Special Issue July 2013: HERO Think Tank Meeting Summary

HERO Think Tank Convening and collaborating for a healthy today, and tomorrow  

Our first HERO Think Tank meeting of 2013 took place in February in Atlanta, Ga. Thank you to everyone who attended for contributing your time and insights to this compelling dialogue. The discussion was lively, covering the following topics: behavior modification strategies, building a healthy and high-performing workforce, the legal and political landscape surrounding health care today, building culture through organizational change, and current employee health management research.

In this special edition of HERO on Health, we’ve captured the highlights from the Think Tank meeting, along with commentary about relevant HERO programs and initiatives.

The HERO committees that are leading these initiatives are all made up of volunteers. And, while it takes a significant investment of time and energy to move the industry forward, HERO committee members and Think Tank members share an extreme level of passion and commitment to our organization and to health management as a scientific discipline. HERO brings this passion, talent and knowledge together to learn, discuss and provide health management research and guidance that benefits businesses.

The next HERO Think Tank will take place on September 23 in Orlando, Fla., prior to the start of the 2013 HERO Forum. To learn more about the Think Tank and how you can become a member, visit us online at www.the-hero.org.   In the meantime, take a few minutes to read the following summary of the discussion sessions that took place at the February Think Tank meeting.

Looking into the future

The concept of employee health has typically been viewed as a benefits function within the corporate organizational structure, with employers looking only at employee health as a measure of claims costs. However, participants at our February Think Tank agreed that there is a much-needed paradigm shift underway when it comes to employee health. What the future holds for sure, no one knows; but here’s a summary of what Think Tank participants envision as the future of employee health.

·         Employee health may move from the benefits department in many corporations to the human resources function. This change signals a deeper understanding by executive leaders of the connection between employee health and corporate performance, including productivity and talent management. Employers who understand the important role that health management can play in their corporation will also care about creating an optimal work environment, promoting “whole person health” for their employees, and encouraging employee engagement in both their workplace health program and in their local community.

·         Employers who opt out of offering health coverage and send their employees to the health insurance exchanges or opt for a defined contribution model will still remain responsible for generating a high performance workforce. This could generate greater concern and attention to prevention (employee health management) in the workplace, rather than treatment (providing health insurance).

·         Employers and individual wellness program participants will have access to increasingly large amounts of data on health care cost and quality, along with information about preventive services and treatment options that will prolong their good health and help them manage chronic conditions.

·         Health care costs will continue to rise, while individuals will assume more risk and more of the cost burden. The way in which companies communicate with their workforce will change in response to the aging workforce and the growing consumer reliance on mobile technology and communications.

What might these changes mean to employers who offer employee health management programs and to the industry that supports them? Think Tank participants envisioned the following as potential future characteristics of employee health management:

·         As individuals become more fiscally responsible for their health, they will become more engaged in preserving their good health or improving their health status. Employee health management programs will, in turn, become more comprehensive to meet the broader health needs of their workforce and to extend the wellness initiative to spouses and dependents.

·         Health management programs will become more closely tied to the community as large employers and employer-led coalitions become engaged in improving the health of their communities and their employees in an interconnected fashion. This could lead to more community-based models of employee health management programs that apply the best practices used in the workplace but that are driven by community volunteers and employees.

·         As employers shift their benefits programs to align more closely with the health insurance exchanges and the broader implementation of health reform, employers may start to offer more onsite services, such as onsite clinics, coaches and case managers, to support the health needs of their workforce and to ensure that employees continue to focus on achieving and maintaining good health and optimal performance.

The HERO Connection

Several recently formed HERO committees and initiatives have been developed to explore opportunities to be in front of these trends. In particular, the Health Performance and Productivity Study Committee was launched late last year and is being chaired by Jack Groppel of Health & Wellness, a Johnson & Johnson Company and Josh Glynn of Google. This committee is currently working on a public commentary studying the connection between employee health and workplace performance and productivity. HERO also recently established the Employer- Community Collaboration Study Committee, which is being chaired by Cathy Baase of Dow Chemical and Nico Pronk of HealthPartners. This committee is charged to explore and document the reasons why employers may want to play active roles in community health initiatives.

Influencing culture through organizational change

A healthy workplace culture is at the core of a successful employee health management program. Research and best practice case studies show that when health is part of the corporate value system and woven into every fiber of the organization—from senior leaders to key influencers and front line employees—healthy behaviors become the norm.

It’s important for employers to be transparent about their health goals and their commitment to improving the health of their workforce. Honesty and transparency with employees will foster greater trust, and transparency at all stages and levels of employment—including during the hiring and recruiting process—will ensure that the values of your employees align with the value of your organization.

