WELLNESS PROGRAM WORKSHOP

Transcription

1 AMERICAN COUNCIL FOR INDEPENDENT LABORATORIES WELLNESS PROGRAM WORKSHOP OCTOBER 8, 2012 NEW YORK CITY, NY PRESENTED BY: ARVID R. DICK TILLMAR, TILLMAR CONNECT LLC Not just politically correct, developing a wellness program can save your laboratory real dollars with studies showing that 80 percent of all health care spending is preventable and 50 percent of these potential savings come from wellness, lifestyle and behavioral changes. This presentation will provide a road map to launch a new wellness program or improve an already existing one, so join us to improve your laboratory s bottom line.

2 THE NEED FOR WELLNESS Prevention Why? Increase in illnesses

3 THE NEED FOR WELLNESS 3 The biggest threats facing the American work force today are obesity, tobacco use, and stress. Together, these lifestyle factors contribute to lost productivity and absenteeism, among other problems, but a wellness program can work to combat all three

4 BENEFITS OF WORKSITE WELLNESS PROGRAMS Source: National Business Group on Health,

5 THE NEED FOR WELLNESS 5

6 MILESTONES IN CONTEMPORARY AMERICA Hostess introduces Twinkies, 1953 Ray Kroc franchises the McDonald Brothers, 1955 And then introduces supersizing, 1993

7 INDIVIDUAL BEHAVIOR Awareness/education Motivation Tools, strategies Policy and environment 7

8 Individual

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13 13 It s All About Behavior Change

14 14 Individual Family

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16 16 Individual Family Worksite

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18 18 Individual Family Worksite Community

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22 22 Individual Family Worksite Community Nation/ World

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24 Constraining Medical Costs BEHAVIOR & LIFESTYLE: WEIGHT GAIN No Country Can Fund All the Consequences: Hypertension Type 2 Diabetes Osteoarthritis Stroke Coronary Heart Gallbladder Sleep Apnea Respiratory Issues Some Cancers Obesity Trends Among U.S. Adults (BMI>30%) No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30% Centers for Disease Control & Prevention, 2006 Behavioral Risk Factors Surveillance System

25 PERCENT OF OBESE (BMI>30) U.S. ADULTS

26 PERCENT OF OBESE (BMI>30) U.S. ADULTS

27 PERCENT OF OBESE (BMI>30) U.S. ADULTS

28 PERCENT OF OBESE (BMI>30) U.S. ADULTS

29 DIABETES TRENDS AMONG ADULTS IN THE U.S. BRFSS No Data <4% 4%-6% 6%-8% 8%-10% >10%

30 DIABETES TRENDS AMONG ADULTS IN THE U.S. BRFSS No Data <4% 4%-6% 6%-8% 8%-10% >10%

31 DIABETES TRENDS AMONG ADULTS IN THE U.S. BRFSS No Data <4% 4%-6% 6%-8% 8%-10% >10%

32 DIABETES TRENDS AMONG ADULTS IN THE U.S. BRFSS No Data <4% 4%-6% 6%-8% 8%-10% >10%

33 DIABETES TRENDS AMONG ADULTS IN THE U.S. BRFSS No Data <4% 4%-6% 6%-8% 8%-10% >10%

34 DIABETES TRENDS AMONG ADULTS IN THE U.S. BRFSS No Data <4% 4%-6% 6%-8% 8%-10% >10%

35 DIABETES TRENDS AMONG ADULTS IN THE U.S. BRFSS No Data <4% 4%-6% 6%-8% 8%-10% >10%

36 DIABETES TRENDS AMONG ADULTS IN THE U.S. BRFSS No Data <4% 4%-6% 6%-8% 8%-10% >10%

37 DIABETES TRENDS AMONG ADULTS IN THE U.S. BRFSS No Data <4% 4%-6% 6%-8% 8%-10% >10%

38 A WEIGHTY TOLL ON EMPLOYERS 38 Obesity costs U.S. companies $13 billion annually These workers have 36% higher medical costs than fit employees

