March Webinar: One Million Data Points: The Link Between Well-Being, Optimal Wellness Outcomes, and Business Performance

Worksite Wellness Council of Massachusetts March 20, 2012

O N E M I L L I O N D ATA P O I N T S

The Link Between Well-Being, Optimal Wellness Outcomes, & Business Performance

John Harris, ChairmanHERO Health Enhancement Research [email protected] me on Twitter: @johnhharris

mailto:[email protected]

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R e s e a r c h & To o l s A d v a n c i n g t h e F i e l d

• HERO Scorecard

• Gallup-Healthways Well-Being Index®

• Healthways Well-Being Assessment

• Other Peer Reviewed Research

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Results from The HERO Employee Health Management Best Practice Score Card 2010 Annual Report

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O t h e r H E R O S c o r e c a r d F i n d i n g s

• Over 600 companies, evenly divided between large, medium, and small companies

• Strong leadership and cultural support results in better EHM program participation

• Larger organizations more likely to collect and use EHM data

• Strongly integrated programs produce greater employee engagement and better outcomes

• % of employers that believe health plan is supportive of EHM– 57% very supportive – 40% somewhat supportive – 3% not at all supportive

• Scorecard users who believe the health benefit design is very supportive are far more likely to report that EHM programs have had a substantial positive impact on medical plan cost trend

• Scorecard users reporting highest levels of consumerism are far more likely to report a substantial positive impact on cost trend

• Just under two-thirds of Scorecard respondents say that medical plan access and design support EHM program objectives:– “Effectively” (55%)– “Very effectively” (9%)

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T h e G a l l u p | H e a l t h w a y s W e l l - B e i n g I n d e x

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• 25-year commitment initiated January 2, 2008• 1,000 telephonic “community” surveys completed

per day, 7 days/week• Approaching 1.5 million completed surveys

• For results based on this sample of respondents, the maximum 95% margin of sampling error is ±0.1 percentage points

• Design support and oversight from leading behavioral economists, psychologists, and experts in psychometric survey design and statistical analysis

• Largest and most comprehensive health survey and database

Six Domains:

1. Life Evaluation

2. Emotional Health

3. Physical Health

4. Healthy Behavior

5. Work Environment

6. Basic Access

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T h e H e a l t h w a y s W e l l - B e i n g A s s e s s m e n t

Life Evaluation

BasicAccess

WorkQuality

EmotionalHealth

Physical Health

HealthyBehavior

Gallup-Healthways Well-Being Index®

Community

Healthways Well-Being Assessment™Individual and Organization

Life Evaluation

BasicAccess

WorkQuality

EmotionalHealth

Physical Health

HealthyBehavior

Productivity

HRA

Biometrics

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Individuals ● Experts ● Social Connections ● Environment ● Policy

Making the Transition from Health to Well-Being

Social

FinancialCommunity

Physical

Emotional

Career

Well-being is biggerthan Physical Health

Proprietary Healthways Construct

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T h e I n t e r c o n n e c t e d n e s s o f A l l D o m a i n s

BMI Risk

Healthy Eating

Exercise

Height WeightEnergy Level

# of Health Risks

Coping with Stress

Negative Affect

Personal Sources of Presenteeism

Days of Best Work

Physical Health

Emotional Health

Recognition at Work

Financial Stress

traditional approach current approach future areas of exploration

Drivers of BMI Risks: Example of New Insight

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Source: Healthways Internal Analysis

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ThrivingAverage 20% Lower Medical Costs

SufferingAverage 50% HigherMedical Cost

4.0

7.0

Struggling

“Please imagine a ladder with steps numbered from zero at the bottom to ten at the top. The top of the ladder represents the best possible life for you and the bottom of the ladder represents the worst possible life for you. On which step of the ladder would you say you personally feel you stand at this time?”

Source: Gallup-Healthways Well-Being Index Community Survey and Wellmark Corporate Survey 2008

Six well-being domains

1. Life Evaluation2. Work Quality3. Basic Access4. Healthy Behavior5. Physical Health6. Emotional Health

Cost Disparity of Life Evaluation & Possible Reasons Why

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R i s k D i s p a r i t y B y L i f e E v a l u a t i o n

0%

20%

40%

60%

80%

Suffering Struggling Thriving

0-1 risks2-3 risks4-5 risks6-9 risks

Risk Category by Life Evaluation

Toward Integration to Enhance Health and Well-Being by Evers, KE, Prochaska, JO, Castle, P. & Prochaska, JM. 2009

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L i f e E v a l u a t i o n & O t h e r Va r i a b l e s

