preventing negative health outcomes, employers can benefit from higher workplace engagement, stronger job performance, and contained rates of absences.
To that end, the Vitality program exerts an impact through three main pillars: understanding your health, taking action, and getting rewarded for your health. Among the workers engaging in the platform, over 80% are actively participating in the first pillar by completing Vitality Health Reviews. That sets the stage for better outcomes down the road, as it supports Manulife’s ability to provide information and nudges that are specifically relevant to the member.
The second pillar, taking action, involves encouraging people to take on various physical activities that would help their long-term health. While the COVID-19 lockdown had the potential to impede a broad raft of exercises, Carbell said that Manulife held a number of virtual athletic events in June, for which they saw a 15-times increase in submissions.
“I don't think we've seen a slowdown. In fact, I just think it's been a bit of a shift,” she said. “For sure, fewer people are at the gym, but the Vitality application is tied to any kind of wearable that you'd like.”
The steps and reps people accumulate aren’t adding up for nothing, either. As Carbell noted, those enrolled in the Vitality program earn points for their efforts, and those points can be redeemed for certain rewards. Manulife hasn’t stopped issuing those points and paying out for rewards claimed, which she said has been confirmed to produce a 28% increase in physical activity per week. And as they maintain their healthy habits, leading to even better states of health over the long term.
“The last bucket is intervention, and that's really disrupting the illness,” Carbell said. “That's really about leveraging analytics to identify and help employees that are at risk of going on leave, then giving them individual nudges toward helpful programs that are available to them.”
One simple example is to alert members with chronic conditions, like diabetes, about programs to manage their maladies that they may be able to avail of. Those outreaches can be done by phone or by app, and they provide valuable just-in-time information and suggestions to support better health among members.
“From a data and analytics perspective, that's what I find particularly exciting, because they can really start to make their benefits program very relevant for them,” she said. “It doesn't mean that there's different coverages; it just means that they can really engage at the right time for them during their health journey.”
More recently, Carbell said Manulife launched a personal medicine program that leverages pharmacogenetics to let members and physicians discuss the right medication for them.
“We did a pilot earlier in the year and saw that 44 percent of our members that participated actually changed or their medication or their dosage to, and that led to better outcomes,” she said.
One area where Manulife can bring its Health by Design system to bear is in mental health, which Carbell said cuts through all three buckets of the system. Research shows one in five Canadians live with or experience a mental health issue, and five hundred thousand Canadians are unable to work each week due to mental health concerns. Manulife’s data also reveals comorbidities between mental health and other issues such as diabetes and cancer, particularly as patients struggle to take steps to cope and make themselves better.
Many new opportunities for treatment have sprung up because of the COVID-19 pandemic. That includes online cognitive behavioural therapy, which offers access to therapists and mental health professionals that are providing treatment virtually. Many employers have opened that option to their workers as they seek to encourage a healthy return to work, and Carbell said online treatment has proven to be just as efficacious, if not more so, than what’s been seen on face-to-face.
“Shifting to Health by Design really is an evolution of our benefits program,” she said. “I think it is based on the belief that healthy employees make healthy organizations, and healthy organizations don't happen by accident. It really is a very mindful exercise and it's really by design.”