INDUSTRY VOICES
Is All the Chatter Mostly Missing the Point?
If you were only tuned in to daily media
during the last six months and had no experience with employee health
management programs, your view of these efforts that consumer media often refer
to as wellness programs, would likely be skewed. That’s because a few pundits
have emerged who in some cases seem hell-bent on discrediting the employee
health management industry.
At the same time, the Rand study on the
effectiveness of worksite wellness programs was released, with the authors
reporting that there is a limited return on investment (ROI) in terms of
medical cost savings for employee health management programs. In spite of the
Rand study having many limitations that have now been well documented, the
press ran with a distorted view of the findings and the pundits jumped on the
bandwagon. Employee health management was even positioned as just another
problematic component of Obamacare, as if the passage of health reform in 2010
was the first time well-being initiatives at the work site ever existed.
One of the most ironic parts of all the
recent chatter is that what is being debated is only one small component of the
story. Even if the Rand researchers and the pundits were right, it would almost
be irrelevant. While there is plenty of data that suggests that well-designed
programs can impact the cost of health care to the extent that an ROI can be
achieved, health care savings is only one focal point of health management programs.
There are many other reasons employers provide employee health management programs,
all of which can deliver business value.
There is a reason most employers are
not changing course with respect to their wellness programs, in spite of all
the chatter by the pundits. It is because they see their employee health
management initiatives bringing value to their people and the performance of
their companies in a multitude of ways, many of which extend far beyond the
impact on reducing healthcare costs. Here are five reasons why employers are
ignoring the chatter:
- Higher employee well-being is correlated with better job performance, higher employee engagement, team effectiveness, leadership effectiveness and even better business unit financial performance. So, for many companies, having “well” employees is valued because of its impact on the top and bottom line, rather than solely on healthcare spending.
- Employees who are well drive workplace effectiveness by turning over less, being highly present while at work and serving customers more effectively. High performance equates to far greater economic value than healthcare cost reduction alone.
- Wellness initiatives help create a more productive culture, where people care about each other and do their best work.
- Employee health management is simply the right thing to do. Consider this: Why do companies pay for a majority of the healthcare cost for their people? Is it because of the stellar ROI they realize when an employee has bypass surgery? Hardly. A bypass surgery is pure cost, but because we value people, we give them opportunities to optimize their health, whether through medical treatment or wellness initiatives.
- There is an undeniable amount of data that demonstrates people who have healthy lifestyles are more likely to avoid or delay chronic illness. On average, healthy people are more productive and cost less to employ. So, even if it’s difficult to unequivocally demonstrate an ROI from reduction in healthcare spending, common sense suggests that employee health management is worth the effort.
With all of this said, we can learn
some things from the chatter. First, too many people both inside and outside
the wellness industry has emphasized the ROI of employee health management based
on health care cost savings. At the same time, we’ve underemphasized the total
value employee health management generates. It’s time we focus on the bigger value
picture.
Second, there is a continual need to
produce high-quality research in our field that demonstrates the total value of
employee health management. Finally, employee health management may have
reached a level of maturity as an industry to benefit from a national public
relations effort.
We will be vulnerable to the pundits
and the press if we don’t get out front on effectively and appropriately communicating
our message that employee health management can bring incredible value to
employees and employers alike. This is a
case where the facts tell a powerful, positive story. At HERO, we are committed
to doing research and identifying best practices that will help employers in
their efforts to improve the health and well-being of their workforce.
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| John Harris Chairman of HERO Board of Directors |
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| Jerry Noyce CEO, HERO |
PROGRAM SPOTLIGHT
HERO Interview with University of Michigan
For this issue of HERO On Health, we interviewed LaVaughn
Palma-Davis, senior director of human resources in charge of health and
wellness at the University of Michigan, and Robert Winfield, the chief health
officer for the university, about the University’s award-winning employee
health management program, MHealthy.