When it comes to the skills, resources and tools that are needed to support a culture of health, Think Tank participants identified the following as key elements:

·         Assessment tool, like one of the following, to help understand the current climate and identify gaps:

o   Survey

o   Focus group

o   HERO Scorecard

o   Qualitative information

·         Resources that appeal to all employees and leadership

·         Policies and practices that support healthy choices and whole person health

·         Communication methods that reach all internal audiences

·         Consistent flow of communications through a variety of channels

·         Shared responsibility and alignment of personal values with corporate values

·         Wellness champion network

·         Connection between the employee health management program and the benefits team

·         Financial resources to support wellness initiatives

The HERO Connection

To keep the topic of culture in the forefront of our efforts, HERO has created a new member-led committee called the Culture of Health Study Committee, which is being chaired by Ralph Colao of Viridian Health Management, Peg Fenner-Gulledge of American Water Company, and Katherine Meachum of HealthFitness. 

The Culture of Health Study Committee is investigating the how and why of developing an organizational culture that supports the improvement of employees’ health as an important strategic element in a business’s plan.

What matters most? From the Provider and Employer Perspectives

A special breakout session was convened during the Think Tank Roundtable to identify topics that are most important to employers and to providers of employee health management programs and services.

Issues or concepts that are top of mind for wellness providers:

·         Connecting community health to workplace health

·         Redefining and measuring return on investment (ROI) vs. value on investment (VOI), and measuring improved health and performance at the individual and organizational levels

·         Encouraging health care providers (medical students) to understand behavior change and population health

·         Moving away from a focus on programs (which imply a start and finish) toward a focus on population health and sustainability

Issues or concepts that are top of mind for employers:

·         How will PPACA affect wellness programs and what opportunities could it present?

·         If alternative standards can’t be outcomes-based (i.e., must be participation based), some companies would get out.

·         Sustainability of programs and results.

·         Continued focus on measurement: value to the company and to the individual

·         How defined contribution plans will affect health management programs

·         VOI and ROI focus: how do we prove this?

·         Extending effectiveness into the community

·         Retirees and dependents

·         Engagement and sustainability

·         Vendor alignment and matching the right vendors to the style and culture of the company

·         Building trust and relationships between employees and employers

The HERO Connection

HERO is heavily involved in a collaborative effort with the Care Continuum Alliance (CCA) to establish a common set of metrics for employee health management programs. Approximately 70 individuals, members of HERO and CCA are working together to identify a set of common success metrics for the health management industry. The work of these committed experts is divided into seven domains: Value on Investment, Financial Outcomes, Health and Productivity, Health Impact, Participation, Satisfaction, and Organizational Support. The release of the recommended core metrics is planned for fall of 2013.

Creating a high-performance workplace

During this Think Tank session, participants discussed several aspects of creating and maintaining a high-performance workplace. As a starting point, the groups defined the difference between performance and productivity. Overall, participants agreed that performance and productivity are both measurable components within the corporate environment. However, while one (productivity) measures output and quantity, the other (performance) measures the process and the end product, or quality.

Both performance and productivity can be measured at the corporate and individual level, and both are influenced by multiple variables, such as company culture, pride in the brand, the specific output or product being produced, and the workplace culture. The two concepts are inextricably connected and feed each other, with optimal performance generating a better end product or higher output, and contributing to a company’s ability to compete at a global level.

Once the parameters of productivity and performance have been defined, as an industry we need to consider how these concepts can be consistently measured.

Think Tank participants identified the following factors as important when measuring productivity and performance:

·         Focus on unique goals of the corporation, the department and the individual. Employ a 360-degree review process on an annual basis, and incorporate both qualitative and quantitative measures.

·         Measure concrete outcomes, such as sales, production, ability to meet deadlines and budget targets, and client satisfaction rating.

·         Keep in mind that how productivity and performance are measured will vary between public, private, and government sectors

·         Consider ways to measure performance for knowledge-based workers whose productivity can be otherwise difficult to measure. Consider evaluating things like number of new ideas generated, programs or ideas implemented, manuscripts published, presentations delivered, partnerships formed, or technical assistance provided.

·         For academic environments, consider measurements such as student ratings of teachers, or for research institutions evaluate grant funding acquired or manuscripts published.

Regardless of what elements are measured and how they’re measured, the outcomes of a specific individual need to connect to their workgroup, which needs to connect to the business unit and up through the organization. To understand how health influences productivity and performance, employers need to identify a correlation between employee health status or change in employee health status and performance and productivity outcomes.

