Ever since Seth Godin’s Book on “Permission Marketing” was published, there has been a significant move toward the idea of getting permission from consumers before sending them marketing messages that might annoy them, rather than have the desired impact of increasing sales while retaining, even promoting customer loyalty. The idea is pretty logical, and most consumers would no doubt applaud any reduction in the epidemic of marketing messages they are subjected to involuntarily.

There has been a movement in the UK for many years toward what has been called “buyer centric commerce” (BCC) there. This goes a good deal beyond permission marketing by seeking to put consumers in essential control of both marketing interactions and their own transactions with sellers. It argues that commerce is normally seller-centric, particularly in business to consumer (B2C) marketing, while is more often controlled by business clients in business to business (B2B) efforts.

By thinking about consumers, as well as businesses, in terms more of lasting partnerships in a value-producing mutual venture, sellers can protect and further many of their own interests and goals, including making their marketing dramatically more efficient. By enabling consumers to control who they will receive messages from, consumers gain a lot of peace, while sellers avoid a lot of wasted communications. By enabling consumers to become better at their job of buying what best promotes their interests and delivers value they want, sellers can gain dramatic increases in their market share and profits.

Consumers in the BCC model would behave much like businesses, issuing requests for proposals (RFPs) to selected sellers describing what specific needs they want filled, value they want delivered, plus when and how they wish to learn about each proposers’ offerings. In some ways, we already have mechanisms that work in much this same fashion, such as priceline.com where consumers can specify what travel and accommodations they are looking for at what price.

The same idea can easily be applied to employee health management (EHM), where the typical model is now controlled mainly by employers, with some input from the suppliers they select to actually do the work. Instead of simply enticing, often “bribing” employees through incentives and reward to participate in EHM interventions that the employer and supplier are “selling”, EHM could empower employees to design their own “solutions” to the health problems each considers most worth addressing.

Consider the basic elements of EHM:

• Assessing the current health status, risk behaviors and conditions, and chronic diseases prevalent among employees, together with the impact these are having on workforce productivity and performance
• Purchasing of developing in-house EHM initiatives that promise to deliver the benefits employers want, in terms of reduced healthcare, disability and workers compensation costs, improved productivity and performance as well as employee retention, and resulting financial gains for the employer
• Selling the idea of participating in EHM initiatives, cooperating enthusiastically in making personal health behavior changes, with promises of extrinsic rewards that inevitably add to employers costs, as main tactics in this “sales” effort

By contrast, an “employee-directed health management (EDHM) alternative would engage employees in designing the EHM program at the outset, and enabling individual employees to select their own method for assessment, type of initiative, and level of cooperation, instead of the employer selling its idea of what’s best. This approach could essentially guarantee that employers would not have to invest any more in EHM than it is predicted to be worth, while empowering employees to deliver the personal investment each thinks is worth their efforts.

This “guarantee” would be achieved through a simple device:

1. Setting the employee incentive amount based on the predicted financial gain to the employer for achieving the result that would cause the incentive to be paid for each particular EHM initiative the employee might choose
2. Enabling each employee to choose whichever assessment/initiative combination each expects to be most worthwhile and efficient in delivering personal value, including the incentive that can be gained through EHM success.

For example, a predictive modeling solution would be used to automatically predict the financial gain potential for each employee relative to each of the EHM initiatives each would be eligible for, given the assessment results or claims analysis by the employer. By automating the assessment and prediction, the privacy of individual employees could be protected so as to avoid HIPAA violation.

The prediction of financial impact to be gained through successful participation by each individual in each EHM initiative offered would be used by the employer, in automated fashion, to set the incentive amount. A simple gain-sharing approach could be used, where the employer pre-sets the share at some percentage of its predicted gain, perhaps 50/50 in the most equitable approach, or whatever share employers figure will work best in the long run, considering their obligations to shareholders.

Each employee would be given their individual-based gain-sharing amount, identifying the incentive they can earn through EHM success for the various incentives they might choose. This incentive amount would be automatically reduced by the amounts that would have to be spent in achieving such success. In effect, the incentive amount becomes a “budget” for employees’ personal use in designing and implementing their personal EHM effort.

The combination of empowering employees to choose their own “problem” and design their own “solution” should enable achieving significantly greater participation among them, particularly with a generous gain-sharing incentive, than will attempts to entice them to enroll in an employer-supplier dictated program. At the same time, the employer is protected against such freedom of choice resulting in employees’ choosing a goal or designing an initiative that costs more than it delivers in financial benefit to the employer, since each element selected by the employee that costs money automatically reduces the employer’s costs by an equal amount.

While there will be a large number of “devils” in the “details” of the EDHM approach, it should fit quite nicely with consumer-directed health plans (CDHPs), which are aimed at providing a similar, but far less empowering, set of options for health insurance. No such approach has been tried anywhere, to the best of my knowledge, though it strikes me as worthy of at least a pilot test. The first reader of this blog willing to conduct such a test may have my enthusiastic and complimentary assistance in designing the experimental model and testing methods to be used in such a test.

Such an empowerment approach will no doubt not appeal to all employers, who are used to controlling their own investments in employee benefits, compensation and health. It will no doubt not appeal equally to all employees, many of whom are too used to choosing among products and services that sellers offer, rather than designing and managing their own purchases. But for some employers, and many employees, the EDHM model may be able to achieve as much if not better in financial gains than is possible with employer-directed options. The only way to find out is to test the model, after all.