Message from Jerry Noyce
This
edition of HERO on HEALTH features
columns by Shelly Wolff of Towers Watson on health exchanges and Jennifer Flynn
from Mayo Clinic, on understanding the importance of organizational support in
creating a successful health management program. Thank you, Shelly and Jennifer
for sharing your thoughts on these two important subjects.
At the
recent annual HERO Research Meeting for members interested in health management
research, attendees voiced their opinions on what topics were most important to
them. The three most-often cited topics were: engagement, communications,
and value on investment. These
topics and others will be addressed during the 2013 HERO Forum.
It’s
hard to believe that the HERO Forum is just around the corner. We hope you plan
to join us at this year’s gathering, September 24-26, at the Disneyworld Hilton
in Orlando. The packed, three-day agenda includes keynotes by Dr. Kevin Volpp
from the University of Pennsylvania on behavioral economics and health, Dr.
Donald Hensrud of Mayo Clinic on the latest research in treating obesity, and
the duo of Jim Clifton, CEO of Gallup, and Ben Leedle, CEO of Healthways, on
the latest in well-being.
We
will also offer three panel discussions on making the business case for
employee health, workforce health and well-being in 2020, and the latest in
health management research. These sessions—along with workshops on a wide range
of topics—promise to be highly engaging.
I am
happy to report that the work of the HERO membership in collaboration with the
Care Continuum Alliance (CCA) and roughly 40 other organizations that are all focused
on identifying a core set of metrics for employee health management programs,
is entering its final phase. A draft of a document outlining the work group’s
recommendations is being reviewed by both subject matter experts in the field
and other organizations supportive of this effort. Once their edits have been
considered and incorporated into the draft, a period for public comment will be
offered to capture others’ thoughts. A copy of that draft will be posted on
both the HERO and CCA websites in September. You are encouraged to check for
the posting and take advantage of this opportunity to comment. The final
version of the report is tentatively scheduled to be released in late October.
I hope
to see many of you this fall at the Forum,
Jerry
Industry Voices
Health and Wellness – Implications for Health Exchanges
It is a transformational time in health care, for patients, care delivery systems and those who purchase health coverage. As health insurance exchanges usher in a new era of health care purchasing, it drives us to consider what the implications are for wellness programs. Employers who choose to shift from the role of “plan sponsor” to “plan supporter” will need to consider questions like:
What changes will take place when wellness programs are bundled into exchange product offerings?
Will levels of wellness programs be differentiated by plan offerings?
How will state products vary and how will that affect multi-state employers?
Time will tell, of course, but we have learned some lessons from our last 10 years of designing employer-sponsored wellness programs that can help determine whether effective wellness solutions become fundamental to individual products.
For starters, we know that consumers will expect first generation health exchange offerings to deliver services that are efficient and price competitive. Keep in mind that state exchanges will vary significantly based on the viability of the exchanges themselves, and the number of competitive service offerings available in each state.
While it is likely that some form of wellness services will be part of all baseline exchange offerings, how sophisticated and engaging their approaches are will determine how the market reacts. Will these wellness products be based on best practices so they are engaging for individuals, or will they simply be passive tools and services that are ultimately underutilized? If approached in the right manner, the health insurance exchanges represent considerable opportunities for wellness to gain market share that can be scaled, measured and evaluated.
To adopt effective wellness solutions, exchanges will need to consider the following:
Wellness programs provide the opportunity to drive engagement to broader care management, advocacy.
Wellness programs for active participants will need to leverage technology, innovative service features such as mobile apps, social networks and challenges to drive more engagement by younger segments of the population.
Incentives will be continue to be useful in driving engagement.
Fitness will be core to any program offering.
Price will matter. Buy-ups for wellness apps or programs will need to be integrated with mobile health plan programs, and will need to be consumer centric to adequately compete with commercially free products that consumers may already have.
Chronic care management and advocacy will have a role for older actives and pre-65 participants.
