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Improving Health and Productivity in the Workplace

Moving towards an outcomes-based approach to wellness, with a focus on prevention
Updated: Thu, 07/06/2017 - 15:30
 
 

sponsored by The Partners Group

There are many benefits to workplace wellness programs ranging from improved employee health to controlled healthcare costs to easier recruitment and retention of employees. Yet, even with these workplace wellness program benefits, our health remains at risk. We continue to see an increase in chronic conditions and a decline in the health status of our employees. This article provides a rationale and approach for moving beyond participation-based wellness programs to outcomes-based wellness programs. 

The costs associated with lifestyle-related health problems are estimated to account for more than a third of the $2.4 trillion the United States spends on health care annually. Chronic diseases, including heart disease, cancer, and diabetes, are the leading causes of death and disability in the United States. They are pervasive, costly, and in many cases, preventable or manageable through the combined application of medical science and healthy lifestyles. Nearly 50% to 80% of all diseases are linked to the behavior choices we make.

However, the good news is that we continue to see an increase in employers offering some type of wellness program.

According to a recent National Business Group on health study, where employers with less than 500 employees were surveyed, 61% offered general wellness programs, increased from 51% last year. Additionally, 69% of Northwest employers recently polled by The Partners Group are implementing some sort of a workplace wellness program.

Why Employers are Prioritizing Workplace Wellness
There are a variety of reasons employers are focusing on and prioritizing workplace wellness. The worksite is a great place to be able to showcase your support of an employee's wellbeing, and in return we're hoping we can begin to show how increased employee productivity, reduced absenteeism, and improved job satisfaction and engagement can cause positive results for an employer’s bottom line. Wellness programs have also become a major factor in the recruiting and retention of employees.

“Chronic diseases and related lifestyle risk factors that you can control are the overall lead drivers of healthcare costs for employers. The riskier your behavior, the more likely we are to get a chronic condition and then our costs continue to go up.” — The Centers for Disease Control and Prevention

Employees who engage in a workplace wellness program for six consecutive months tend to see more positive results than those that don't participate. Their employers have reported results such as weight loss and stress reduction or relief by participating in focused programs. Many employees have also experienced a reduction in year-over-year health risks because of their participation in a biometric health screening campaign.

“The future of workplace wellness initiatives must go beyond the standard definitions of “wellness” to the creation of a more holistic culture geared toward health and performance. Done right, everyone wins.” — Philip Swayze: Society for Human Resource Management.

At the Partners Group, we absolutely believe the old adage: "an ounce of prevention is worth a pound of cure." To figure out how to transition our impact on the risk, we need to understand what our healthcare spend accounts for:

Well/At Risk
75-80% of employees have less than three risk factors and account for about 20% of the overall United States healthcare spend. These employees are typically those who are healthy, or have some risk factors including smoking, obesity, or high cholesterol. Their health management goals might include weight loss programs, smoking cessation programs, and wellness or healthy lifestyles and prevention opportunities, including routine physical examinations. The objective with these employees is to keep them healthy and loyal participants to the healthcare system. Our measures of success for this risk group might include engagement, patient activation, retention, and provider satisfaction.

Rising Risk
15-20% of employees have greater than three but less than nine health risk factors and account for 50% of all healthcare spend in the United States. These employees have one or more chronic conditions that are generally well managed. Their health management goals might include self-care through education, engagement in a primary care medical home model, reduction or risk factors, medication compliance as needed, care coordination, and wellness or healthy lifestyles and prevention programs. The objective with the rising risk population is to improve engagement, self-care, and management of chronic conditions. The aim is to reduce the number of people who move to a high-risk category. Measures of success for the rising risk group are engagement and activation, reduction in readmissions and emergency room utilization, and provider satisfaction. 

High Risk
1%-2% of employees with more than nine health risks account for 30% of dollars spent on their healthcare. These employees have a catastrophic diagnosis, multiple chronic conditions, or advanced disease burden, and are not managed well or are frail. Their health management goals might include patient engagement, treatment compliance, informed decision making, care coordination, advanced care planning as needed, and treatment compliance and support. The objective with the high-risk population is to stabilize the care, reduce the barriers to care and compliance, utilize a patient centered care plan, and avoid adverse events. Measures of success for the high-risk population are engagement and activation, appropriate utilization of health care services, reduction in emergency room visits and readmission, as well as provider satisfaction. 

