The Well-Being Journal

Reflections from The HERO

Jennifer Rudloff

A couple of weeks ago the Health Enhancement Research Organization, also known as HERO held its bi-annual Think Tank meeting and Forum (the HERO version of a conference) in Phoenix Arizona. After having some time to reflect on both of those meetings, I would like to share some of my reactions with you. Let me start with the Think Tank.

The Think Tank brings employee health management (EHM) experts together bi-annually to exchange ideas, expertise, and recommendations in an effort to solve problems and react to opportunities. Members of the think tank have a major role in the creation and dissemination of national EHM policy, strategy, leadership and infrastructure. During the most recent session we addressed three subjects: (1) the role of consumer directed initiatives and personal responsibility in health care, (2) the impact of an aging workforce and actions that must be taken both domestically and internationally, and (3) the role of financial incentives in the health management industry. As you might imagine, the use of incentives drew significant debate so let me expound upon that discussion.

Overall the field is fairly supportive of the use of financial incentives to drive participation in health management programs. However, we also agree that while financial incentives can drive participation, little evidence exists to show that financial incentives alone change behavior. The lightning rod seems to be the use of incentives to reward “health outcomes” as it is defined in The Patient Protection and Affordable Care Act. Such incentives reward people for keeping biometrics such as cholesterol, blood pressure, and body fat within reasonable limits. The opinions on this issue varied widely at the HERO Think Tank.

From my experience I know that all employers are different. As the result, I believe America’s employers need the latitude to put in place the incentive programs that work best for them, based on their cultures and their business environments. We do not need further regulation regarding incentives. Instead, the pros and cons of various incentive programs should be evaluated so that employers can make discriminating choices that support the needs of their people and culture. Others may disagree with my perspective. For instance, American Heart Association has distributed position statements taking the view that outcomes-based incentives tied to health plan or self-insured company premium costs are unfair and discriminatory, instead advocating for ‘‘participation-based’’ incentives. Their fear appears to be that such incentives could lead to the mistreatment (including greater cost burden) of people with existing disease. While an understanding view points, current law already provides many safeguards and people who take good care of themselves already pay a disproportionate amount of the health care cost burden.

Regardless of our individual views, the one thing that the think tank fully agrees on is that as an industry, we must speak with a united voice. Articles by Michael O’Donnell, and by Paul Terry and David Anderson have done a nice job of advocating for the “one voice” approach.

The HERO Forum was also an enlightening experience. Highlights were the following:

  • Many companies are going back to the basics. Part of the format at the HERO Forum is to have “How To Do It” workshops where best-practice health management programs are highlighted. This year many of the professionals guiding these programs described how they were getting back to the basics of superior program planning, setting clear objectives, communicating their programs effectively, generating engagement through creative approaches, and measuring outcomes effectively.
  • People were networking and discussing some of the most timely topics in health management. Many good ideas were discussed in areas like the broader view of well-being, program integration, and the impact of work culture on health management success.
  • The research showing the efficacy of health management is continuing to advance and HERO is leading the way.
  • There are many breakthroughs in the area of participant engagement that involve superior communications, incentives, program positioning, and the ability to use new media and technology in the effort.
  • The use of small actions and social media in effectively advancing behavior change was addressed by Chris Cartter, General Manager of MeYou Health, in the closing keynote. Chris provided deep insights into this topic.

Both the HERO Think Tank and the Forum were well attended and the sessions and debate were provocative. If you are not a member of HERO, I urge you to consider getting involved. If you were there, what were your impressions and biggest takeaways?What are your thoughts on the incentive debate? Please share.

Topics: HERO Think Tank Workplace Well-Being Healthcare Engagement Business Performance Health Financial Incentives for Health Management Program Events Health Enhancement Research Organization

Well-Being: Move the Needle, Reduce Costs

Jennifer Rudloff

John Harris, Chief Well-Being Officer at Healthways, talks about the correlation between the well-being of employees and an organizations costs, productivity, engagement, and performance. In this video blog, you will learn about how impacting well-being will return results.

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Topics: Basic Access Work Environment Workplace Well-Being Healthcare Engagement Physical Health Business Performance High Performing Teams Health Well-Being Index Employee Satisfaction Competitive Advantage Cost Reduction Cost Savings Productivity Healthways Reduce Absences Well-being Assessment Performance/Productivity

Are You Seeing the Big Picture?

Jennifer Rudloff

It’s important to keep a finger on the pulse of your organization to stay in tune with employee needs and challenges, and engagement levels. You can’t move what you can’t measure. This need to measure has led to a seemingly endless stream of surveys. There are health risk assessments, engagement surveys, presenteeism surveys, and the list goes on…Like many other people in the market, we recognized that there had to be a better way.