MHealthy was launched in 2009 as
part of a five-year plan to improve health at the University of Michigan, which
is comprised of four campuses and approximately 40,000 employees. The MHealthy
program was developed based on the input of a cross-sectional group of
employees from many different University departments in both the Health System
and academic units. The goal is to create a “community of health” at the
University, and Palma-Davis and team are well on their way to achieving this.
The University offers MHealthy
to employees and spouses. The program features, among other things: an annual
health assessment, onsite wellness screenings and flu shots, counseling and
coaching services, numerous physical activity programs offered throughout
campus buildings, weight management, stress management, smoking cessation and
healthy eating programs, as well as online competitions using personal
trackers. Palma-Davis and her team have established a wellness champion network
of more than 360 champions across all campus locations, who work to promote the
program, educate employees about the University’s commitment to health, and reinforce
the culture of health. HERO ON Health
asked Palma-Davis and Winfield about what drives the MHealthy program and about
their success.
HERO: What have been the keys to your success in
creating an effective employee health management program?
The success of MHealthy can be attributed largely to the support
the program receives from the highest levels of the University. Our leadership,
including our president and the senior executive officers fully endorsed the
program and have committed to adequately funding it. This was particularly
crucial in the early stages, because it allowed us to allocate the resources needed
to get the program off the ground. Now, it allows us to build on the momentum
we’ve generated with ongoing enhancements to the program.
Another essential element to our approach was gaining
broad-scale engagement in our long-term strategic plan, across departments and throughout
the University community. The fact that we had such broad support and that we
had packaged the plan as a five-year minimum commitment, made it easier for our
leadership to get behind and support our efforts. We convened a
multidisciplinary committee of faculty and staff and conducted a benchmark
analysis using the HERO Scorecard of the essential elements we needed in our
program, what the status of those elements was across our campuses, what gaps
existed, what we could do to address those gaps, and what the timeline and
priorities were. Faculty members participated in this, helped us think through
each aspect, and blessed the findings and our recommendations for program
implementation.
Effective marketing and communications has been another
significant factor for MHealthy. We’ve learned as we’ve progressed through the
last few years just how critical it is to engage your entire population. This
is especially important when you have a large, diverse population in multiple
locations. As a result, we’ve made sure that we’re everywhere, in every channel
you can think of when communicating with employees. This has been key to informing
people about the goals we hope to collectively achieve, what’s available to
help them, and how to participate.
And, finally, the lynchpin to all of this is the network of
unit-based champions across the organization. This network of close to 400 volunteers
serve as wellness advocates in their respective units. They are the ones who are
truly changing our culture and sustaining the positive momentum we’ve
generated. In some ways, the champions are more effective than other
communication tools because they can’t be deleted or ignored. At the end of the
day, a good champion can make a huge difference.
HERO: When you look at your program, what results
or outcomes do you feel are the most significant?
Early on, we set specific evaluation goals, which was very
helpful. We knew we needed to measure things like participation, satisfaction,
risk reduction, absenteeism and medical costs. We’re just finishing our fifth
program year, so our analysis is not complete. However, we do look every year
at the data and can see that all of our metrics are trending in the right
direction.
Our participation increases every year and we’re approaching a
60 percent participation rate, with a very modest incentive of $100. We know
that participation and satisfaction are early keys to how you’re doing, because
if people aren’t taking part and aren’t happy, then you have a problem. When it
comes to satisfaction, on a scale of 1 to 5, our employees consistently rank
their satisfaction in the 4.5 range every year.
We’re also very proud of the fact that our risk reduction is trending
in the right direction and that we’ve already exceeded our goal of increasing
the number of people at low risk by 5 percent by year five. We’ve also
decreased the number of people at high and moderate risk every year. In
addition, when we examine medical claims costs for nonparticipants vs.
participants over multiple years, we see that claims costs for participants have
consistently been lower than for nonparticipants, even though both groups
started out at the same cost level prior to program implementation. These
changes are all statistically significant.
In addition to these specific measures, we also are applying the
socio-ecological model to our program design. In this model, we evaluate the interplay
between the layers of our community, including the individual and their knowledge,
attitude and skills; the interpersonal relationship between employees, which is
where the champions come in; the organizational structure and environment and
how they influence outcomes; their families; and public policy such as
smoke-free buildings and grounds.
