Why Wellness Matters Now:Setting the Foundation for Success and Sustainability

Second Annual Worksite Wellness ConferenceNovember 4, 2014

Wellness

History of Wellness

• Safety• Fitness

1890‟s

• Wellness Continuum

1960‟s• Diet• Exercise

1980‟s

• Well-Being

2000‟s

The New Wellness Landscape

Personal Wellness

MBGH Employer Member SurveyWhy should an employer offer health benefits and wellness activities?

• 84% of employers believe health benefits are a necessary cost of

doing business - Helps to recruit and retain talent

• 85% of employers view health benefits as an investment in

human capital

• 95% of employers agree there is a link between an employee‟s

health and productivity – Want to ensure a healthy workforce

• A majority of employers want employees to take responsibility

for their health

• As a response to a health system that has overly focused on the

management of chronic conditions rather than wellness and

prevention

The Current Health Care Environment

• The health care delivery system is changing and consolidating

– ACOs - Medical Homes - Onsite clinics - Centers of Excellence

• Technology‟s growing impact on health care

– Online information - Mobile apps

– Wearable monitoring devices

– eVisits - Telemedicine

• Health insurance premiums have increased on average 8 – 12% a year

• Health vendors focused on comprehensive population health management strategies

• Companies - reducing costs across all areas of the organization

MBGH Benchmarking Surveys

2014 MBGH Employer Survey Health Management Priorities

45%

56%

59%

59%

64%

0% 10% 20% 30% 40% 50% 60% 70%

OFFERING MORE TARGETED WELLNESS PROGRAMS

CREATING A CULTURE OF HEALTH

CREATING EFFECTIVE BENEFIT COMMUNICATIONS

AVOIDING THE 2018 EXCISE TAX

REDUCING HEALTH CARE COSTS

2014 MBGH Employer SurveyWellness Activities Priorities

42%

42%

35%

54%

33%

32%

32%

38%

44%

62%

0% 10% 20% 30% 40% 50% 60% 70%

INCENTIVE/DISINCENTIVES TO IMPROVE ENGAGEMENT

STRESS/RESILIENCY PROGRAMS

EFFECTIVE WEIGHT MANAGEMENT PROGRAMS

INCREASE EMPLOYEE USE OF PREVENTIVE SERVICES

INCREASE EMPLOYEE ENGAGEMENT

High Priority Medium Priority

2014 MBGH Employer SurveyWellness Activities Priorities

44%

38%

31%

18%

21%

21%

0% 10% 20% 30% 40% 50%

OFFERING FITNESS CHALLENGES

OFFERING HEALTHY FOOD CHOICES AT WORKSITE

REDUCING TOBACCO USE AT THE WORKSITE

High Priority Medium Priority

Around the World2012 Buck Global Wellness Survey

Around The World2012 Buck Global Wellness Strategy

Making the Business Case for Wellness

Making the Business Case for Wellness

After payroll,

employee benefits is company‟s

largest budgeted expense

Small Business Strategies Criteria to Consider

• Capturing CEO Support

• Designating a Company Wellness Leader

• Conducting an Employee Health Interest Survey

• Implementing Healthy Policies and Procedures

• Providing an Opportunity for Health Screening

• Administering an Annual Physical Activity Campaign

• Holding a Healthy Eating In-service/Lunch „n Learn

• Establishing an In-house Wellness Library

• Disseminating a Quarterly Health Newsletter

• Supporting Community Health Efforts

Source: WELCOA, https://www.welcoa.org/services/build/wellness-small-business/

Making the Business Case for Sustainability

• Assess current population health status

• Use company data to determines direction and trend – compare to industry benchmark

• Use data that is actionable

• Answers the question “Why should we take action?”

• Assess current benefit design strategy • Does it support employees navigating the healthcare system

appropriately? (benefits, incentives/disincentives, etc.)

• How and when to incentivize? • Focus on “readiness to change” as well as behavior change

• Use key activities to highlight overall wellness

• What programs/activities will anchor your wellness strategy?

• Annual Fitness/Walking Challenge

• Biometric Screenings

• Maintain and Internal Health Management Team

• Brings together key stakeholders in the company that are focused on employee health, safety, benefits, compensation, workers comp, etc.

• Engages leadership through program outcomes and participation

• Team has access to decision-making authority in order to move forward with programs and activities

Making the Business Case for Sustainability

MBGH 2010 Landmark Research Triggers and Barriers to Engagement

MBGH Research Triggers and Barriers to Engagement

Project Objectives

• To better understand what prompts (triggers) or prevents (barriers) employees from participating or maintaining involvement in employer-sponsored health benefits and health improvement programs.

• To gain insight into what motivates and engages employees to take responsibility for managing their own health, and what it takes to support them in changing unhealthy behaviors.

• To determine the influencers of employee decisions and actions by collecting input from audiences beyond the employee - specifically, physicians, spouses and health coaches.

• To use the findings to support employer efforts in effective and efficient benefit design, administration and communication of health care and VBD benefits, wellness programs, incentives and health improvement activities.