Fortunately, we didn’t have to look far for the answer. Realizing the power behind our work with Gallup on the Well-Being Index (WBI) Healthways quickly asked how we could apply the science and research behind the WBI to individual employers or health plans. As a result, Healthways went to work building a tool that combined elements of the WBI with those of other common surveys, creating a comprehensive tool to measure the health and well-being of an employer population. This resulted in the birth of the Healthways Well-Being Assessment™ (WBA).

This is not your typical survey. It goes far beyond the standard HRA question set and shifts focus to include the entire individual - and for good reason. Research increasingly reveals vital linkages between healthcare costs, productivity, physical health, emotional health, health behavior, work environment, social support, and basic access to necessary resources. Shifting away from purely physical health, the WBA leverages WBI questions for a baseline comparison against the nation, with an emphasis on employee health, productivity, and the work environment. With an understanding of employee engagement, health, and well-being, organizations can better determine where to focus efforts to influence the greatest performance opportunities, both financial and personal, within their populations. Makes sense, right? Individual and population-level reports generated from the WBA provide an intimate, holistic view of the workplace and actionable information that can help guide decisions on health benefits, work environment, corporate culture and overall business performance.

In more detail the WBA allows organizations to:

  • Gain a comprehensive view of employees’ social, emotional, physical and financial well-being to understand how to target investments that best support those needs.
  • Assess the real quality of the work environment, including its stressors, culture, leadership, wellness and prevention programs, and recruitment and retention strategies to determine exactly where improvements are needed for a more engaged workforce.
  • Benchmark your organization or institution nationally, regionally and locally; or by job, business unit or location. (Who else can provide a real-time benchmark against the nation.)
  • Create customized solutions for your unique workforce to provide a more supportive work environment and earn recognition as an employer of choice.
  • Understand the health conditions the workforce is experiencing and how you can support them for optimal productivity and minimal absenteeism.
  • Learn what the significant contributors are to direct medical costs – whether they are systemic or exist in unique locations within the organization – and apply the findings to design and target ways to better address health cost drivers and reduce healthcare costs.
  • Use the results as a market differentiator to retain and attract customers. (for health plans)
  • Make specific comparisons among subsets of their populations and conduct year-to-year comparisons to gauge progress over time.

Human performance drives business performance in every organization. While many organizations use HRAs to understand and improve workforce health and guide programs to reduce healthcare costs, they’re missing the big picture. There are many factors that influence our well-being and impact performance. The Healthways WBA offers organization-specific insight on these factors. Results magnify opportunities to maximize the outcomes of health and performance program investments, and to measure their impact and effectiveness over time.

Do you believe this broader approach to assessing the well-being of your workforce seems like the right idea? Is learning more about emotional, social, work culture, and the access variables of your organization important to you? Is it time the standard HRA evolves into more? We’d love to get your thoughts.

Topics: Well-Being Benchmark Workplace Well-Being Healthcare Business Performance Innovations in Healthcare Health Well-Being Index Competitive Advantage Prevention HRA How to Improve Employee Performance Health in the Workplace Wellness Healthways Employee Performance Improvement WBA WBI Well-being Assessment

When it Comes to Our Nation's Budget Crisis, Medicare is Not the Problem

Jennifer Rudloff

Road Sign: ChangesYou would have to be living on a deserted island to not know that the Congress — specifically the House — and the Administration are playing chicken in the ongoing posturing over whether or not to increase the country’s debt ceiling. What makes this round of debate unique is for the first time in history, Congress has tied the debt ceiling topic to the budget process.

The positions of our elected representatives are unfailingly predictable. Republicans want to reduce taxes and spending, notably on entitlements; Democrats want to increase taxes and protect entitlement programs. In this debate, it is no surprise that Medicare [and Social Security] should be the center of the bullseye for each sides’ daily talking points. The rhetoric is hot on both sides. Unfortunately, with elections around the corner, officials are maintaining a focus on their campaigns. This can obscure facts and solutions and create barriers that keep officials from accomplishing what they were sent to DC to do. That’s the bad news.

The good news is that Medicare, per se, is not the problem. Yes it’s expensive and yes the aging of the Baby Boom Generation will add millions of new beneficiaries over the next 25 years. But the simple truth is that there IS a way to reduce Medicare cost by more than a Trillion dollars over the next decade, without reducing benefits or capping provider pay. The approach derives from this universal truth: Healthier People Cost Less. And they don’t have to be a lot healthier to save a lot of cost.

In a paper published in Population Health Management this past February, the authors demonstrate the significant dollar impact of relatively modest improvements in modifiable health risks. The Trillion dollar savings is fully 25% of the package both sides say they want to reach. Why, one must wonder, is there little or no energy in that direction?

The well-being of our country is at stake. It's time that we see less brinkmanship and more leadership in DC.

Topics: In the News Healthcare Prevention Budget Crisis Medicare Advantage Government