HERO: What lessons or tips can you share with other
companies who strive to improve employee health?
Maintaining an effective employee health management program is
an ongoing effort and a constant learning process. Changes in technology, communication
styles, health needs, medical standards, and executive leadership vision are
emerging every day. That means you have to continually refine your program to
stay relevant to your audience and to the needs of your organization. With that
in mind, here are few specific tips that we’ve gleaned along the way:
1. For real change to
occur in an organization and community, a website alone won’t cut it. You need
to engage all levels of the broader community in how they live and work.
2. Develop a strong
business case. Do your homework around what the best practices are and what
best practice organizations are achieving. Then communicate your business case
and value proposition to your leadership—over and over. And compare your
organization’s investment in wellness to other investments in the organization,
so people understand why it’s important. Talk about value, not ROI.
Organizations don’t talk about the ROI for paying the electricity to keep your
buildings running, so don’t take that narrow approach to justify what health
management programs can contribute to your employees.
3. Don’t promise more
than what you can realistically deliver. For the skeptical executives and employees,
you can put yourself in an awkward spot if you promise a specific ROI or
overstate your potential outcomes.
4. Know your
organization and incorporate organizational values into whatever you’re
striving to achieve. If you introduce something that the organizational culture
doesn’t support, you will likely fail. Design a program that aligns with your
culture and community.
5. Engage your
audience in planning for your program. This ensures early and ongoing buy-in.
6. Culture and
environment are the keys to sustaining improvement over time. Policies around smoking, healthy eating,
healthy beverages, as well as providing leadership training will all sustain
your improvements over time.
7. Offer an adequate incentive to get people involved, but
remember the incentive is not the program. If you offer only a modest incentive
to get people involved, you will have to work harder on culture, communication
and environment to get and keep your employees’ attention.
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| LaVaughn Palma-Davis Sr. Director Health and Well-Being Services University of Michigan SCORECARD COMMENTARY |
HERO Scorecard: A Tool in Guiding Successful Employee Health Management
Programs Stakeholder
and Employee Assessment
To build or expand an employee health program, it is important for
organizations and their leaders to understand their current program. An
organizational assessment can help determine the progress, limitations, and
future strategies and goals for a program. To be most effective, the assessment
should look, not only at current wellness programming, but at the many factors
that affect it: workplace culture, leadership support, environment,
communication methods, employee health benefits and policies, and access to
data to evaluate the program. Ideally, comprehensive employee health management
assessments are done prior to developing new initiatives and then repeated
every two to three years to measure progress as well as identify opportunities
for improvement.
The HERO Employee Health Management Best Practices Scorecard in collaboration with Mercer© (Scorecard) was designed to help organizations gather information about their health management programs as well as to provide them aggregate information to use in benchmarking – on a national, regional, industry and employer size basis. The Scorecard provides an inventory of best practices in employee health management in six areas: strategic planning, leadership engagement, program level management, programs, engagement methods, and measurement and evaluation. As best practices evolve, so does the Scorecard and a significant revision will be released later this year with Version 4.
The HERO Employee Health Management Best Practices Scorecard in collaboration with Mercer© (Scorecard) was designed to help organizations gather information about their health management programs as well as to provide them aggregate information to use in benchmarking – on a national, regional, industry and employer size basis. The Scorecard provides an inventory of best practices in employee health management in six areas: strategic planning, leadership engagement, program level management, programs, engagement methods, and measurement and evaluation. As best practices evolve, so does the Scorecard and a significant revision will be released later this year with Version 4.
The HERO Scorecard and other employee health assessment
instruments emphasize the importance of leadership engagement and employee
involvement. One way to build engagement
among leaders and employees is by actively involving them in the assessment
process. This can be accomplished in a
number of ways, including key stakeholder interviews, focus groups, and
employee surveys. These assessment tools are described below.
