Building a Healthy Corporate Culture

1. Building a Healthy Corporate Culture

2. Presentation Overview • So, What’s Wellness? • Why the Concern? • A Blueprint for Implementation • Questions

3. So, what’s Wellness? ...A process of beingawareof and actively working toward better health! Definition is: A broad framework that highlights personal responsibility to achieve physical, emotional, mental and spiritual health.

4. 27 haveheart disease 24 have highblood pressure 25 have highcholesterol 10 havediabetes 22 aresmokers 64 are obese oroverweight 50 aredistressed 60 aresedentary Why the Concern? For Every 100 Employees

5. Organizational Concerns • Employee complacency toward health & wellness • Increased individual and organizational health risk • Large % of employees in high-risk categories • Rapidly rising healthcare costs, especially as employee population ages • High absenteeism rates, high presenteeism costs, and diminished workplace productivity • Decreased productivity of managers who must deal with at-risk employees

6. Health and Wellness in the News! “82% of small employers, 90% of midsize employers and 99% of large employers see value in implementing wellness programs”-— Benefits and Behavior: The Voice of American Business Owners and Benefit Decision Makers Today –June, 2007 Aetna announces enhanced portfolio to their medical management strategy offering with value-added wellness components.” - September, 2006. “Wellness program converts CEO’s to cause” – Employee Benefits News – Feb. 2006 More Companies Implementing Health and Productivity Practices” – Watson Wyatt – Dec. 2005 “Top 10 Issues for Health Industry in 2006 / Wellness & Obesity #5” – PricewaterhouseCoopers – Jan. 2006 “Survey: U.S. Employers Turning to Wellness Programs to Manage Healthcare Costs.” – Deloitte Services – June 2005 “Promoting healthy habits and consumerism is the most effective way to lower medical costs” – Mercer Human Resource Consulting – Sept. 2005

7. Organizations are Asking For… Wellness Management Information Motivation Preventive Screening Disability Management Case Management Decision Support Disease Management Compliance Risk Management Demand Management Self Care Nurse Advice Line Risk Management Targeted Intervention Targeted Screening At Risk Inactivity, Obesity, Stress, High Blood Pressure Health & Well-Being Low Risk, Optimal Health Disability Traumatic Injury Cancer Chronic Disease Diabetes Heart Disease Minor Illness/Injury Doctor Visits ER Visits 15 % of employees 85% of costs 85 % of employees 15% of costs

8. Core Planning Cycle

9. Approach to Wellness • Concentration on Senior-Level Support • Creating a Cohesive Team • Collecting Data to Drive Health Efforts • Carefully Crafting a Strategic Plan • Choosing Appropriate Health Interventions • Creating Supportive Environments-Incentives • ConsistentlyEvaluating Outcomes

10. Data Collection: Assess and Analyze • Crucial to gather data BEFORE planning health interventions • The types of information to collect • Where to find data you need • The art and science of balancing needs and interests • Who to tell about your results, and how • Tips for successful data collection & analysis

11. Why you need to gather data before health interventions • Data allows you to pinpoint company health concerns • Data allows you to satisfy employee interests • Data increases the likelihood that people will accept wellness • Data provides a baseline by which to measure change • Data moves your program from activity-centered to results-oriented

12. Demographic Information Health Risk Appraisals Health Screening Data Interest Surveys Business Needs-Data Wellness Program Models • Quality of Life • Traditional/Conventional • Health and Productivity Management • Medical Claims • Disability • Absenteeism • Facility Assessment • Culture Audits

13. Quality of WorkLife Improving morale Add to quality of worklife Improve camaraderie and relationships Voluntary activities Approach is passive Offer information and experiences Operative word “FUN” Traditional ½ of eligible population will do one or more activity Voluntary Something for everyone Site-based activities No significant incentives Economic return is not a high priority Minimal Evaluation Operative word “SAFE” Program Models Health & Productivity Management • Proactive, highly structured interventions • Large portion of workforce and spouses • 80% take an HRA • Survey-prompted programming • Coaching & support • Site-based & virtual activities • Personalized • Outcomes driven Evaluation • Operative word “SERIOUS”

14. The Health Risk Appraisal • Written • Lifestyle choices, behaviors, current health conditions • Self or computer-scored • Stimulate employee interest • Initiate behavior change or movement along stage of readiness

15. The Art & Science of Balancing Needs & Interests • Employee interest initiatives draw participation • Business needs drive wellness budgets • Results are produced with a combination of the best interests of the business and the employees Key Idea!To be effective, the great health promotion planners will balance organizational needs & employee health interests.

