Building a Healthy Corporate Culture

Presentation Overview

So, What’s Wellness? Why the Concern? A Blueprint for

Implementation Questions

So, what’s Wellness?

...A process of being aware of and actively working toward better health!

Definition is:A broad framework that highlights personalresponsibility to achieve physical, emotional, mental and spiritual health.

Why the Concern? For Every 100 Employees

22are

smokers

64are obese oroverweight

60are

sedentary

27have

heart disease

24have high

blood pressure

10have

diabetes

50are

distressed

25have highcholesterol

Organizational Concerns

Employee complacency toward health & wellness Increased individual and organizational health risk Large % of employees in high-risk categories Rapidly rising healthcare costs, especially as

employee population ages High absenteeism rates, high presenteeism costs,

and diminished workplace productivity Decreased productivity of managers who must deal

with at-risk employees

Health and Wellness in the News!

“82% of small employers, 90% of midsize employers and 99% of large employers see

value in implementing wellness programs”-— Benefits and Behavior: The Voice of

American Business Owners and Benefit Decision Makers Today –June, 2007

Aetna announces enhanced portfolio to their medical management strategy offering with value-added wellness components.” - September, 2006.

“Wellness program converts CEO’s to cause” – Employee Benefits News – Feb. 2006

More Companies Implementing Health and Productivity Practices” – Watson Wyatt – Dec. 2005

“Top 10 Issues for Health Industry in 2006 / Wellness & Obesity #5” – PricewaterhouseCoopers – Jan. 2006

“Survey: U.S. Employers Turning to Wellness Programs to Manage Healthcare Costs.” – Deloitte Services – June 2005

“Promoting healthy habits and consumerism is the most effective way to lower medical costs” – Mercer Human Resource Consulting – Sept. 2005

Organizations are Asking For…

Health & Well-BeingLow Risk,

Optimal Health

Health & Well-BeingLow Risk,

Optimal Health

Chronic Disease Diabetes

Heart Disease

Chronic Disease Diabetes

Heart Disease

Disability Traumatic Injury

Cancer

Disability Traumatic Injury

Cancer

Minor Illness/InjuryDoctor Visits

ER Visits

Minor Illness/InjuryDoctor Visits

ER Visits

At Risk Inactivity, Obesity, Stress, High Blood PressureAt Risk Inactivity, Obesity,

Stress, High Blood Pressure

Wellness Management Information Motivation Preventive Screening

Wellness Management Information Motivation Preventive Screening

Risk ManagementTargeted InterventionTargeted Screening

Risk ManagementTargeted InterventionTargeted Screening

Demand ManagementSelf CareNurse Advice Line

Demand ManagementSelf CareNurse Advice Line

Disease ManagementComplianceRisk Management

Disease ManagementComplianceRisk Management

Disability Management Case Management Decision Support

Disability Management Case Management Decision Support

15 % of employees 85% of costs 85 % of employees 15% of costs

Core Planning

Cycle

Approach to Wellness

Concentration on Senior-Level Support Creating a Cohesive Team Collecting Data to Drive Health Efforts Carefully Crafting a Strategic Plan Choosing Appropriate Health

Interventions Creating Supportive Environments-

Incentives Consistently Evaluating Outcomes

Data Collection: Assess and Analyze

Crucial to gather data BEFORE planning health interventions

The types of information to collect Where to find data you need The art and science of balancing needs and

interests Who to tell about your results, and how Tips for successful data collection & analysis

Why you need to gather data before health

interventions

Data allows you to pinpoint company health concerns

Data allows you to satisfy employee interests

Data increases the likelihood that people will accept wellness

Data provides a baseline by which to measure change

Data moves your program from activity-centered to results-oriented

Business Needs-Data

Demographic Information Health Risk Appraisals Health Screening Data Interest Surveys

Wellness Program Models Quality of Life

Traditional/Conventional Health and Productivity Management

Medical Claims Disability Absenteeism Facility Assessment Culture Audits

Program ModelsQuality of WorkLife Improving morale Add to quality of

worklife Improve camaraderie

and relationships Voluntary activities Approach is passive Offer information and

experiences Operative word “FUN”

Traditional ½ of eligible

population will do one or more activity

Voluntary Something for

everyone Site-based activities No significant

incentives Economic return is

not a high priority Minimal

Evaluation Operative word

“SAFE”

Health & Productivity Management

Proactive, highly structured interventions

Large portion of workforce and spouses

80% take an HRA Survey-prompted

programming Coaching & support Site-based & virtual

activities Personalized Outcomes driven

Evaluation Operative word

“SERIOUS”

The Health Risk Appraisal Written Lifestyle choices, behaviors, current health

conditions Self or computer-scored Stimulate employee interest Initiate behavior change or movement

along stage of readiness

The Art & Science of Balancing Needs &

Interests

Employee interest initiatives draw participation

Business needs drive wellness budgets Results are produced with a

combination of the best interests of the business and the employees

Key Idea! To be effective, the great health promotion planners will balance organizational needs & employee health interests.