Which came first: the chicken or the egg?
Think Tank participants pondered a similar question when asked to discuss which is more important: performance or productivity. The response was a resounding, “It depends.”

At a high level, participants agreed that performance and productivity are equally important, and that the degree to which they are weighted depends on the goals of the individual organization. For example, are worker’s compensation claims and medical costs out of control, or is customer service or product quality suffering because of malaise?

With that said, more work has been done across the health management industry to document the impact of poor health on productivity, whereas little is known about the impact of health improvement on performance. There is also a tendency among employers to focus on the pain points (a.k.a., loss of performance) and the factors that contribute to this situation, rather than to focus on what’s driving positive trends in the organization that are creating a higher performing workforce.

If measuring performance and productivity varies from industry to industry and company to company, can we safely say where health falls in the hierarchy of factors that influence performance and productivity? And what are the other key factors to be considered?

Based on the Think Tank discussion groups, some of the key factors that influence productivity and performance are:

·         Strategy

·         Leadership

·         Continuous improvement

·         Physical work environment and supportive culture

·         Corporate vision

·         Compensation

·         Employee recognition

·         Sense of individual purpose

·         Training and professional development

·         Supportive culture

·         Stress level

·         Job stability and predictability

·         Personal happiness

·         Freedom to make decisions on the job

·         Accountability

·         Alignment of values of company and the values of the employees

·         Appropriate resources and tools to do one's job

·         Employee feeling valued

·         Comprehensive and consistent communication

·         Treating employees with respect

Health exists as an overarching factor that helps sustain long-term performance. Health is about wellbeing, not just the absence of disease, and for this reason, Think Tank participants felt that health is high on the list of factors that influence performance and productivity.

These topics and others bear continued discussion and scrutiny by the HERO Think Tank membership. As thought leaders in health management and business come together to consider these important issues, a clear agenda for further research and identification of best practices emerges. Then, our task will be to do the research and broadly share uncovered best practices to help make America healthy.

We invite all members of the HERO Think Tank to attend our next scheduled meeting, Monday, September 23, from 2:00 to 5:30 p.m., at the Disneyworld Hilton Hotel in Orlando, Florida, as we convene to consider these and other important issues of the day in health management.

HERO Think Tank Convening and collaborating for a healthy today, and tomorrow

 

Our first HERO Think Tank meeting of 2013 took place in February in Atlanta, Ga. Thank you to everyone who attended for contributing your time and insights to this compelling dialogue. The discussion was lively, covering the following topics: behavior modification strategies, building a healthy and high-performing workforce, the legal and political landscape surrounding health care today, building culture through organizational change, and current employee health management research.

In this special edition of HERO on Health, we've captured the highlights from the Think Tank meeting, along with commentary about relevant HERO programs and initiatives.

The HERO committees that are leading these initiatives are all made up of volunteers. And, while it takes a significant investment of time and energy to move the industry forward, HERO committee members and Think Tank members share an extreme level of passion and commitment to our organization and to health management as a scientific discipline. HERO brings this passion, talent and knowledge together to learn, discuss and provide health management research and guidance that benefits businesses.

The next HERO Think Tank will take place on September 23 in Orlando, Fla., prior to the start of the 2013 HERO Forum. To learn more about the Think Tank and how you can become a member, visit us online at www.the-hero.org.  In the meantime, take a few minutes to read the following summary of the discussion sessions that took place at the February Think Tank meeting.

Looking into the future

The concept of employee health has typically been viewed as a benefits function within the corporate organizational structure, with employers looking only at employee health as a measure of claims costs. However, participants at our February Think Tank agreed that there is a much-needed paradigm shift underway when it comes to employee health. What the future holds for sure, no one knows; but here’s a summary of what Think Tank participants envision as the future of employee health.
 
·        Employee health may move from the benefits department in many corporations to the human resources function. This change signals a deeper understanding by executive leaders of the connection between employee health and corporate performance, including productivity and talent management. Employers who understand the important role that health management can play in their corporation will also care about creating an optimal work environment, promoting “whole person health” for their employees, and encouraging employee engagement in both their workplace health program and in their local community.

 

·        Employers who opt out of offering health coverage and send their employees to the health insurance exchanges or opt for a defined contribution model will still remain responsible for generating a high performance workforce. This could generate greater concern and attention to prevention (employee health management) in the workplace, rather than treatment (providing health insurance).