Key Stakeholder Interviews
The purpose of the key stakeholder interview is to better understand the link between business operations and employee health and performance, while identifying potential causes of poor health and loss of productivity. Key stakeholders usually include the chief executive officer or president, chief financial officer, and one or more vice presidents. Results from the interviews help to shape a program’s overall mission, goals and strategy. Interview questions usually include gathering information about the organization’s current commitment to, and understanding of, employee health as it relates to business operations; the current participation and involvement in programs from all levels of the organization; an understanding of what success in optimizing employee health looks like and how stakeholders would like it measured; and perceptions of critical health issues. Key findings from the interview should be summarized and reported to the stakeholders and used in strategic planning for the program.
Focus Groups
Employee focus groups can help organizations elicit suggestions for ways that employee health management programs may better meet the needs of employees and their family members. Each focus group is usually composed of an experienced facilitator and six to ten individuals, with enough groups conducted to assure good representation from across the organization. The focus group session will usually last up to one hour. Focus groups can serve as an opportunity to collect information on the health and wellness issues about which employees are concerned, as well as to explore options for the best delivery of programs and services, which may include individual coaching sessions, group classes, online courses, self-guided study programs, books, or brochures. Additionally, key questions include barriers to participation in current program offerings, and methods to help gain additional support for the program. This feedback will help organizations to better design effective communication tools and health improvement opportunities that best meet employee needs and preferences.
Key Stakeholder Interviews
The purpose of the key stakeholder interview is to better understand the link between business operations and employee health and performance, while identifying potential causes of poor health and loss of productivity. Key stakeholders usually include the chief executive officer or president, chief financial officer, and one or more vice presidents. Results from the interviews help to shape a program’s overall mission, goals and strategy. Interview questions usually include gathering information about the organization’s current commitment to, and understanding of, employee health as it relates to business operations; the current participation and involvement in programs from all levels of the organization; an understanding of what success in optimizing employee health looks like and how stakeholders would like it measured; and perceptions of critical health issues. Key findings from the interview should be summarized and reported to the stakeholders and used in strategic planning for the program.
Focus Groups
Employee focus groups can help organizations elicit suggestions for ways that employee health management programs may better meet the needs of employees and their family members. Each focus group is usually composed of an experienced facilitator and six to ten individuals, with enough groups conducted to assure good representation from across the organization. The focus group session will usually last up to one hour. Focus groups can serve as an opportunity to collect information on the health and wellness issues about which employees are concerned, as well as to explore options for the best delivery of programs and services, which may include individual coaching sessions, group classes, online courses, self-guided study programs, books, or brochures. Additionally, key questions include barriers to participation in current program offerings, and methods to help gain additional support for the program. This feedback will help organizations to better design effective communication tools and health improvement opportunities that best meet employee needs and preferences.
Employee Surveys and Demographic Analysis
To better understand the opportunities for enhancing participation levels, program managers should consider important employee and plan member demographics. Working with the organization’s human resources, finance, and health and safety departments allows an organization to capture data on employees and dependents based on gender, age, educational level, and job role, as well as information on absenteeism due to personal illness, health-care costs, and worker’s compensation costs for the previous three years. This information assists in the design of health and safety interventions
Another aspect of program planning is to explore health
disparities that may exist among people of varying race, ethnicity, gender,
age, income level, and geographic location. In considering the demographic
profile of an organization, there are several significant issues that must be
considered in disseminating information and resources. Health resources must be
provided to address differences in health literacy and be time sensitive to
attract all segments of the workforce. Efforts must also be made to target
health improvement solutions not only for the employee, but also for the
employee’s spouse and family members.
In addition to gathering data from employee surveys, an organization may want to consider gathering health-care cost data. By gathering these data, an organization can identify the most critical health issues for its particular workplace based on the category of disease and cost of medications. Information may include a review of the past three years for health care claims and other health-related information.
In addition to gathering data from employee surveys, an organization may want to consider gathering health-care cost data. By gathering these data, an organization can identify the most critical health issues for its particular workplace based on the category of disease and cost of medications. Information may include a review of the past three years for health care claims and other health-related information.