16. Tips for successful data collection and analysis • Use multiple data sources that support one another • Commit to honesty in analyzing data • Remember that all the information collected is extremely sensitive • Use only the data which is properly gathered • Protect the individual’s privacy at all costs • Don’t stop after data collection – your program is still building • Establish a database for evaluation of outcomes • Be creative with the information

17. Carefully Crafting the Operating Plan Building a Healthy Corporate Culture

18. Why Plan? • Builds and gains support • Moves us from activity-centered to results-oriented • Keeps everyone in the loop • Serves as a roadmap to success • Eliminate unnecessary activities

19. The eight elements of a comprehensive operating plan • Vision Statement • The Program’s Primary Goal(s) • Supporting, Measurable Objectives • Timelines for Implementation • Delineation of Roles • Evaluation Procedures • Itemized Budget • Communications Strategy

20. Goals & Objectives • Goals are the overall intent or purpose of the program such as the containment of health care costs, reduction of absenteeism, etc. • Objectives are short and concise clarifying statements. • Specific • Measurable • Achievable • Realistic • Time Sensitive

21. Sample Program Objective: To improve the health and well-being of employees and their family members. • Establish a wellness advisory group and develop a program plan, budget and evaluation plan by January 1, 2008. • Launch a employee wellness program by February 1, 2008. • Provide lipid and glucose screening for employees by March 1, 2008. • Implement a Consumer-Drive Health Plan (CDHP) for all employees by September 1, 2008. • Train employees and family members in medical self-care and health care consumerism by September 30, 2008.

22. Choosing the Appropriate Interventions

23. How to Select the Right Areas of Intervention • What are the risk factors and health concerns of your population? • What does the latest research suggest? • What do your employees want? • What do your senior people want to achieve? • How much money and time do you have?

24. Strategy— Setting the Stage for Interventions • Strong incentives for completion of an annual Health Risk Assessment • Balance between long-and short-term clinical health risk factors • Focused use of biometric screening • Annual use of HRA-Personal Health Plan • Acute and chronic disease focus • Primary, secondary and tertiary prevention focus • Light use of group education • Integration with employer policies, benefits, and other health related areas. • Organized high risk interventions • Extensive use of incentives • Communication strategies • Medical self-care consumerism • Offered throughout the day, not just workday • Formal evaluation

25. Smoking Cessation Exercise/Physical Activity Nutrition/Weight Control Cardiovascular Disease Detection/Prevention Stress Management Seatbelts Medical Self-care Stress Management Personal Finance Immunization Ergonomics Prenatal care Low back pain management Diabetic care Asthma Treatment Somatic disorder patterns Allergic reactions Preventive screenings Most Frequently Addressed Programming Areas Secondary & Tertiary Prevention Primary Prevention

26. Strategy— Setting the Stage for Interventions • Strong incentives for completion of an annual Health Risk Assessment • Balance between long-and short-term clinical health risk factors • Focused use of biometric screening • Annual use of HRA-Personal Health Plan • Acute and chronic disease focus • Primary, secondary and tertiary prevention focus • Light use of group education • Integration with employer policies, benefits, and other health related areas. • Organized high risk interventions • Extensive use of incentives • Communication strategies • Medical self-care consumerism • Offered throughout the day, not just workday • Formal evaluation

27. Some Group Activities • Run periodic weight loss, fitness activity and cholesterol reduction groups with financial incentive for those who maintained or achieved improvements at the end of 6 months. • Organize active walking club • Offer weight management seminars • Offer targeted nutrition seminars such as “LDL-lowering strategies.”

