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Motivating Employees to Make Lifestyle Changes

Motivating Employees to Make Lifestyle Changes. by Elaine Frank, M.Ed., RD Vice President American Institute for Preventive Medicine. Total Employee/Employer Health Care Costs: 2003 - 2008. Average Amount of Time (in Hours) Consumers Spend Thinking About Various Purchase Decisions.

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Motivating Employees to Make Lifestyle Changes

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  1. Motivating Employees to Make Lifestyle Changes by Elaine Frank, M.Ed., RD Vice President American Institute for Preventive Medicine

  2. Total Employee/Employer Health Care Costs: 2003 - 2008

  3. Average Amount of Time (in Hours) Consumers Spend Thinking About Various Purchase Decisions Source: MetLife, 2007

  4. Determinants of Health 50% 20% 20% 10%

  5. Actual Causes of Death in U.S. 435,000 400,000 85,000 75,000 55,000 43,000 29,000 20,000 17,000 * Indicates lifestyle related

  6. The Cost of an Unhealthy Lifestyle • 87.5% of health care claims costs are due to an individual’s lifestyle. Source: Indiana University-Purdue University, Fort Wayne (IPFW) Study, 2006

  7. Higher Premiums for Unhealthy Lifestyle? • Is it fair to charge those who live unhealthy lives to pay higher insurance premiums? Source: Wall Street Journal Online/Harris Interactive Poll, 2007

  8. How Companies Are Responding to Increased Health Care Costs % of companies Increased participant cost Increased deductibles Switched providers Offer wellness program Increased copays Participants pay more for prescription drugs Source: Society for Human Resource Management, 2008

  9. Association of Risk Levels with Several Corporate Cost Measures Source: Wright, Beard, Edington, JOEM 44(12): 1126-1134, 2002

  10. Issues Most AffectingEmployee/Member Productivity Stress Personal/Family Chronic medical conditions Unscheduled absences Presenteeism Lifestyle medical conditions Source: Watson Wyatt, 2005

  11. Characteristics of Low Health Care Cost Companies • Understand the current state • Are decisive and take action • Don’t simply shift costs to employees • Create a “culture of health” • Solutions target underlying causes • Invest in programs that encourage employees to manage their health risks and conditions • Require employee to be more accountable for their decisions and provide info and resources to help Source: Towers, Perrin, 2007

  12. Prevalence of Wellness Programs Do Plan to Source: SHRM 2008 Benefits Survey Reports

  13. How to Offer Wellness Programs • Make activities/programs accessible • Make activities/programs affordable • Involve dependents • Responsible for 70% of costs • Women make 80% of decisions

  14. Maximize Employee Participation • Create a culture of health • Multi-component methods • Saturation effect • Incentives

  15. What Determines Employee Motivation • Relative ease and ability to achieve an outcome or earn a prize/reward • Extent to which the reward is worthwhile and the goal is achievable • Short term versus long term consequences of behavior

  16. The Strategic Use of Incentives • Identify the behavior(s) you’re trying to change • Understand what will motivate your employees/members • Identify the incentives to be used • Communicate the incentive program • Evaluate the impact

  17. Participation Compliance Behavior change Productivity Learning Achievement Awareness Performance Incentives Can Increase

  18. What Consumer BehaviorsEarn Incentives

  19. Use of Incentives

  20. Dollars Being Spent Per Person Per Year on Incentives

  21. Types of Incentives, NAM / ERIC 2008

  22. Types of Incentives, WELCOA 2006 279 respondents Cash Awards 30.4% 679 respondents Prizes 74.0% 424 respondents Special Recognition 46.2% 356 respondents 38.8% Company-Paid Programs 216 respondents Co-Payment/Reimbursement 23.6% 147 respondents Flex Time to Participate 16.0% 431 respondents Company Time to Participate 47.0% 118 respondents Premium Reduction 12.9% Other 94 respondents 10.3% 6.2% 57 respondents None Source: Wellness Councils of America, 2006

  23. Cash vs Merchandise • Merchandise has residual value • 65% say cash is remembered shortest time period • 60% see cash as part of compensation package • Cash is taxable Source: Incentive Federation Study, 2005

  24. Effect of Incentives on Participation Participation Time Source: Larry Chapman, Summex WebMD

  25. Impact of Incentive on HR Participation Participation $0 $25 $50 $75 $100 $ Incentive

  26. Linking Wellness to Benefit Plan Design • Offer reduced health premiums • Provide preventive medical benefit coverage • Add wellness to the health plan coverage • Provide a rebate of a portion of the savings

  27. Advantages of Incentives • Can increase motivation and change behavior • Easy to implement • Can be very powerful

  28. Potential Pitfalls of Incentives • May only reach healthy employees • Confidentiality concerns • May not be offered equitably • Unintended artifacts • May create a dependency • May not yield desired results • Can be costly

  29. HIPAA Issues • Latest guidelines • Effect on incentives • A limited value • Designed to improve the participant’s health • Available to all employees in the same circumstances

  30. Health Belief Model(Becker) • Recognize existence of risks • Identify with risk • Think behavior change reduces risk • Think behavior change is worth effort Source: American Journal of Health, 64:205-216, 1974

  31. Stages of Change Model(DiClemente and Prochaska) • Pre-contemplation • Contemplation • Preparation • Action • Maintenance Source: Health Psychology, 13:39-46, 1994

  32. BEMEM Model of Behavior Change (Powell) • Behavioral • Educational • Motivational • Enjoyable • Maintainable Source – American Institute for Preventive Medicine, 2008

  33. Multiple Treatment Approach • Stimulus control • Thought control • Behavioral rehearsal • Cognitive restructuring • Assertiveness training • Incompatible behavior • Goal setting • Successive approximations • Positive reinforcement • Data collection • Contracting

  34. Methods for Increasing Motivation/Compliance • Make materials easy to use • Use feedback system • Model and practice techniques • Provide materials for techniques • Dramatize the concept • Make activities enjoyable • Make materials easy to read

  35. Appropriate Program Materials • Attractiveness • Reading level • White space • Culturally diverse illustrations • Fast food education

  36. Multi-Component Program • Assessment activities • Communication materials • Self-help programs • Group programs • Coaching

  37. Quit Rates for White-Collar and Blue-Collar Employees Combined 12-Month Follow-Up

  38. Programming with Short Term Benefits • Seat belt usage • Consumer education • Prenatal care • Medical self-care

  39. Unnecessary Utilization • Doctor visits – 25% • Average cost -- $101 • E.R. visits – 55% • Average cost -- $383 Source: National Ambulatory Medical Care Survey, 2006

  40. Employee/Member Co-Pay Costs

  41. “The Lowe’s Health at Home® book was the reason I went to see my doctor and it saved my life.” • Jeff Bilbrey • Sales Specialist, • Bloomfield Hills, MI

  42. “If it weren’t for Health at Home®, I wouldn’t have discovered I had ovarian cancer in an early stage. After radiation and chemo, my prognosis is excellent.” • Registered Nurse • Fairview Health System • Minneapolis, MN

  43. Understand How Your Employees/Members Learn • Printed material • Telephonically • Online

  44. Thank you for your attention. Questions? Contact: Elaine Frank efrank@HealthyLife.com, or Don Powell dpowell@HealthyLife.com 800-345-2476, ext. 221 Fax: 248-539-1808 Web Site:www.HealthyLife.com

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