Tips for successful data collection and analysis

Use multiple data sources that support one another Commit to honesty in analyzing data Remember that all the information collected is

extremely sensitive Use only the data which is properly gathered Protect the individual’s privacy at all costs Don’t stop after data collection – your program is still

building Establish a database for evaluation of outcomes Be creative with the information

Carefully Crafting the

Operating PlanBuilding a Healthy Corporate Culture

Why Plan?

Builds and gains support Moves us from activity-centered to

results-oriented Keeps everyone in the loop Serves as a roadmap to success Eliminate unnecessary activities

The eight elements of a comprehensive operating plan

Vision Statement The Program’s Primary Goal(s) Supporting, Measurable Objectives Timelines for Implementation Delineation of Roles Evaluation Procedures Itemized Budget Communications Strategy

Goals & Objectives

Goals are the overall intent or purpose of the program such as the containment of health care costs, reduction of absenteeism, etc.

Objectives are short and concise clarifying statements.

Specific Measurable Achievable Realistic Time Sensitive

Sample Program Objective:

Establish a wellness advisory group and develop a program plan, budget and evaluation plan by January 1, 2008.

Launch a employee wellness program by February 1, 2008. Provide lipid and glucose screening for employees by March

1, 2008. Implement a Consumer-Drive Health Plan (CDHP) for all

employees by September 1, 2008. Train employees and family members in medical self-care

and health care consumerism by September 30, 2008.

To improve the health and well-being of employees and their family members.

Choosing the Appropriate

Interventions

How to Select the Right Areas of Intervention

What are the risk factors and health concerns of your population?

What does the latest research suggest? What do your employees want? What do your senior people want to

achieve? How much money and time do you have?

Strategy— Setting the Stage for

Interventions Strong incentives for completion of an annual Health Risk

Assessment Balance between long-and short-term clinical health risk factors Focused use of biometric screening Annual use of HRA-Personal Health Plan Acute and chronic disease focus Primary, secondary and tertiary prevention focus Light use of group education Integration with employer policies, benefits, and other health

related areas. Organized high risk interventions Extensive use of incentives Communication strategies Medical self-care consumerism Offered throughout the day, not just workday Formal evaluation

Most Frequently Addressed Programming Areas

Smoking Cessation Exercise/Physical Activity Nutrition/Weight Control Cardiovascular Disease

Detection/Prevention Stress Management Seatbelts Medical Self-care Stress Management Personal Finance Immunization Ergonomics

Prenatal care Low back pain

management Diabetic care Asthma Treatment Somatic disorder

patterns Allergic reactions Preventive screenings

Primary Prevention Secondary & Tertiary Prevention

Strategy— Setting the Stage for

Interventions Strong incentives for completion of an annual Health Risk

Assessment Balance between long-and short-term clinical health risk factors Focused use of biometric screening Annual use of HRA-Personal Health Plan Acute and chronic disease focus Primary, secondary and tertiary prevention focus Light use of group education Integration with employer policies, benefits, and other health

related areas. Organized high risk interventions Extensive use of incentives Communication strategies Medical self-care consumerism Offered throughout the day, not just workday Formal evaluation

Some Group Activities

Run periodic weight loss, fitness activity and cholesterol reduction groups with financial incentive for those who maintained or achieved improvements at the end of 6 months.

Organize active walking club Offer weight management seminars Offer targeted nutrition seminars such as “LDL-

lowering strategies.”

Strategy— Setting the Stage for

Interventions Strong incentives for completion of an annual Health Risk

Assessment Balance between long-and short-term clinical health risk factors Focused use of biometric screening Annual use of HRA-Personal Health Plan Acute and chronic disease focus Primary, secondary and tertiary prevention focus Light use of group education Integration with employer policies, benefits, and other health

related areas. Organized high risk interventions Extensive use of incentives Communication strategies Medical self-care consumerism Offered throughout the day, not just workday Formal evaluation

Key Activities- The “Interventions”

HRA—Personal Health Plans Risk interventions—prompted by HRA—web, print, telephonic Telephonic Coaching delivered to—

Low Risk Multiple or elevated health risks Disease Management Disability Selected “at risk”

Medical Self-care and Consumer Training Injury Prevention—Work, home, vehicular Benefit linked Incentive-

Premium differential Increased vacation days Larger contribution to health savings accounts 300.00 to 1,000.00 in order to gain high levels of participation

Serves Spouses Resiliency Initiatives—Life Goal Planning, Stress Relief, Energy

Management

Sample Wellness Communication

Post wellness and motivational posters on bulletin boards Provide wellness library—hard copies or online Launch Letter- 1 to 2 page letter outlining the new program Mail request card-Allows employees to self-select materials Posters Wallet Cards PowerPoint Decks Payroll Inserts Web Information Email List Serves Fax Trees PDA messaging

3 Levels of Communication and Programming

Awareness Distribution of information encouraging individuals to become conscious of

the benefits and methods to achieve a healthy lifestyle. Brochures, fliers, books, posters, newsletters, exhibits, bulletin boards and screenings.