Education will be a key factor in the success of the exchanges because, at least initially, there will be widespread confusion about how the exchanges work, available products, how high-deductible health plans work, state availability, network availability (Kaiser in some states, not others), how to participate in programs, how to earn incentives, how deductibles work, and much more. Fortunately, we’ve learned much from the last decade of employer-sponsored wellness programs that can help, including:
One-size-fits-all wellness programs don’t work — customization by work culture and individual employer is necessary to ensure success.
Senior leadership involvement is needed to align corporate priorities to health priorities; simply outsourcing programs with no company linkage makes success less likely.
Ongoing communication in a variety of forms and formats is necessary to reach a wide range of audiences.
Programs need to be diverse, comprehensive and continuously updated in order to be effective in a diverse employee population.
Effective incentives that drive intrinsic vs. extrinsic motivation are not delivered by cash alone.
Consumer protections and strong oversight are necessary to ensure that access and the ability to improve health are available to all eligible employees.
Simple messaging about changes in benefits, regulations, limits, etc., is essential.
Health exchanges may prove to be a unique opportunity to quickly address individual health needs, helping to transform and reshape first-generation wellness services to become “more sticky.” In other words, this could be a time where we witness higher utilization, more measurable health improvement and greater sustainability. Providing protections and oversight in state-based exchanges will be vitally important, all the while balancing the critical need to address the nation’s poor health and its resulting impact on employee incomes and economic growth.
Current estimates indicate that exchanges will ultimately be available to the 70 percent of the population who are employed by small companies. This sizable population may become the testing ground for exchange solutions to accelerate the evolution of wellness programs, with web-based applications and devices, and creative incentive designs leading to improved and measureable population health.
We can’t say for sure whether health insurance exchanges will “dial back” wellness efforts due to cost pressures or if they will use the large-scale opportunity to spur the rapid evolution of wellness solutions that will create even more efficient, effective wellness approaches. Time will tell; however, I am certainly hoping for the latter.
It is a transformational time in health care, for patients, care delivery systems and those who purchase health coverage. As health insurance exchanges usher in a new era of health care purchasing, it drives us to consider what the implications are for wellness programs. Employers who choose to shift from the role of “plan sponsor” to “plan supporter” will need to consider questions like:
What changes will take place when wellness programs are bundled into exchange product offerings?
Will levels of wellness programs be differentiated by plan offerings?
How will state products vary and how will that affect multi-state employers?
Time will tell, of course, but we have learned some lessons from our last 10 years of designing employer-sponsored wellness programs that can help determine whether effective wellness solutions become fundamental to individual products.
For starters, we know that consumers will expect first generation health exchange offerings to deliver services that are efficient and price competitive. Keep in mind that state exchanges will vary significantly based on the viability of the exchanges themselves, and the number of competitive service offerings available in each state.
While it is likely that some form of wellness services will be part of all baseline exchange offerings, how sophisticated and engaging their approaches are will determine how the market reacts. Will these wellness products be based on best practices so they are engaging for individuals, or will they simply be passive tools and services that are ultimately underutilized? If approached in the right manner, the health insurance exchanges represent considerable opportunities for wellness to gain market share that can be scaled, measured and evaluated.
To adopt effective wellness solutions, exchanges will need to consider the following:
Wellness programs provide the opportunity to drive engagement to broader care management, advocacy.
Wellness programs for active participants will need to leverage technology, innovative service features such as mobile apps, social networks and challenges to drive more engagement by younger segments of the population.
Incentives will be continue to be useful in driving engagement.
Fitness will be core to any program offering.
Price will matter. Buy-ups for wellness apps or programs will need to be integrated with mobile health plan programs, and will need to be consumer centric to adequately compete with commercially free products that consumers may already have.
Chronic care management and advocacy will have a role for older actives and pre-65 participants.