Thriving

Struggling

Suffering

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

33%

61%

80%

% With Significant Stress

Thriving

Struggling

Suffering

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

82%

57%

30%

% Feeling Well Rested

Thriving

Struggling

Suffering

95%

79%

50%

% With Sufficient Energy

Thriving

Struggling

Suffering

0% 10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

91%

74%

50%

% Satisfied with Job

Source: Gallup-Healthways Well-Being Index Community Survey and Healthways Well-Being Assessment

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L i f e E v a l u a t i o n & P r e s e n t e e i s m D r i v e r s

0%20%40%60%80%

24% 21% 11%

54% 49%24%

69% 65%

33%

Thriving Struggling Suffering

During the past four weeks (28 days), how often have you been at work but had trouble concentrating or doing your best because of:

0%20%40%60%

10% 11% 4%

35% 30%7%

60%48%

15%


Job Overload Co-Worker Issues

Technology Issues

0%

10%

20%

30%

40%

50%

60%

70%

80%

53%

13%

30%

65%

23%

39%

70%

33%45%


0%10%20%30%40%

9% 11%19%18% 20%

32%32% 30%42%



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P r o d u c t i v i t y I m p a i r m e n t D i s p a r i t y b y L i f e E v a l u a t i o n

0%

5%

10%

15%

20%

25%

Suffering Struggling Thriving

Activity Impairment

Work Presenteeism

Work Productivity Loss

Source: Toward Integration to Enhance Health and Well-Being by Evers, KE, Prochaska, JO, Castle, P. & Prochaska, JM. 2009

Activity Impairment, Work Presenteeism and Work Productivity Loss by Life Evaluation

Prod

uctiv

ity Im

pairm

ent

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C o m m u t e T i m e & W e l l - B e i n g

17%

15%

14%

14%

13%

0% 2% 4% 6% 8% 10% 12% 14% 16% 18%

Over 60 Minutes

46-60 Minutes

31-45 Minutes

16-30 Minutes

1-15 Minutes

% Reporting Anger

64%

66%

67%

69%

71%

60% 62% 64% 66% 68% 70% 72%

Over 60 Minutes

46-60 Minutes

31-45 Minutes

16-30 Minutes

15 Minutes or Less

% Feeling Well Rested

Over 60 minutes

46-60 minutes

31-45 minutes

16-30 minutes

15 minutes or less

46% 48% 50% 52% 54% 56% 58% 60%

50%

50%

52%

56%

58%

% Exercising

Over 60 minutes

46-60 minutes

31-45 minutes

16-30 minutes

15 minutes or less

61% 62% 63% 64% 65% 66% 67% 68%

63%

63%

65%

67%

67%

% Eating Healthy

Over 60 minutes

46-60 minutes

31-45 minutes

16-30 minutes

15 minutes or less

0% 5% 10% 15% 20% 25% 30% 35% 40%

36%

34%

32%

29%

28%

% Obese

Source: Gallup-Healthways Well-Being Index Community Survey

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W o r k E n v i r o n m e n t I m p a c t o n E m p l o y e e s W i t h C h r o n i c C o n d i t i o n s

13.5

52.7

20.1

68.9

0

10

20

30

40

50

60

70

80

1-3 Conditions 4+ Conditions

Neutral or Positive Work Negative Work

6.6 Days/Year

16.2 Days/Year

Days Unable to Carry Out Usual Activities Per Year

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O t h e r R e s e a r c h

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Gallup Research – Only 28% of American workers are engaged in their work

Price Waters Cooper, 2010 – 1 in 4 high-potential employees intend to leave their employers in the next 12 months

AON Hewitt – Global engagement scores are on the decline with recent drops being the largest in 15 years

Research by Ratey in a book published in 2008 – People learn vocabulary words 20% faster after exercise than before

Confidential and Proprietary 20

W E L L - B E I N G , C O S T & P E R F O R M A N C E

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W e l l - B e i n g R e l a t i o n s h i p t o To t a l M e d i c a l C o s t s

0-50 (n=109) >50-60 (n=151)

>80-90 (n=683)

>70-80 (n=582)

>60-70 (n=347)

>90-100 (n=363)

Annual Costs(Indexed)

ANNUAL MEDICAL AND RX CLAIMS COST | Low:High Well-Being = ~3.5x more cost

Source: Wellmark Data, Healthways Center for Health Research Analysis (n=2,235)

4.0

1.0

2.0

3.0

Well-Being Score (Composite)Low High

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W e l l - B e i n g & P r o d u c t i v i t y

HIGHER IS ASSOCIATED WITH HIGHER OVERALL WELL-BEING PERFORMANCE & PRODUCTIVITY

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Well-Being and Performance Well-Being and Absenteeism

Source: Healthways Well-Being Assessment and , Healthways Center for Health Research Analysis