 ·        Employers and individual wellness program participants will have access to increasingly large amounts of data on health care cost and quality, along with information about preventive services and treatment options that will prolong their good health and help them manage chronic conditions.

·        Health care costs will continue to rise, while individuals will assume more risk and more of the cost burden. The way in which companies communicate with their workforce will change in response to the aging workforce and the growing consumer reliance on mobile technology and communications.

What might these changes mean to employers who offer employee health management programs and to the industry that supports them? Think Tank participants envisioned the following as potential future characteristics of employee health management:

·        As individuals become more fiscally responsible for their health, they will become more engaged in preserving their good health or improving their health status. Employee health management programs will, in turn, become more comprehensive to meet the broader health needs of their workforce and to extend the wellness initiative to spouses and dependents.

·        Health management programs will become more closely tied to the community as large employers and employer-led coalitions become engaged in improving the health of their communities and their employees in an interconnected fashion. This could lead to more community-based models of employee health management programs that apply the best practices used in the workplace but that are driven by community volunteers and employees.

·        As employers shift their benefits programs to align more closely with the health insurance exchanges and the broader implementation of health reform, employers may start to offer more onsite services, such as onsite clinics, coaches and case managers, to support the health needs of their workforce and to ensure that employees continue to focus on achieving and maintaining good health and optimal performance.

The HERO Connection

Several recently formed HERO committees and initiatives have been developed to explore opportunities to be in front of these trends. In particular, the Health Performance and Productivity Study Committee was launched late last year and is being chaired by Jack Groppel of Health & Wellness, a Johnson & Johnson Company and Josh Glynn of Google. This committee is currently working on a public commentary studying the connection between employee health and workplace performance and productivity. HERO also recently established the Employer- Community Collaboration Study Committee, which is being chaired by Cathy Baase of Dow Chemical and Nico Pronk of HealthPartners. This committee is charged to explore and document the reasons why employers may want to play active roles in community health initiatives.

 

Influencing culture through organizational change

A healthy workplace culture is at the core of a successful employee health management program. Research and best practice case studies show that when health is part of the corporate value system and woven into every fiber of the organization—from senior leaders to key influencers and front line employees—healthy behaviors become the norm.

It’s important for employers to be transparent about their health goals and their commitment to improving the health of their workforce. Honesty and transparency with employees will foster greater trust, and transparency at all stages and levels of employment—including during the hiring and recruiting process—will ensure that the values of your employees align with the value of your organization.

When it comes to the skills, resources and tools that are needed to support a culture of health, Think Tank participants identified the following as key elements:

·         Assessment tool, like one of the following, to help understand the current climate and identify gaps:

o   Survey

o   Focus group

o   HERO Scorecard

o   Qualitative information

·         Resources that appeal to all employees and leadership

·         Policies and practices that support healthy choices and whole person health

·         Communication methods that reach all internal audiences

·         Consistent flow of communications through a variety of channels

·         Shared responsibility and alignment of personal values with corporate values

·         Wellness champion network

·         Connection between the employee health management program and the benefits team

·         Financial resources to support wellness initiatives

The HERO Connection

To keep the topic of culture in the forefront of our efforts, HERO has created a new member-led committee called the Culture of Health Study Committee, which is being chaired by Ralph Colao of Viridian Health Management, Peg Fenner-Gulledge of American Water Company, and Katherine Meachum of HealthFitness. 

The Culture of Health Study Committee is investigating the how and why of developing an organizational culture that supports the improvement of employees’ health as an important strategic element in a business’s plan.

What matters most? From the Provider and Employer Perspectives

A special breakout session was convened during the Think Tank Roundtable to identify topics that are most important to employers and to providers of employee health management programs and services.

Issues or concepts that are top of mind for wellness providers:

·         Connecting community health to workplace health

·         Redefining and measuring return on investment (ROI) vs. value on investment (VOI), and measuring improved health and performance at the individual and organizational levels

·         Encouraging health care providers (medical students) to understand behavior change and population health

·         Moving away from a focus on programs (which imply a start and finish) toward a focus on population health and sustainability

Issues or concepts that are top of mind for employers:

·         How will PPACA affect wellness programs and what opportunities could it present?

·         If alternative standards can’t be outcomes-based (i.e., must be participation based), some companies would get out.

·         Sustainability of programs and results.

·         Continued focus on measurement: value to the company and to the individual

·         How defined contribution plans will affect health management programs

·         VOI and ROI focus: how do we prove this?

