Best Practices Revealed: Leveraggging THE HEROSCORECARD · workshops required “checklist” of program components, activities and outcomes. • Recognizing potential value, team

Best Practices Revealed: Leveraging g gTHE HEROSCORECARDP d b J N P id & CEO HEROPresented by Jerry Noyce, President & CEO HERO

May 10, 2012

HERO

• The Health Enhancement Research Organization• Non-profit 501(c)3 founded in 1996• Vision: To integrate employee health management into large

and small business operations, mainstream medicine, and the national culturenational culture

• Core Purpose: To create and disseminate research, policy, leadership, and infrastructure which advances the principles, science and practice of employee health management

• Major Activities–HERO Think Tank–HERO EHM Best Practice Scorecard in collaboration with MERCER–HERO Forum–HERO Research

THE HEROSCORECARD in collaboration with MERCER

HERO BEST PRACTICE SCORECARDHERO BEST PRACTICE SCORECARD• HERO created a national EHM conference in 2005, the HERO Forum,

centered on facilitation of “HOW TO DO IT” Workshops Selectingcentered on facilitation of HOW TO DO IT Workshops. Selecting workshops required “checklist” of program components, activities and outcomes.

• Recognizing potential value, team of Think Tank members expanded checklist to fully encompass EHM best practices identified from research or expert opinion. Resulted in HERO SCORECARD V1.0 in 2006.

• Based on initial user feedback, HERO SCORECARD V2.0released in 20072007.

• In 2008, HERO and Mercer discussed a Scorecard collaboration. Both parties agreed this collaboration could be a major step forward for the


p g j pEHM industry

THE HEROSCORECARD in collaboration ith MERCERwith MERCER

• Team of HERO and Mercer experts jointly created HERO Scorecard• Team of HERO and Mercer experts jointly created HERO Scorecard V3.0. Collects much more granular data and, unlike V1.0 and V2.0, V3.0 available online on HERO website.

• HERO and Mercer created a database to manage Scorecard data. To assure security and confidentiality, data processed by third-party vendor on their servers Unless instructed otherwise identifiers removed before providing dataservers. Unless instructed otherwise, identifiers removed before providing data to HERO or Mercer for research

O S d l il bl h l bli i ll• HERO Scorecard tool available to the general public. Users automatically receive complimentary report comparing their overall and major component scores with overall database norms.


SCORECARD CONTENT:

• Needs assessments, Measurable goals, Total population health strategy, targeted eligible populations

Section 1: Strategic Planning

• Senior leadership commitment, Manager support, Ambassadors, Physical work environment, Policies

Section 2: Leadership Engagement

• EHM program integration, Benefit plan design and inclusionsSection 3: Program Level Management

f l & d l• HRQ, Campaigns, Lifestyle & DM, TDS, Modalities, EAP, Onsite clinicsSection 4: Programs

• Communications IncentivesSection 5: Engagement

• Communications, Incentivesg g

Methods

• Performance data capture and useSection 6: Measurement and Evaluation


and Evaluation

• Does not contribute to Best Practice score• Data vital to explore the relationship

between outcomes and program designp g g• May help adjust future weighting of

tcomponents• Decision to capture modest data with

greatest consistency - goal is to expand

SCORECARD CONTENT I PROGRAM OUTCOMES


Include multiple stakeholders in

completion of Scorecardp

Consider including different organizational departments as well as consultant and vendor

Overall investment to complete is

commensurate with complexity of EHM efforts, size of organization & partners involved in EHMsize of organization, &

quality of results desired Scorecard Completionp

Treat completion as an opportunity to engage

Consider including members of completion t i lt i


opportunity to engage stakeholdersteam in results review

discussions

SCORECARD R E P O R T I N G O P T I O N S

A d S

Benchmark Report:

Drawn from the full Scorecard database the

Custom Benchmark Report:

Allows forAuto‐generated Score:

Generated instantly providing a score for each of the six sections

Scorecard database, the Benchmark Report compares program strategy, design and

t f 21

Allows for benchmarking against employer groups that you specify, for example:each of the six sections

and an overall score (free)

outcomes for 21 employer benchmark groups based on industry, size, and

example:

• Any 10 or more employers from the list of participants

geographic location provided to partners

• Groups with similar programmatic features (use of incentives, ability to measure outcomes, etc )


etc.)

S C O R E C A R D R E P O R T

From: [email protected]

Subject: HERO Scorecard results

Thank you again for submitting the HERO Best Practice Scorecard. Here are your organization’s scores.

Sections Your S

National A

Maximum P iScore Average Points

Section 1: Strategic Planning 5 5 11

Section 2: Leadership Engagement 20 17 33

Section 3: Program Level Management 15 11 22Section 3: Program Level Management 15 11 22

Section 4: Programs 25 27 56

Section 5: Engagement Methods 28 27 67

Section 6: Measurement and Evaluation 4 5 11Section 6: Measurement and Evaluation 4 5 11

Total Score 97 91 200

Note: National average shown is based on 616 employers that have completed the HERO Scorecard as of December 31 2011


December 31, 2011.