About 1%-2% of employees have nine or more risk factors, accounting for about 30% of the dollars spent on healthcare in the United States.

The Right Strategy For Your Company
Knowing where your risk is and being able to implement programs with targeted interventions to address it mitigates your risk over time. So how do we begin to transition people from that 15% to 20% rising risk category to the well/at risk category? And how do we keep them in the well/at risk well category?

Before we can even begin to evaluate what type of health promotion program is appropriate for your organization, we must start with shifting from a sick care culture that treats the disease to one that is based on prevention and wellness.

There are various prevention strategies covering a range of activities and interventions based on reducing health risks or threats to an employee's health and preventing disease or injury before it happens. Strategies can also include helping people identify and manage conditions early, as well as manage long-term, complex health problems. These strategies build upon each other for maximum benefit--get more details on prevention strategies here.

The below chart illustrates employers in the Northwest who are actively pursuing or already have in place a health contingent outcomes-based program. This includes programs that reward employees for achieving specific health improvements, such as: reduction of tobacco use, improvement of BMI (body mass index), and improvements in cholesterol or blood pressure.

While many employers have added wellness programs to their health plan, some employers are reporting low levels of employee participation in these programs. As a result, they're looking for new ways to increase engagement in wellness programs and ultimately influence their employees to change health behaviors. Consequently, interest in outcomes-based incentives has never been higher.

Having a long-term investment strategy is the right approach for incorporating a successful long-term wellness program. While you may not necessarily be achieving high participation at this point, we wouldn't suggest immediately dropping your current program and moving towards an outcomes-based incentive program. Making that leap from participation-based to outcomes-based should certainly not be taken lightly—you should get details first around the legal requirements of incorporating a contingent outcomes-based program into your workplace. 

Beyond physical health—what’s next in workplace wellness?
Many employers are very engaged in improvements to their employees' physical health right now. They're focusing on activities designed to get employees moving, making healthier food choices, and eliminating tobacco in their workplace. 

We’ve heard from employees we've surveyed and from research that we need to look beyond just those physical triggers and factors. We need to begin to incorporate overall wellbeing, something that many people are calling total health. 

A growing element of wellness programs is promoting emotional well-being and financial literacy in addition to physical health. These things intertwine and contribute to workplace well-being. Employers are now looking at the impact of stress, financial wellness, and poor health on productivity of their employees. 50% of Americans worry about personal financial issues during work, while nearly 30% manage personal finances on job. 

You can start to transition beyond physical health by fostering a culture of health that supports the worker’s emotional and fiscal health, and ultimately, performance. Here are a few examples:

Bring employees together around a shared purpose by supporting philanthropic activities as part of your company’s mission so everyone reaps the psychic income of helping others. 

Integrate stress management, financial wellness, and sleep hygiene programs in with your traditional walking programs and healthy eating classes to address other key components of well-being.

Consider integrating a robust menu of voluntary benefits into your overall program. The options can range from offering identity theft and pet insurance to retirement plan counseling services that can address a more urgent need and create peace of mind for an employee. 

Helpful Resources
We’ve highlighted a particular employer and how they went down the path of implementing a workplace risk reduction strategy in this case study

Additionally, we’ve invited our legal counsel, Iris Tilley from Barran Liebman Attorneys, to address legal considerations to be aware of when moving forward with a health contingent wellness program. 

This list of free resources is a great place to get started regardless of where you're at with your workplace wellness program. This is a sampling of organizations, both locally and nationally, that have evidenced-based health promotion best practices that you can reference. Certainly, we at The Partners Group are happy to assist you and answer any questions that you have around the development of a workplace wellness program as well. 

Within the Employer Services Division of the Partners Group, we not only offer employee benefits, we also provide employee health and productivity consulting services, healthcare analytics, total absence management consulting services, as well as employer retirement plans. Please contact us if we can be of further assistance to you, and subscribe to our email list for the latest updates and news.

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