·         Extending effectiveness into the community

·         Retirees and dependents

·         Engagement and sustainability

·         Vendor alignment and matching the right vendors to the style and culture of the company

·         Building trust and relationships between employees and employers

The HERO Connection

HERO is heavily involved in a collaborative effort with the Care Continuum Alliance (CCA) to establish a common set of metrics for employee health management programs. Approximately 70 individuals, members of HERO and CCA are working together to identify a set of common success metrics for the health management industry. The work of these committed experts is divided into seven domains: Value on Investment, Financial Outcomes, Health and Productivity, Health Impact, Participation, Satisfaction, and Organizational Support. The release of the recommended core metrics is planned for fall of 2013.

 

Creating a high-performance workplace

During this Think Tank session, participants discussed several aspects of creating and maintaining a high-performance workplace. As a starting point, the groups defined the difference between performance and productivity. Overall, participants agreed that performance and productivity are both measurable components within the corporate environment. However, while one (productivity) measures output and quantity, the other (performance) measures the process and the end product, or quality.

Both performance and productivity can be measured at the corporate and individual level, and both are influenced by multiple variables, such as company culture, pride in the brand, the specific output or product being produced, and the workplace culture. The two concepts are inextricably connected and feed each other, with optimal performance generating a better end product or higher output, and contributing to a company’s ability to compete at a global level.

Once the parameters of productivity and performance have been defined, as an industry we need to consider how these concepts can be consistently measured.

Think Tank participants identified the following factors as important when measuring productivity and performance:

·         Focus on unique goals of the corporation, the department and the individual. Employ a 360-degree review process on an annual basis, and incorporate both qualitative and quantitative measures.

·         Measure concrete outcomes, such as sales, production, ability to meet deadlines and budget targets, and client satisfaction rating.

·         Keep in mind that how productivity and performance are measured will vary between public, private, and government sectors

·         Consider ways to measure performance for knowledge-based workers whose productivity can be otherwise difficult to measure. Consider evaluating things like number of new ideas generated, programs or ideas implemented, manuscripts published, presentations delivered, partnerships formed, or technical assistance provided.

·         For academic environments, consider measurements such as student ratings of teachers, or for research institutions evaluate grant funding acquired or manuscripts published.

Regardless of what elements are measured and how they’re measured, the outcomes of a specific individual need to connect to their workgroup, which needs to connect to the business unit and up through the organization. To understand how health influences productivity and performance, employers need to identify a correlation between employee health status or change in employee health status and performance and productivity outcomes.

Which came first: the chicken or the egg? Think Tank participants pondered a similar question when asked to discuss which is more important: performance or productivity. The response was a resounding, “It depends.”

At a high level, participants agreed that performance and productivity are equally important, and that the degree to which they are weighted depends on the goals of the individual organization. For example, are worker’s compensation claims and medical costs out of control, or is customer service or product quality suffering because of malaise?

With that said, more work has been done across the health management industry to document the impact of poor health on productivity, whereas little is known about the impact of health improvement on performance. There is also a tendency among employers to focus on the pain points (a.k.a., loss of performance) and the factors that contribute to this situation, rather than to focus on what’s driving positive trends in the organization that are creating a higher performing workforce.

If measuring performance and productivity varies from industry to industry and company to company, can we safely say where health falls in the hierarchy of factors that influence performance and productivity? And what are the other key factors to be considered? 

Based on the Think Tank discussion groups, some of the key factors that influence productivity and performance are:
 

·         Strategy

·         Leadership

·         Continuous improvement

·         Physical work environment and supportive culture

·         Corporate vision

·         Compensation

·         Employee recognition

·         Sense of individual purpose

·         Training and professional development

·         Supportive culture

·         Stress level

·         Job stability and predictability

·         Personal happiness

·         Freedom to make decisions on the job

·         Accountability

·         Alignment of values of company and the values of the employees

·         Appropriate resources and tools to do one's job

·         Employee feeling valued

·         Comprehensive and consistent communication

·         Treating employees with respect

Health exists as an overarching factor that helps sustain long-term performance. Health is about wellbeing, not just the absence of disease, and for this reason, Think Tank participants felt that health is high on the list of factors that influence performance and productivity.

These topics and others bear continued discussion and scrutiny by the HERO Think Tank membership. As thought leaders in health management and business come together to consider these important issues, a clear agenda for further research and identification of best practices emerges. Then, our task will be to do the research and broadly share uncovered best practices to help make America healthy.

We invite all members of the HERO Think Tank to attend our next scheduled meeting, Monday, September 23, from 2:00 to 5:30 p.m., at the Disneyworld Hilton Hotel in Orlando, Florida, as we convene to consider these and other important issues of the day in health management.