Education will be a key factor in the success of the exchanges because, at least initially, there will be widespread confusion about how the exchanges work, available products, how high-deductible health plans work, state availability, network availability (Kaiser in some states, not others), how to participate in programs, how to earn incentives, how deductibles work, and much more. Fortunately, we’ve learned much from the last decade of employer-sponsored wellness programs that can help, including:
One-size-fits-all wellness programs don’t work — customization by work culture and individual employer is necessary to ensure success.
Senior leadership involvement is needed to align corporate priorities to health priorities; simply outsourcing programs with no company linkage makes success less likely.
Ongoing communication in a variety of forms and formats is necessary to reach a wide range of audiences.
Programs need to be diverse, comprehensive and continuously updated in order to be effective in a diverse employee population.
Effective incentives that drive intrinsic vs. extrinsic motivation are not delivered by cash alone.
Consumer protections and strong oversight are necessary to ensure that access and the ability to improve health are available to all eligible employees.
Simple messaging about changes in benefits, regulations, limits, etc., is essential.
Health exchanges may prove to be a unique opportunity to quickly address individual health needs, helping to transform and reshape first-generation wellness services to become “more sticky.” In other words, this could be a time where we witness higher utilization, more measurable health improvement and greater sustainability. Providing protections and oversight in state-based exchanges will be vitally important, all the while balancing the critical need to address the nation’s poor health and its resulting impact on employee incomes and economic growth.
Current estimates indicate that exchanges will ultimately be available to the 70 percent of the population who are employed by small companies. This sizable population may become the testing ground for exchange solutions to accelerate the evolution of wellness programs, with web-based applications and devices, and creative incentive designs leading to improved and measureable population health.
We can’t say for sure whether health insurance exchanges will “dial back” wellness efforts due to cost pressures or if they will use the large-scale opportunity to spur the rapid evolution of wellness solutions that will create even more efficient, effective wellness approaches. Time will tell; however, I am certainly hoping for the latter.
About The Author -Shelly WolffTowers Watson
Towers Watson is a leading global professional services company that helps organizations improve performance through effective people, risk and financial management. With 14,000 associates around the world, we offer solutions in the areas of benefits, talent management, rewards, and risk and capital management.
Scorecard Commentary
HERO
EHM Best Practices Scorecard in Collaboration with Mercer
Understanding the importance of
organizational support
Although
supporting the health and well-being of employees might seem to be a given
within organizations that provide employee health management programs, we are
learning that organizational support is a key factor in program effectiveness.
Experts have been working to define the elements of organizational support and
demonstrate how the degree of support (type, quantity and quality) correlates
with program outcomes.
As it
relates to Employee Health Management, organizational support can be defined as
the degree to which an organization commits to the health and well-being of
its employees. Furthermore, the formal and informal programs, policies and
procedures within an organization that “make the healthy choice, the easy
choice” are recognized as the deliberate steps that define organizational support.
Recognized as an important dimension of an organization’s culture, companies
have begun to focus on organizational support within their overall strategy and
programming in an effort to create a “culture of health.”
The HERO Employee
Health Management Best Practice Scorecard in collaboration with Mercer assesses
many of the foundational elements of organizational support. And, while these
elements may not be found in all companies, based on data from companies that
completed the Scorecard we can see some trends, including:
·
34
percent report that their corporate mission statement supports a healthy
workplace culture
·
52
percent say senior leaders participate in program initiatives
·
50
percent recognize employees for healthy behaviors
·
60
percent offer fitness facilities or walking trails
While
no single best practice will make or break a health management program,
analysis of the Scorecard database suggests programs that incorporate the most
organizational support best practices are the most likely to report overall
program success.
Organizational
Support linked to greater overall use of best practices
Using
the HERO Scorecard database, an analysis was conducted to test the hypothesis
that companies that provide a greater degree of organizational support reap the
benefits of better outcomes. Three degrees of organizational support were
created (low, medium, high), based on the use of best practices in the areas of
leadership support, employee involvement, supportive environment, health
policies, programs/resources, strategy and rewards. We learned that, on
average, those companies that report a higher level of organizational support
not only have higher overall scores on the HERO Scorecard, but also have higher
scores within each section of the Scorecard. In other words, the companies that
provide a greater degree of organizational support tend to be stronger in all
best practice areas.
