Healthcare costs keep rising. Employers deserve a better answer.
For years, employers have faced a difficult challenge: healthcare costs continue to rise, while many of the solutions designed to manage those costs have fallen short. Traditional wellness programs may drive participation, but often struggle to convert engagement into measurable reductions in health risk and cost. At the same time, many common cost-management strategies simply shift more expense to employees through higher premiums, deductibles, and out-of-pocket costs.
Healthcare is still largely funded around what happens after someone becomes a patient. Yet many of the biggest drivers of future healthcare costs sit before that point: preventive care, medication adherence, physical activity, sleep, nutrition, screening, and chronic condition management. These are areas where individuals can often influence their risk, but most health insurance designs do not create a meaningful connection between health effort and healthcare costs. Consequentially, everyone, including those actively managing their health, continues to pay more each year.
The result is a system with misaligned incentives. As healthcare costs rise and are passed on to members – rather than managing their costs and risks – members are incentivized to delay care and ‘revenge spend’ when they hit their deductibles and out of pocket costs. This is not sustainable.
Today, we’re introducing Vitality Contribution Flex: a new approach to healthcare funding that helps align employees, employers, and the cost of care in a more equitable and sustainable way. To reflect our confidence in this model and our belief that healthcare savings can and should be measured, we have paired Vitality Contribution Flex with a 3-year ROI Guarantee.
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What is Contribution Flex?
Vitality Contribution Flex is a healthcare funding model that links medical plan contributions to verified health-management effort through Vitality status and personalized health pathways.
Employees who actively engage in improving and managing their health can share in the value they help create through lower healthcare contributions. Those who do not engage may fund a greater share of the contribution, reflecting the principle that employers should not bear the full cost of avoidable, controllable health risk. The goal is not to penalize illness or reward people for simply being healthy. Instead, Vitality Contribution Flex is designed to recognize effort, progress, and sustained engagement.
At the center of the model is Vitality status: a validated measure of sustained health-management effort across a personalized pathway. That pathway can include physical activity, sleep, preventive screenings, medication adherence, nutrition, condition management, coaching, and other interventions tailored to each person’s health profile.
Importantly, Vitality Contribution Flex is designed around effort and progress, not pre-existing health. Because each pathway is personalized, members can advance from their own starting point and earn status through achievable, relevant actions. The model is intended to reward engagement without penalizing illness or factors outside an individual’s control.
A different way to think about healthcare funding
Most healthcare financing models focus on what happens after someone becomes a patient. Vitality Contribution Flex focuses on everything that happens before.
Rather than treating prevention, engagement, screenings, condition management, and healthy behaviors as separate programs, Contribution Flex connects them directly to healthcare funding. Through personalized pathways and measurable engagement, employees can see a clear relationship between the actions they take and the contributions they make toward their healthcare coverage.
This creates alignment across the healthcare ecosystem:
- Employees are recognized for taking actions that improve and manage their health.
- Employers gain a model that protects their net position by connecting contribution levels to engagement, creating savings when health improves and resilience when engagement is lower than expected.
- The healthcare system benefits when more people participate in prevention, screening, and condition management before higher-cost interventions become necessary.
Powered by Vitality AI
Contribution Flex is enabled by the broader Vitality AI ecosystem. Drawing on decades of behavioral science and more than 60 million life years of health and behavior data, Vitality AI creates personalized pathways designed to guide members toward the actions most likely to improve health and reduce future risk. It delivers the right nudge, to the right person, at the right time, then translates verified engagement into Vitality Status and ultimately into the share of healthcare contribution the member funds.
In a Vitality U.S. analysis of 93,000 members, higher Vitality status was associated with up to 15% lower medical claims versus lower Vitality statuses, even after adjusting for age, gender, client, entity role, and condition count. The relationship between Vitality status and healthcare costs has also been independently validated by the Validation Institute.
Built Around Accountability
Employers are increasingly asking an important question: How do we know it’s working?
That’s why Vitality has paired Vitality Contribution Flex with a 3-year ROI Guarantee.
For qualifying employers, Vitality places 50% of eligible administrative fees at risk if cumulative net savings over the guarantee period are not positive. The guarantee reflects the confidence we have in this model and our belief that healthcare savings can and should be measured, not assumed.
The Future of Healthcare Funding
Healthcare costs are unlikely to stop rising. But employers have an opportunity to rethink how healthcare is funded.
Vitality Contribution Flex does not ask employers to rebuild the healthcare system. It gives them a way to influence the part of healthcare that has historically been hardest to manage: what happens before people become high-cost patients. By connecting personalized pathways, verified engagement, Vitality Status, contribution design, and measurable accountability, Vitality Contribution Flex creates a more aligned model for employees, employers, and the cost of care.
We’re excited to introduce Vitality Contribution Flex and begin the conversation about what a more aligned future for healthcare funding could look like.
Ready to learn more? Connect with the Vitality team to explore how Vitality Contribution Flex could fit into your organization’s benefits strategy.