The majority of the HERO Scorecard respondents – 81% -- have
assessed employee health needs. However,
fewer than half of these assessments included focus groups or employee
surveys. Interestingly, the largest
employers are the least likely to use surveys or focus groups. Among respondents with 5,000 or more
employees, most say they use claims data (73%) and health risk assessments
(87%) to learn about their employees’ health needs, while just 42% use employee
interest surveys or focus groups. Among
employers with fewer than 500 employees, 63% use employee interest surveys or
focus groups; 78% use health risk assessments, but just 39% use claims
analysis.
Although smaller employers may not have the technology platforms
or access to health-related claims information, such as medical claims and disability
data, they have higher rates of participation in employee interest surveys and
focus groups. If they are not already
doing so, larger-sized employers may wish to consider enhancing their current
efforts by incorporating such surveys and focus groups into their assessment
process.
The role of stakeholder and employee assessment in shaping an organization’s employee health goals and strategy, and ultimately in creating a healthy work environment and culture, continues to be a valuable opportunity for all organizations.
The role of stakeholder and employee assessment in shaping an organization’s employee health goals and strategy, and ultimately in creating a healthy work environment and culture, continues to be a valuable opportunity for all organizations.
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| Rebecca K. Kelly, PhD. RD The University of Alabama |
HERO RESEARCH
Biometric Screening Paper Released
The HERO Screenings Study Committee, which is made up of HERO members and representatives from the American College of Occupational & Environmental Medicine and the Care Continuum Alliance, have collaborated to create a paper that provides guidance for employers on how to integrate biometric screenings into their employee wellness programs.
The paper, “Biometric Health Screening for Employers”, was published in the October 2013 issue of the Journal of Occupational & Environmental Medicine.
This is the second paper created by a HERO study committee. The first, “Guidance for a Reasonably Designed, Employer-Sponsored Wellness Program Using Outcomes-Based Incentives,” is also available on the HERO website. Three other HERO study committees have been formed and are at work to produce guidance for employers on important health related topics. These committees include the Health, Performance & Productivity Committee, Creating A Culture of Health Committee, and the Employer-Community Health Collaboration Committee. Watch for updates on work from these committees in future editions of HERO on Health.
HERO Scorecard Research Project
We are pleased to report that the research study, “The Predictive Validity of the HERO Scorecard in Determining Future Healthcare Cost and Risk Trends” has been accepted for publication by the Journal of Occupational and Environmental Medicine. This study authored by Ron Goetzel, the Truven Health Analytics and Emory University research teams, and members of the HERO Research Study Subcommittee, looks at the relationship between actual medical costs and reported health risks for employees of companies that have also completed the HERO Scorecard. Time of publication is yet to be determined.
CEO PLEDGE
CEO Pledge Initiative Escalates Quickly After HERO
Forum
The number of CEO Pledge
signors has grown 50% in the short time since Dr. Jack Groppel announced at the
HERO Forum that Dr. Donna Shalala, President of the University of Miami and
former Secretary of Health and Human Services, had become the 100th
signor. The purpose of the CEO Pledge is
to align America’s decision-making leaders (Organizational CEOs and Presidents)
around the importance of physical activity in the workplace and in their
communities. You can read the pledge, review the list of recommended workplace
strategies, see the list of signors, and sign online at http://drupal.ncppa.org/ceo-pledge .
If you haven't already,
please consider adding your organization's leadership to the impressive list of
signors.