Greater
organizational support, better outcomes
Many
companies judge the success of their programs based on employee participation
and engagement, positive health trends, and improvement in healthcare spending.
When we reviewed these outcomes for companies with high organizational support
compared to those with a low degree of support, we found that the average
participation in health assessments, biometrics screenings, disease management
programs and lifestyle change programs increased as the degree of
organizational support increased. (See Table 1).
Table 1
|
|||||||
Program Component
|
Average Participation Rates Based on
Organizational Support
|
||||||
Low
|
Moderate
|
High
|
|||||
Health Assessment
|
30%
|
46%
|
59%
|
||||
Biometric
Screenings
|
33%
|
45%
|
53%
|
||||
Disease Management
Programs
|
15%
|
24%
|
27%
|
||||
Lifestyle Change
Programs
|
13%
|
21%
|
28%
|
||||
In
addition to participation, we also found that companies with higher degrees of
organizational support reported greater success in managing health risks and
costs. More specifically, 71 percent of companies with a high score in
organizational support reported a slight or significant improvement in health
risk, as compared to 23 percent for those companies with a low score in
organizational support. In addition, 27 percent of companies with a high
organizational support score reported that the program has had a substantial
positive impact on medical trend in comparison to 9 percent of companies with a
low organizational support score. In addition, high-scoring companies collected
more data for the management of their programs, and reported program
performance more frequently to key stakeholders.
The
role of organizational support in creating a culture of health is drawing a
great deal of attention among those working in employee health management
today. This analysis helps to emphasize the value of organizational support and
its importance in achieving positive outcomes.
About the Author - Jennifer
Flynn, MS
Strategy
Consultant, Mayo Clinic
Jennifer serves as a Health Management Strategy Consultant for Mayo Clinic Global Business Solutions. She advises clients in the areas of strategic planning, program design, implementation, engagement strategies, incentive design, and evaluation of their population health management programs.
HERO Research
Research
is a key component of HERO’s work. That’s why each year members meet to review
and update the organization’s agenda of research priorities. One of the
priorities that have remained at the top of our list has been the findings from
the HERO Employee Health Management Best Practices Scorecard in Collaboration
with Mercer.
HERO Scorecard
Predictive Validity Study
Ron
Goetzel, Ph.D., and his team from Truven Health Analytics and Emory University
have been working together with members of the HERO Research Study Subcommittee
to conduct a predictive validity study on the HERO Scorecard. The purpose of
this study is to determine the ability of the Scorecard to predict changes in
employee health risks and growth in healthcare expenditures. The results of
this study will be highlighted at the HERO Forum in September. A
detailed description of the study is being prepared for peer review and
publication. Register for the Forum
Onsite Screenings
Article
The
HERO Joint Study Committee on Biometric Screenings has completed its work and an
article on guidance for employers has been submitted to the Journal of Occupational and Environmental Medicine
for publication. Our hope is that the online version of the paper will be
released around the time of the HERO Forum, with the print version available in
October. Thank you to our members who have contributed to this work, along with
the American College of Occupational & Environmental Medicine, and the Care
Continuum Alliance (CCA), who have collaborated with us to make it possible. A
special thank you to Chris Behling from Mollen Clinics and Rebecca Kelly at the
University of Alabama, who served as co-chairs for this committee.
CCA-HERO Employee
Health Management Core Metrics Project
As
mentioned in the opening column, the Core Metrics Team, led by members of CCA
and HERO has spent the past two years working to develop a core set of metrics
for the health management field. A draft document presenting the recommended
measures is now going through three comment steps. First, noted subject matter
experts not previously involved in creating the document will review the draft.