Education An interactive presentation or activity intended to increase knowledge and

change attitudes regarding health. Seminars, workshops, interactive computer programs, counseling after screenings and demonstrations.

Behavior An ongoing program that actively involves individuals in long-term

behavior modification with measurable results. Classes (ongoing, multi-session), incentive programs tied to outcomes, training programs, support groups and one-on-one counseling over a period of time.

Communication Strategies

Educate on UseInteractive Communication-Personalized Approach

Invitation/Examples built into current product deliveryDirect Mail

Kiosks/Booths-DemonstrateBuild credibility

Sign up for the email daily health tips

Positive Attitude Intent to try Will try

Opportunities to TryOn-line fitness campaign

Recreation and Fitness Day Teachable Moments “Point of Delivery” Signage

Primary Care Physician ReferralIncentive/Drawing

Regular UseInteractive with CoachesPersonalized homepages

Calendar Appointment remindersShare with physician

Progress Reports

Awareness

Em

ploy

ees

at C

ompa

ny X

YZ

Time/Specific Strategies

Effective Use of Incentives Increase participation Increase adherence to specific behaviors Increase follow-through by a factor of 2 to 8 Participation AND outcome components – HIPAA- Reward exchanged for behavior—Pay Value Cash, Benefits,Time-off, Material Goods,

Recognition and Personal Challenge

Incentives

Incentives and Product Life Cycle

Introduction/ Program Launch

Door prizes Discount fees for

early registration “Bring a Buddy”

discounts Handouts or gifts Drawing Attendance with

lower premium

Growth/ Increase Participation

Rebate 20- 30% of fees for nearly perfect attendance—Fitness Center

Prize drawings at end of series

Divide a dollar pot Attractive prize for

near-perfect attendance

Maturity/Make long-term behavior change

Rebate 20- 30% of fees for nearly perfect attendance—Fitness Center

Prize drawings at end of series

Divide a dollar pot Attractive prize for

near-perfect attendance

Examples of IncentivesIncentive System Incentive Award Impact

Participation based, self-report and affidavit based validation, uses paper and telephonic reporting

Ranges from low cost ($25.00 or less per item) health support tools such as pedometers to $15.00 per month premium differential for tobacco users

Low cost items impact event based participation, premium differential dramatically increased telephonic tobacco quit line utilization

Participation based and use of paper, electronic and telephonic tracking, rewards are based on completion of programs

Financial incentive for completing calls

Financial incentive for completing calls has increased participation.

Participation based uses electronic and paper reporting

Received free generic medications for “active” participation

Many participants are participating who are not on medication. Through coaching and lifestyle modification to reduce medications taken

Participation based with primarily electronic tracking and reporting. Rewards are based on completion of programs/services

Ranges from $50-500 placed into a Health Reimbursement Account for completion of screening and coaching services

Still in the early stages of assessment but participation among companies offering greater incentives is increased

Participation based, wellness goals set and reviewed with company RN, uses paper and electronic reporting

Average $750.00 per employee and spouse ($1,500 total) for achieving set wellness goals,

Incentives for ongoing program participation /completion (t-shirts, jackets, and others)

Average health screen participation rate of 98 percent

Overall health care costs have decreased in recent years

Carefully Evaluating Outcomes

3 Levels of Evaluation

Process: How well is the program being implemented?

Impact: To what extent were the immediate outcomes achieved?

Outcome: To what extent were the long-term outcomes achieved?

3 Levels of Evaluation in Action

Process: How well is the program being implemented?

Quality and quantity of programs Operating plan Executive Employee Satisfaction

3 Levels of Evaluation in Action

Impact: To what extent were the immediate

outcomes achieved? Awareness levels, knowledge, attitudes/beliefs,

skills, behavior change, physical and cultural climate changes

Realistic expectations

3 Levels of Evaluation in Action

Outcome: To what extent were the long-term

outcomes achieved? Risk factors, mortality, morbidity, disability,

health care costs, policy changes Company goals & objectives

Evaluation & Program Design

MeasurementQuality of

Life

Traditional/ Convention

al

Health & Productivity Management

Participation in program components

X X X

Satisfaction X X X

Suggestions for Program Improvement

-- X X

How important was the program to helping with

behavior change?X X

Changes in health risk prevalence X

Change in readiness to change X

Behavior patterns X

Health care utilization X

Sick leave experience X

Return on Investment X

Presenteeism Effects X

Questions

Selected References for Presentation: WELCOA Absolute Advantage and Prevention Partners