Please contact Tom
Richards, an executive committee member of the National Coalition for Promoting
Physical Activity, with any questions about the CEO Pledge: tgr@ihrsa.org
Jack Groppel, PhD, National Spokesperson
for the CEO Pledge , Co-Founder of the Human Performance Institute, and
Vice President of Applied Science & Performance Training for Johnson &
Johnson’s Wellness & Prevention
HERO NEW THINK TANK MEMBERS
BioIQ
BioIQ is a health improvement technology company that has implemented the industry’s first integrated, customizable and measurable approach to optimizing investments in corporate health and wellness programs. The company’s unique health screening platform, ecosystem of health improvement tools, and proven methodology for obtaining quantifiable wellness insights are serving beneficiaries across the United States. BioIQ works with some of the largest employers and health companies in the nation and has launched over 2,500 successful health improvement programs since its inception in 2005. Learn more at www.BioIQ.com
Covidien
Covidien is a leading global healthcare products company
that creates innovative medical solutions for better patient outcomes and
delivers value through clinical leadership and excellence. Covidien
manufactures, distributes and services a diverse range of industry-leading
products in medical devices and supplies. With 2012 revenue of $9.9 billion, Covidien
has 38,000 employees worldwide in 70 countries, and its products are sold in
over 140 countries. Learn more at www.covidien.com
Hylant
Hylant, a five consecutive year winner of Best Places to
Work in Insurance (2009, 2010, 2011, 2012, and 2013), was founded in 1935 and
is a full-service insurance brokerage with 14 offices in Ohio, Michigan,
Illinois, Indiana, Tennessee, and Florida.
As a member of the Worldwide Broker Network, Hylant offers complete risk
management services, employee benefits brokerage and consultation, employee
health and wellness strategies, loss control, healthcare management and
insurance solutions for businesses and individuals. Hylant is one of the largest privately held
brokerage firms in the United States and serves a wide variety of clients
locally, nationally, and internationally.
Learn more at www.hylant.com.
Keas
Keas is leading the
charge for employee wellness as a business strategy in today’s enterprises. We
believe in the power of social interactions and peer motivation to drive
healthier, happier employee behaviors, and we stand behind the impact of our
solution with the only employee engagement program guarantee in the industry. If you're considering a new corporate
wellness solution, or are thinking about making a change to your current
program, we'd love to discuss how Keas could benefit you! Learn more at www.keas.com
Lockton
Clients across the globe
count on Lockton for risk management, insurance and employee benefits. Our
experts tailor solutions to the unique needs of each company, organization, and
individual just about anywhere. Our long-term relationships with underwriters
around the world allow us to structure and negotiate comprehensive coverage at
the best price possible. Learn more at www.lockton.com
NASM
For more than 20 years,
the National Academy of Sports Medicine (NASM) has set the standard in
certification, continuing education, solutions and tools for health and
fitness, sports performance and sports medicine professionals. NASM has
pioneered evidence-based health and fitness solutions that optimize physical
performance and allow individuals to achieve a variety of fitness activity
goals. Today, NASM serves thousands worldwide and positively impacts the lives
of millions of people the world over. As the world’s foremost resource for
health and fitness information, the organization continues to elevate its
industry best practices by providing outstanding programs and quality
certification courses for its members.
Learn more at www.nasm.org
Performance pH
Performance pH is a progressive strategic advisory firm
that creates measurable business transformation strategies which enable our
customer to balance operational and cultural needs in order to achieve optimal
performance. We focus on human factors
such as well-being, purpose, communications, and work environment. Find the balance. Achieve Optimal Performance. Learn more at www.performph.com.
Shape Up
ShapeUp Inc., the
leading global provider of social networking and incentives-based employee
wellness solutions. Over the past seven
years, we’ve used social networking, gaming, and behavioral economics to
support over 200 employers and health plans around the world in their efforts
to empower their employees and members to become healthier. Through our work,
we’ve helped participants lose over one million pounds of weight, and have fun
while doing it. Learn more at www.shapeup.com
HERO HAPPENINGS
Hero Members – Only Events
The Winter Think Tank
Meeting of the HERO membership is scheduled for February 11-12 in Dallas,
Texas. We will gather at the Hilton DFW
Lakes Executive Conference Center, Grapevine TX.
HERO Forum 2014
Mark your calendars:
The 2014 HERO
Forum will be September 30-October 2 at the San Diego Westin, San Diego
California. Those interested in presenting and sponsorship opportunities at the
2014 HERO Forum please go to the HERO website, www.the-hero.org, beginning December 1st
for information.