Then, a revised draft will be shared with other organizations within this field
for comment. Finally, the edited draft will be posted on the CCA and HERO
websites in September for public comment. We encourage anyone interested in employee
wellness to review and comment so this becomes a core set of agreed-upon
metrics that the entire field can use to report results, thereby contributing
to and strengthening our collective knowledge base.
HERO Research
Partners
Funding
for HERO research is provided by organizations that have an interest in
building evidence-based knowledge in the field of employee health management.
Please contact Jerry Noyce at jerry.noyce@the-hero.org for more information.
National Food Day - October 24th
What is Food
Day?
Food should be tasty, healthy, affordable, and produced with care for the
environment, animals, and the women and men who grow, harvest, and serve it. Created
two years ago by the nonprofit Center for Science in the Public Interest and
driven by a diverse coalition of food movement leaders and citizens, Food Day
aims to bring us closer to that ideal. Food Day is a nationwide celebration of
healthy, affordable, and sustainably produced food and a grassroots campaign
for better food policies. It builds all year long and culminates on October 24.
Last year, people organized more than 3,200 events in all 50 states, and a number
of companies used Food Day to create change in the work site.
With an average working adult spending nearly
10 hours working and commuting a day, eating real and staying healthy at work
can be a challenge. With
about two‐thirds of American adults pre‐obese or obese,
and about 86 percent of full-time workers above normal weight and with at least
one chronic condition, annual medical costs for obesity and related diseases, such as high blood pressure, heart disease, and diabetes amount to around $150 billion. Employees’ better health brings higher morale, greater productivity, and
lower health care costs.
How can Food Day promote work site wellness?
Food
Day is an occasion for employers to create work environments that foster health and
wellness.
For the last two years, LSG Sky
Chefs, the world’s largest provider of in-flight services, has used Food Day to
continue the internal health and wellness education campaign it launched on
Food Day 2011. During the weeks leading up to October 24, the company held a
nutrition education campaign for its 8,600 employees in the North America
region, gave away seed packets, and created digital boards within each of 40
locations promoting local farmers markets. In celebration of Food Day 2011, Bolthouse Farms, one of the nation’s largest
carrot growers, sponsored an employee wellness program and a farmers market.
Whether you’re an employee or employer,
work site wellness programs can greatly facilitate better health. Use Food Day as an opportunity to promote a supportive work environment with healthier
foods in cafeterias, vending machines, or during meetings and events. And why not devote some land to a vegetable
garden, start a farmers market, or hold a healthy food celebration for
employees? Visit http://www.foodday.org/resources to learn
about how to bring Food Day--and better health--to work!
New Think Tank Members
Abacus Health Solutions
Abacus Employer Health Solutions (Abacus) and its principals are nationally recognized behavioral scientists and health experts who have been providing cost-containment solutions for over two decades. Abacus has developed numerous evidence-based e-health tools financed in part with grant funding from the National Institutes of Health and the Agency for Healthcare Research and Quality. Today, Abacus provides employers with an array of unique programs and services to address their wellness and chronic condition management, specializing in integrating behavioral science principles into modern benefit plans and providing incentive program design and administration.
Abacus Employer Health Solutions (Abacus) and its principals are nationally recognized behavioral scientists and health experts who have been providing cost-containment solutions for over two decades. Abacus has developed numerous evidence-based e-health tools financed in part with grant funding from the National Institutes of Health and the Agency for Healthcare Research and Quality. Today, Abacus provides employers with an array of unique programs and services to address their wellness and chronic condition management, specializing in integrating behavioral science principles into modern benefit plans and providing incentive program design and administration.
Businessolvers
With our founding roots in insurance, technology, and
benefits consulting, Businessolver has a strong footing to deliver a
consultative approach and highly efficient, effective online enrollment and
administration capabilities. In turn, clients enjoy cost savings, employee
satisfaction improvements and more strategic Human Resource deployment. (Can
you say “employee engagement?”)