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HIGHER IS ASSOCIATED WITH HIGHER OVERALL WELL-BEING ENGAGEMENT AND RETENTION

W e l l - B e i n g a n d W o r k W i t h d r a w a l

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Well-Being and Engagement Well-Being and Retention


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W e l l - B e i n g & Te a m E f f e c t i v e n e s s , L e a d e r s h i p a n d P r o d u c t i v i t y

74767880828486

64 to 66 67 to 69 70 to 72 73+Well-Being Score

Lead

ersh

ip S

core

40

45

50

55

60

65

70

75

80

1 2 3 4 5 6 7 8 9 10

11 32 88 564 2,133 4,980 4,267 1,582337

Overall ProductivitySelf-reported on a scale of 1-10

N=

Wel

l-B

eing

Sco

re

747678808284

64 to 66 67 to 69 70 to 72 73+

Team

Effe

ctive

ness

Sco

re

Well-Being and Team Effectiveness

Well-Being Score

Well-Being and Leadership

Implementation of Survey: March, 2010 ************* NO INCENTIVES *************

Eligible WBA Population: 27,090 employees WBA Completion Rate: 52.7%

Completed Surveys: 14,276 employees

Well-Being and Productivity


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W e l l - B e i n g & Te a m F i n a n c i a l P e r f o r m a n c e

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TOP QUINTILE 2ND QUINTILE 3rd QUINTILE 4TH QUINTILE 5TH QUINTILE


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W e l l - B e i n g & Te a m F i n a n c i a l P e r f o r m a n c e

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OverallLife

EvaluationEmotional

HealthPhysical Health

Healthy Behavior

Work Environment Basic Access

% at Optimal Income

Caterpillar 68.4 60.9 76.4 78.1 62.6 46.9 85.5 41.7%BU #16 68.6 61.6 75.5 76.8 65.2 46.4 86.2 51.8%BU #17 68.6 59.6 76.3 80.3 66.4 44.4 84.8 41.6%BU #18 68.1 59.9 77.9 78.9 61.5 45.3 85.0 40.8%BU #19 67.8 58.0 75.7 78.1 63.9 43.4 87.7 57.2%BU #20 66.3 58.3 74.7 76.4 59.2 46.0 83.3 31.7%BU #21 66.2 52.4 75.0 76.9 61.1 45.4 86.5 37.9%BU #22 65.8 59.1 76.4 75.8 53.4 45.6 84.2 28.4%BU #23 65.7 57.3 73.9 76.8 61.7 40.1 84.2 36.6%BU #24 65.5 56.8 76.3 76.7 56.8 43.2 83.4 28.3%BU #25 64.5 52.5 73.0 75.3 60.2 42.4 83.8 26.8%

Well-Being Assessment Results by Business Unit

TOP QUINTILE 2ND QUINTILE 3rd QUINTILE 4TH QUINTILE 5TH QUINTILE

High Well-Being BUsvs.

Low Well-Being BUs+ 84% Better Performance


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E x p a n d e d V a l u e P r o p o s i t i o n

ImproveWell-Being

Adopt or maintainhealthy behaviors

Reduce health-related risks

Optimize care for health conditions and disease

IncreasePerformance

• Productivity

• Engagement

• Absence

• Work Impairment

Reduce Total Medical Cost

• Hospitalizations

• Event Rates

• Disease Rates

• Lifestyle Risks

Increase Total Economic Value

• States

• Communities

• Sponsors

• Individuals

Prevent or delay next new case of disease or conditionPrevent or reduce impact of the next new episode of careEnhance one’s ability to actively manage their well-being

Economic Drivers

Proprietary Healthways Construct

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L i n c o l n I n d u s t r i e sA C u l t u r e o f W e l l - B e i n g f o r t h e W h o l e P e r s o n

• Vertically integrated manufacturer of metal finishing-intensive parts

• 600 employees• 15% revenue growth rate per year

sustained for 15 years• “50 Best Small and Medium Companies

to Work For” for five years in a row• Culture of caring for people and

innovative wellness program

4 “levels” of participation Each level is based on seven criteria:

• Tobacco use, quarterly checks (blood pressure, flexibility, body fat), participation in wellness events, health information update, health risk appraisal, blood profile, behavior based safety participation and work behavior

Highest level are eligible for a company-paid trip to climb a 14,000 foot mountain

• Last year 77 made the climb

Four dedicated wellness resourcesFocus on “Wellness for the Whole Person” based on six domains (shown left)Numerous program components including free pedometers, tobacco free campus, onsite tobacco cessation, health education seminars, gym reimbursements, annual “poker walk”, “brain ‘n pain challenge”, etc.