MBGH Research Triggers and Barriers to Engagement

Participating Organizations• 3 Manufacturing Companies (L)

• 1 Hospital (M)• 1 Health Care Delivery System (M)

Individual Participants• 140 employees completed online survey • 22 Focus groups conducted• 192 Total # of focus group participants

• 148 Employees• 14 Physicians• 14 Spouses (2 companies)

• 16 Health coaches (2 companies)

MBGH Research Triggers and Barriers to Engagement

MBGH Research Triggers and Barriers to Engagement

Top barriers: Trust, Time, Money, Convenience, Stress

• Family and loved ones can have strong influence on employee behaviors – BUT can be a barrier to supporting healthy lifestyle change

• For women, guilt about making health a priority– feel they need to take care of others vs. themselves - especially true for mothers, single-parents and health care workers

• Men do not like to be told what to do. Due to the economy, they feel pulled to spend more time at their job, rather than being with family –adds stress.

• Employees concerned with confidentiality do not want to provide information to a health coach they don‟t know or complete employer assessments if they don‟t know what happens to results

MBGH Research Recommendations for a Successful Health Management Strategy

• Make sure your company‟s benefit design helps employees and covered dependents navigate the healthcare system effectively

• Provide employees with concise communications on benefits coverage and options, out-of pocket costs and descriptions of benefit changes

• Structure incentives as part of the benefit design - employees may value them more AND it can maximize the organization‟s investment

• Determine the overall picture of health using agreed upon metrics

• Share your company‟s needs with health management vendors (i.e. data access, potential outcomes, etc) - coordinate efforts so a consistent message is conveyed to employees

• Have performance measures built into your health plans and pharmacy benefit vendors that support medication compliance

• Provide self-care resources (i.e. handbook) that offer ways employees can better manage when to see the doctor

Employer Case Studies

Improving Employee EngagementOutcomes-based Incentives

• Growing interest in employers integrating outcomes-based (or results-based) incentives into existing incentive program designs to increase personal accountability and achieve results

• Differs from traditional, participation-based incentive programs which may or may not lead to a measurable difference in key health factors

• Emerging industry best practices indicates that…..

Employers that combine incentives for participation in healthy activities with rewards for healthy outcomes can increase engagement in health and wellness programs

Employer Example Outcomes-based Incentives

Employer A Employer B

Industry/Size/locati

on(s)

Manufacturer / 34,000 employees /

various locations around the country

Printing / 22,000 / various locations

around the country

Branded Wellness

Strategy

Yes Yes

Company Health

Goals

Develop an incentive program that

targets risks proven to drive costs

Design a program that increases

awareness and accountability for

health risks and costs

Focus cost differentials on the highest

risk population and provide achievable

goals

Provide employees and their families

sufficient time to plan for change

Control costs by providing a full range

of healthcare services

Focus on wellness, preventive

medicine

Offer benefits that attract, retain staff

Maintain flexibility in benefits design

Improve patient access with onsite

and near site facilities

Want to shift from “fixing” to

“preventing”

Initial Wellness

Strategy

Offering gift cards for screening

participation

Know Your Numbers Campaign

Premium differentials

Monetary rewards depending on

level of engagement

Employer ExampleLearnings: Outcomes-based Incentives

• Communicate early and often – Communicate overall strategy – no surprises!

• Use data to determine next steps

• Provide ongoing employee support

• Clear and persistent communications critical to success

• Use the underlying theme of personal responsibility for your own health

• “Confidentiality is the cornerstone of our company‟s message”

Developing a Culture of Health

Culture of Health: “The creation of a working environment where employee health and safety is valued, supported and promoted through workplace health programs,

policies, benefits, and environmental supports…”

Building a Culture of Health

• involves all levels of the organization

• establishes the workplace health program as a routine part of business operations aligned with overall business goals

• Results have a positive impact on health care costs and improved worker productivity

• Encourage engaged and empowered employees

This takes Time& Commitment !Source: Center for Disease Control and Prevention

Employer ExamplesCulture of Health Strategies

Case Study: Lincoln IndustriesCulture of Health

Number of employees: 600

Annual Health Care costs are 40% lower than industry standards

Source: Welcoa Employer Case Studies

Measuring ROI and Investing in Wellness

Measuring ROIGaining Value for Your Investment

• To measure ROI to reduce health care costs and productivity

• Align programs with metrics that can affect health care costs and productivity

• Align benefit strategy to impact health care costs and productivity

• Measuring Value on Investment• Identifying the benefits

• Impact is on satisfaction

• Provides opportunity for population to connect

• Engages people to take responsibility for their health

ROI and Wellness

• Most companies don‟t define ROI – some are moving to VOI

• Some use reduction in health care costs as the only valuable metric – others are moving to what’s the “value proposition?”

• Vendors have used “cost avoidance” metrics – has gotten a “bad rap” in the news

Companies Need To:

• Determine agreed upon metrics that will be valuable to the C-Suite

• Focus on policies and benefit design strategies that increase engagement and support employees to navigate the health care system

• Develop an overall strategy that includes leadership support, a focus on reducing risk, engagement and culture of health

Employer Investment in Wellness Is it having an impact?

Employer Investment on Wellness Effect on the Economy

What‟s Next for Employers?

• Outcomes-Based Incentives

• Defined Contribution

• Plan Options: Movement towards CDHPs

• Public/Private Exchanges

• Specialty Pharmacy

• Chronic condition management through technology

• Onsite clinics/Tele-medicine

Q & A

THANK YOU!

Margaret Rehayem

Senior Director of Strategic Initiatives and Communications

Midwest Business Group on Health

www.mbgh.org

mrehayem@mbgh.org