IBM
IBM is a globally integrated technology and consulting
company headquartered in Armonk, New York. With operations in more than 170
countries, IBM attracts and retains some of the world's most talented people to
help solve problems and provide an edge for businesses, governments and non-profits.
Innovation is at the core of IBM's strategy. The company
develops and sells software and systems hardware and a broad range of
infrastructure, cloud and consulting services.
Lifetime Fitness
As the Healthy Way of Life Company, Life Time (NYSE: LTM)
delivers the certified professionals, comprehensive businesses and incredible
destinations that help people positively change their lives every day. The
Company's healthy way of life approach enables its customers to achieve their
health and fitness goals by engaging in their areas of interest — or
discovering new passions — both inside and outside of Life Time's distinctive
and large sports, professional fitness, family recreation and spa destinations.
Today, the Company operates 105 centers under the LIFE TIME FITNESS® and LIFE
TIME ATHLETIC(SM) brands in the United States and Canada.
lifetimefitness.com
Sanofi U.S.
Sanofi, a diversified global healthcare leader, discovers,
develops, and distributes therapeutic solutions to improve the lives of
everyone. We work to prevent and treat the diseases that we know of today, as
well as those we may face tomorrow. With more than 100,000 dedicated
professionals in more than 100 countries, Sanofi is devoted to advancing
healthcare around the world. Sanofi US, with headquarters in Bridgewater, New
Jersey, employs more than 17,000 professionals throughout the country. At
Sanofi, we work for what really matters: health.
Virgin HealthMiles
Virgin HealthMiles, part of Sir Richard Branson’s famed Virgin Group, provides programs that engage your workforce in good health. We offer a range of solutions and program integration capabilities that help employers drive higher awareness and participation, and better insight into the impact of all your employee health investments.
Wells Fargo
Wells Fargo is a provider of banking, mortgage, investing,
credit card, insurance, and consumer and commercial financial services. The merger of Wells Fargo and Wachovia
doubled our size. We’re no longer defined as just a regional bank. We’re a
national company, with operations that stretch across the globe. With this growth in size and scope, what
makes us different than other so-called “large banks”? How do we define
ourselves? We’re a community-based, diversified financial services company.
Universities Wellness Alliance of KY
What started out as a place dedicated to the Kentucky
Worksite Wellness Initiative (KWWI) has quickly (before launch actually) grown
broader and now also serves as home to the Barren River Worksite Wellness pilot
project, School Health Promotion (K-12) Resources, and the University Wellness
Alliance of Kentucky (UWAK). Worksite Wellness in Kentucky is available to
provide evidence-based strategic wellness program resources and support in all
sectors for all size organizations and companies in the state. As we move
forward to improve the health and economy in Kentucky through worksite wellness
programs, it is sure others will also join us in this effort. The purpose of this initiative is to provide
businesses and organizations in the state with education, technical assistance,
support, resources, and tools necessary to implement effective comprehensive
wellness programs including prevention and management of chronic diseases and
other worksite health related issues.
Interested in Membership
Contact – Marlene Abels
Coordinator Member Services
(952) 835-4257 Membership Application
HERO Happenings
HERO Forum 13 for
Employee Health Management Solutions:
September 24-26,
2013, Hilton at Walt Disney World, Lake Buena Vista, FL
Activities include:
HERO EHM Awards Dinner- Tuesday,
September 24th
C. Everett Koop Awards & Luncheon- Wednesday,
September 25th
Forum Run/Walk Sponsored by StayWell-
Wednesday,
September 25th
HERO Members Only:
Pre-Forum Think Tank Meeting & Dinner- Monday, September 23rd
Think Tank Members Resource Center
Folders have now been created in the Think Tank Library containing rosters, articles, meeting notes and other information pertaining to the activities of those committees. This information is accessible to all members. Active committees are:
o Culture Committee
o Employer-Community Collaboration Committee
o Health, Performance & Productivity Committee
o Research Committee
The Rand Report to Congress is now posted in the Library
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