28. Strategy— Setting the Stage for Interventions • Strong incentives for completion of an annual Health Risk Assessment • Balance between long-and short-term clinical health risk factors • Focused use of biometric screening • Annual use of HRA-Personal Health Plan • Acute and chronic disease focus • Primary, secondary and tertiary prevention focus • Light use of group education • Integration with employer policies, benefits, and other health related areas. • Organized high risk interventions • Extensive use of incentives • Communication strategies • Medical self-care consumerism • Offered throughout the day, not just workday • Formal evaluation

29. Key Activities- The “Interventions” • HRA—Personal Health Plans • Risk interventions—prompted by HRA—web, print, telephonic • Telephonic Coaching delivered to— • Low Risk • Multiple or elevated health risks • Disease Management • Disability • Selected “at risk” • Medical Self-care and Consumer Training • Injury Prevention—Work, home, vehicular • Benefit linked Incentive- • Premium differential • Increased vacation days • Larger contribution to health savings accounts • 300.00 to 1,000.00 in order to gain high levels of participation • Serves Spouses • Resiliency Initiatives—Life Goal Planning, Stress Relief, Energy Management Integrate

30. Sample Wellness Communication • Post wellness and motivational posters on bulletin boards • Provide wellness library—hard copies or online • Launch Letter- 1 to 2 page letter outlining the new program • Mail request card-Allows employees to self-select materials • Posters • Wallet Cards • PowerPoint Decks • Payroll Inserts • Web Information • Email List Serves • Fax Trees • PDA messaging

31. 3 Levels of Communication and Programming • Awareness • Distribution of information encouraging individuals to become conscious of the benefits and methods to achieve a healthy lifestyle. Brochures, fliers, books, posters, newsletters, exhibits, bulletin boards and screenings. • Education • An interactive presentation or activity intended to increase knowledge and change attitudes regarding health. Seminars, workshops, interactive computer programs, counseling after screenings and demonstrations. • Behavior • An ongoing program that actively involves individuals in long-term behavior modification with measurable results. Classes (ongoing, multi-session), incentive programs tied to outcomes, training programs, support groups and one-on-one counseling over a period of time.

32. Communication Strategies Regular Use Interactive with Coaches Personalized homepages Calendar Appointment reminders Share with physician Progress Reports Opportunities to Try On-line fitness campaign Recreation and Fitness Day Teachable Moments “Point of Delivery” Signage Primary Care Physician Referral Incentive/Drawing Employees at Company XYZ Educate on Use Interactive Communication-Personalized Approach Invitation/Examples built into current product delivery Direct Mail Kiosks/Booths-Demonstrate Build credibility Sign up for the email daily health tips Awareness Positive Attitude Intent to try Will try Time/Specific Strategies

33. Effective Use of Incentives • Increase participation • Increase adherence to specific behaviors • Increase follow-through by a factor of 2 to 8 • Participation AND outcome components – HIPAA- • Reward exchanged for behavior—Pay Value • Cash, Benefits,Time-off, Material Goods, Recognition and Personal Challenge

34. Incentives

35. Introduction/ Program Launch Door prizes Discount fees for early registration “Bring a Buddy” discounts Handouts or gifts Drawing Attendance with lower premium Incentives and Product Life Cycle Growth/ Increase Participation • Rebate 20- 30% of fees for nearly perfect attendance—Fitness Center • Prize drawings at end of series • Divide a dollar pot • Attractive prize for near-perfect attendance Maturity/Makelong-term behavior change • Rebate 20- 30% of fees for nearly perfect attendance—Fitness Center • Prize drawings at end of series • Divide a dollar pot • Attractive prize for near-perfect attendance

36. Examples of Incentives

37. Carefully Evaluating Outcomes

38. 3 Levels of Evaluation • Process: How well is the program being implemented? • Impact: To what extent were the immediate outcomes achieved? • Outcome: To what extent were the long-term outcomes achieved?

39. 3 Levels of Evaluation in Action • Process: • How well is the program being implemented? • Quality and quantity of programs • Operating plan • Executive Employee Satisfaction

40. 3 Levels of Evaluation in Action • Impact: • To what extent were the immediate outcomes achieved? • Awareness levels, knowledge, attitudes/beliefs, skills, behavior change, physical and cultural climate changes • Realistic expectations

41. 3 Levels of Evaluation in Action • Outcome: • To what extent were the long-term outcomes achieved? • Risk factors, mortality, morbidity, disability, health care costs, policy changes • Company goals & objectives

42. Evaluation & Program Design

43. Questions Selected References for Presentation: WELCOA Absolute Advantage and Prevention Partners