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 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.   

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. 

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.  

By - Rebecca K. Kelly, PhD, RD

The University of Alabama