S a m p l e S C O R E C A R D B e n c h m a r k R e p o r t


HERO Scorecard DatabaseWhat does the data tell us?


What Does The S C O R E C A R D Data Tell Us?

• The Scorecard asks about EHM program designThe Scorecard asks about EHM program design in detail to become a powerful EHM benchmarking toolbenchmarking tool.

L ki h i f ifi EHM i• Looking at the impact of specific EHM practices on outcomes gives employers information they

h l d id h i i h ican use to help decide how to invest in their own programs.


What Outcomes Data Is Collected & How Is It Used?

• Outcomes data collected: i i i f HRA di– participation rates for HRA, disease

management and lifestyle managementimpact on employee health risk and medical– impact on employee health risk and medical plan cost trend

• Outcomes data is analyzed to identifyOutcomes data is analyzed to identify which best practices are associated with favorable EHM program results. Analysis p g yof Scorecard data has shown that employers with higher scores (those using

b i ) bTHE HEROSCORECARD in collaboration with MERCER

more best practices) report better outcomes

Scorecard Respondents as of December 2011, By Employer Size

Employer Size Number of Employer Size respondents

All employers 624

Employers with fewer than 500 employees 114 (19%)

Employers with 500-4,999 employees 264 (43%)

Employers with 5,000 or more employees 234 (38%)


The Maximum Score is 200 Points, but Most Respondents Score Less than 100 Distribution of respondents by best practice scoreDistribution of respondents by best practice score

S b t 1

Score between 161 – 200 points

12%15%

4

Score between 1 – 40 pointsScore between 131

– 160 points

21%

15%

Score between 4121%

22%


25%Score between 71




EHM Spending Based On Best Practice Score

Low scorers (66 Average scorers (67

High scorers (

or below) scorers (67-113) (114 or

above)

Best Practice Score 44 89 138(average for group) 44 89 138

EHM spending per eligible per month (median) $6 $10 $13per month (median)

Number of respondents 198 218 208


Health Risk Assessment Participation RatesPercent of Eligible Employees Completing HRAPercent of Eligible Employees Completing HRA

61%

45%

61%

25%

Low scorers Average scorers High scorers


Perceived EHM Program Outcomes: Employee Health Risk

Significant improvement Slight improvementNo improvement found yet Have not attempted to measure

30% 44% 8% 18%

High scorers

30% 44% 8% 18%

Average scorers

10% 36% 10% 43%

13% 30% 53%4

Low scorers


Perceived EHM Program Outcomes: Medical Plan Cost Trend

Substantial positive impact Small positive impactNo improvement found yet Have not attempted to measure

31% 29% 15% 25%

High scorers

31% 29% 15% 25%

Average scorers

11% 12% 34% 43%

34% 58%2 6%

Low scorers


STRATEGIC PLANNING:It is important


Employers That Have A Strategic Plan & Set Formal EHM Targets Report Better Results

Have plan and targets

No formal plan or

59%targets

29%26%

40%

6%9%

Average HRA participation rate

Reported "significant improvement" in health risk

Reported "substantial positive impact" on medical

t d


trend

Results suggest that having a strategic plan contributes more to success than the number of programs offeredHave achieved a “significant improvement” in health riskHave achieved a significant improvement in health risk

17%

10%

Have strategic plan, low/average No strategic plan, high program score


program score

LEADERSHIP ENGAGEMENT:Needs Improvement


Room for Improvement in Leadership Engagement in EHM

Senior leadership active in EHM programs

46%

Mission statement supports culture of health

32%

Believe senior leadership & culture is “very supportive” of EHM

25%

Believe senior leadership & culture is very supportive of EHM

22%

Organized network of wellness champions in place


Senior Leadership Commitment to EHM Programs

55%59%

46%

33% 32% 34%

Leadershipcommunicateswith staff about

Leadershipactively

participates in

Leadership hasendorsed EHM

strategy to Board

Mission statementsupports a healthyworkplace culture

Employee well-being included incompany goals

Allocatedadequate budget

for EHM


EHMp p

EHM programsgy p p y g

Management/Supervisor Involvement in EHM Programs

45%5%36%

28% 27%

13% 11%

Th Th id Th i Th j it f Th Th iThey encourageemployee

participation inEHM programs

They provideflexible schedulingso that employeescan attend EHM

programs

They receiveperiodic trainingand information

about EHMprograms and

The majority ofmanagers /supervisors

activelyparticipate in

They canarticulate the linkbetween health,productivity, andtotal economic

They receivereports with EHM

engagementmetrics


p g p gresources

p pEHM programs value

Use of Employee Champions to Promote EHM Programs, By Industry

Organized EHM network at mostworksites, with formal communications andmeetings

Wellness champions / ambassadors atsome worksites who receive internalcommunication

35%29% 27%

22% 23% 24%23%

co u cat o

11%

22% 23%16%

20%24%23%

17%22%

All respondents Manufacturing -mining,

construction,

Education Financial services Health care Wholesale / retail


,energy, petroleum

Work-Environment Is Supportive Of Health & Well-being

84%85%

Safe work environment, including ergonomics

80%

84%

78%Well‐lit and accessible stairwells

73%77%

Employers with 5 000 or

Smoke‐free environment

Healthy food options

60%

69%

68%Employers with 5,000 ormore employees

Employers with fewerthan 5,000 employees

Healthy food options

Fitness centers, walking or biking trails, etc.