Program Elements

Intellectual

Physical

Spiritual

Social

Occupational

Emotional

Wellness for the Whole Person:

Company “Wellness Wheel”

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W e l l - B e i n g C u l t u r e I m p a c tE x c e p t i o n a l P e r f o r m a n c e o n A l l D i m e n s i o n s

• Since 2000, tobacco use has gone from 77% to 23%• The industry average of health care costs per person is almost $10,000; for

Lincoln Industries, it is just over $3,500 per person• In 2003, workers compensation costs were over $500,000; in 2006, these

costs were less than $50,000

69.1

66.4

72.2

62 64 66 68 70 72 74

Nation

Local City

Company

Well-Being Assessment: Gallup-Healthways Well-Being Index

58.8

48.6

65.1

Nation

Local City

Company

60.5

58.2

60.9

Nation

Local City

Company

80.6

78.5

82.4

Nation

Local City

Company

48.7

49.6

57.2

Nation

Local City

Company

81.6

78.3

82.5

Nation

Local City

Company

84.1

84.8

85.4

Nation

Local City

Company

Life Evaluation Healthy Behavior

Emotional Health Work Environment

Physical Health Basic Access

Participation rate = 87%

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T h e L i n c o l n I n d u s t r i e s S t o r y

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Note: Shaded estimates reflect significant difference at the 0.05 level.*Means were simultaneously estimated for each of the variables shown in the table.

Lincoln Industries Employee

Number % Physical Health

Mental & Environmental

HealthHealth

BehaviorBasic

Access

Mean* Mean* Mean* Mean*

Yes 422 25 79.4 80.8 61.7 84.4

No 1,276 75 76.5 77.2 56.0 83.4

Four well-being domains according to company and selected demographic variables, 100 point scale, 2009


H O W W I L L P R O G R A M M I N G C H A N G E B A S E D O N T H E K N O W L E D G E G A I N E D ?

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W e C a n ’ t R e l y o n t h e S t a t u s Q u o

• Worksite health programs have been in existence for about 40 years• There is evidence that these programs can generate an ROI• However, penetration and sustained engagement have been lacking

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Insanity: doing the same thing over and over again and expecting different results - Albert Einstein

The Result?• 67% of American adults overweight or obese• 60% do not exercise• 83% report high to moderate levels of stress• 21% still smoke• 56% have at least one chronic illness

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The Best Science Behavioral Change

Social Networks• A social structure of “nodes” which are connected by

one or more specific types of interdependency, such as friendship, kinship, common interest, knowledge, etc.

Decision Making

Behavioral Economics

Mindfulness

Social Connectivity

Prochaska’s Transtheoretical Model • Rational decision-making through stages of change• Leveraging of learning style, decisional balance, and other techniques

Neuro-plasticity and other approaches• Paying attention in a particular way: on purpose, in the

present moment, and non-judgmentally• The changing of neurons via new experiences• Archetyping

Predictably irrational decision making in humans• Dynamic intermittent reinforcement• Hyperbolic discounting• Stimulating pleasure centers of the brain

Gamification

Gaming Theory• Fun vs. fulfillment• Appealing to all…Explorer, achiever, socializer, competitor• Small actions

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T h e T h e o r y o f S m a l l A c t i o n s

Source: BJ Fogg, Stanford University

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Small Daily Actions | Conversations | Assessment | Social Engagement

3. Assess & track well-being1. Complete Daily Challenges

2. Share, discuss, celebrate4. Social support & comparison

T h e D a i l y C h a l l e n g e – B y M e Yo u H e a l t h

www.dailychallenge.com MeYou Health is a wholly owned subsidiary of Healthways

http://www.dailychallenge.com/

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M a k e i t F u l f i l l i n g – “ G a m i f i c a t i o n ”

Adapted from Dr. Richard Bartle

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M a k e i t S o c i a l• Social graph

analysis provides breakthrough insights

• Dense social ties drive sustained health behavior change

• Facebook integration creates immediate & social context and diffusion

“Dynamics of Smoking Cessation,” - Christakis & Fowler

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M a k e i t G r o w

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Daily Challenge members invite their friends to form therapeutic communities

Friend connections

drive adherence

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M a k e i t R e a l i s t i c

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The likely impact of one person reducing their soft drink consumption over time?• They lose weight • Their overweight friends may lose

weight• Their normal weight friends will be less

likely to gain weight

Now, imagine if 100,000 people do it?

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M a k e i t A c c e s s i b l e A n y w h e r e

Smart Phones and Mobile Devices


F I N A L T H O U G H T S

Health & Medicine

March Webinar: One Million Data Points: The Link Between Well-Being, Optimal Wellness Outcomes, and Business Performance