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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