47%

53%

65%

69%

Lactation rooms


47%

Participation Rates are Higher When Senior Leadership is Considered to Be Supportive of EHMEmployee Participation RatesEmployee Participation Rates

Leadership is "very supportive"of EHM

61%54%

Leadership is minimally or not atall supportive of EHM

35% 34%26%

18%

Health assessment DM participation rate Biometric screening


completion rate participation rate

Leadership Support Translates to Better Program OutcomesImpact of EHM On Health Risk & Medical Trend

Leadership is "verysupportive" of EHM

33%

Leadership is "minimally ornot at all supportive" ofEHM

27%

6% 6%

EHM program has produced a EHM has had a "substantial positive


"significant improvement" in health risk impact" on medical trend

Results suggest that strong leadership and culture contribute more to success than the number of programs offered Have achieved a “significant improvement” in health riskHave achieved a significant improvement in health risk

22%

18%

High leadership score, low/average Low/average leadership score, high


program score program score

A LOOK AT PROGRAMS


EHM Programs Offered

80%Disease management programs

77%Health risk assessment

73%Targeted behavior modification program

66%Population‐based health education

63%Onsite or near‐site health screenings


%

Health CoachingHealth Coaching • 77% of respondents offer lifestyle/behavioral

programs • Phone and web most popular form of health

coaching• 60% of programs ith coaching offer• 60% of programs with coaching offer

incentives to participate• Average participation rates:Average participation rates:

– 28% with incentives, 16% without incentives• Coaching contributes to better outcomes

– 57% reported improvement in health risks – 42% reported improvement in medical cost trend

No coaching: 18% & 13%


– No coaching: 18% & 13%

Screenings70% of respondents provide some type of screening

Onsite, near-site, awareness raising campaignsProgram participation rates and outcomes by provision of screening services

Provided on/near-site

Provided on/near site screenings AND conducted awareness

g p p y p g

Participation Provided on/near site screenings only

awareness campaigns

Health risk questionnaire participation rate (mean) 61% 61%

Health screening participation rate (mean) 53% 50%Health screening participation rate (mean) 53% 50%

Disease management participation rate (mean) 19% 30%

Lifestyle management participation rate (mean) 22% 30%

Reported significant improvement in health risk 21% 37%

Reported substantial positive impact on medical trend 19% 34%


trend

ENGAGEMENT:Use of Incentives


Use Of Incentives in EHM Programs

Incentive Type HRA Disease management

Behavior modificationg

Offer any incentive 83% 27% 61%

Cash/gift card 35% 12% 33%

Lower premiums 31% 4% 16%

Contribution to Health Savings Account 7% 2% 4%Savings Account

Contribution to other spending account (FSA, HRA)

10% 3% 6%HRA)

Average value of incentive $224 $153 $154


The Value of EHM Program Incentives Matter!In the top thirdIn the bottom third

Average participation rate when value of incentive is:

65%

42%

33%

24%


HRA Lifestyle management

Summary


HEROSCORECARDSSummary

• Higher scores are associated with better reported outcomes– Participation– Risk reduction– FinancialFinancial

• Having strong leadership and cultural support, and a strategic plan, appear to have a greater impact on risk reduction than the number of programshave a greater impact on risk reduction than the number of programs

• HERO Scorecard appears to have precision to identify which best practices are i d i h f bl EHM lassociated with favorable EHM program results


HEROSCORECARDL ki t th f tLooking to the future

• Encourage additional participation by organizations of all sizes• Repeat use of Scorecard to see how your score has changed• V-4 will be released in early 2013

– More robust outcomes reporting sectionMore robust outcomes reporting section– Deeper dive into a few topics (i.e. use of incentives)– Add questions on productivity

C id ll i– Consider a small company version• Consider becoming a Scorecard Preferred Provider

– Custom link to on-line Scorecard for your constituents– Access to your constituents’ responses (by organization with permission)– Access to Benchmark Report and reporting templates– Annual License Fee: $10 000


Annual License Fee: $10,000

FORUMTHE HEALTH ENHANCEMENT RESEARCH ORGANIZATION

FORUMFOR EMPLOYEE HEALTH MANAGEMENT SOLUTIONS

P A T H W A Y S T O S U S T A I N A B I L I T Y

MINNEAPOLIS MN l RADDISSON PLAZA HOTELMINNEAPOLIS, MN l RADDISSON PLAZA HOTELOctober 2-4, 2012

NETWORK l LEARN l ENGAGE

Questions?h hwww.the-hero.org

[email protected]

Documents

Best Practices Revealed: Leveraggging THE HEROSCORECARD · workshops required “checklist” of program components, activities and outcomes. • Recognizing potential value, team