39 THE HIGH COST OF SMOKING 39 A smoker costs the employer $3856/yr in added healthcare costs and lost productivity The overall prevalence of tobacco use is about 25% of the population, which can be generalized to any workplace population Calculating the cost of smoking: Assume a workplace with 100 employees Assume 25 employees use tobacco Result = $96,400/yr in business borne costs associated with smoking Because of this high cost, it is estimated more than 6,000 companies now refuse to hire smokers Alaska Airlines requires a nicotine test before hiring people Kalamazoo Valley Community College stopped hiring smokers for full-time positions Union Pacific won t hire smokers

40 THE COST OF POOR HEALTH 40 Lost productivity related to absence & presenteeism compared to medical & pharmacy costs Presenteeism Lost Productivity Medical Costs 25% 34% STD/LTD/WC 5% Absenteeism Lost Productivity 36% IBI Research Insights - Single employer example

41 TOP 10 MOST COSTLY HEALTH CONDITIONS 41 Chronic disease has $1 TRILLION impact on U.S. lost productivity each year. Goetzl, R; JOEM 45(1)

42 EXPENSE DRIVERS 42 Health Care System 10% Environment 20% Genetics 20% Lifestyle 50%

43 PREVENTABLE CAUSES OF DEATH IN WISCONSIN 43 Tobacco: 8,100 +/- deaths per year in Wisconsin Poor diet: Physical inactivity: 6,900 +/- deaths per year in Wisconsin Microbial agents: 1,700 +/- deaths per year in Wisconsin Alcohol: 1,600 +/- deaths per year in Wisconsin Toxic agents: 1,000 +/- deaths per year in Wisconsin Medical errors: 1,300 +/- deaths per year in Wisconsin Motor Vehicles: 800 +/- deaths per year in Wisconsin Firearms: 400 +/- deaths per year in Wisconsin Sexual behavior: 400 +/- deaths per year in Wisconsin Uninsurance: 300 +/- deaths per year in Wisconsin Illicit drug use: 300 +/- deaths per year in Wisconsin TOTAL: 22,800

44 Six Unhealthy Truths Tell the Story of the Rise of Chronic Disease and It s Impact on Health and Health Care 44 Truth #1: Chronic Diseases are the #1 cause of death and disability in the U.S. Truth #2: Chronic diseases account for 75% of the nation s health care spending. Truth #3: About two-thirds of the rise in health care spending is due to the rise in the prevalence of treated chronic disease. Truth #4: The doubling of obesity between 1987 and today accounts for nearly 30% of the rise in health care spending. Truth #5: The vast majority of cases of chronic disease could be better prevented or managed. Truth #6: Many Americans (five in six) are unaware of the extent to which chronic disease harms their health and their wallets.

45 IMPACT OF HEALTH RISK FACTORS ON PRODUCTIVITY 45 Risk Factors considered in study include: Tobacco Use BMI <18.5 or >24.9 Physical inactivity Lack of emotional fulfillment, High stress High blood pressure High cholesterol Alcohol use Overdue preventive visits Diabetes Mean Lost Productivity 30% 25% 20% 15% 10% 5% 0% Presenteeism Absenteeism 25.9% 6.3% 0.0% 0 risks 1 risk 2 risks 3 risks 4 risks 5 risks 6 risks 7 risks 8 risks Boles M, Pelletier B, Lynch W. The Relationship Between Health Risks and Work Productivity.

46 AS HEALTH RISKS INCREASE, SO DO EXCESSIVE COSTS 46 $6,000 $5,000 Excess Costs Base Cost Average Annual Medical Cost $4,000 $3,321 $3,000 $840 $1,261 $2,000 $1,000 $0 $1,500 Low Risk (0-2 Risks) Excess Costs Base Cost HRA Non- Participant Medium Risk (3-4 Risks) High Risk (5+ Risks) Average Annual Disability Cost These represent the maximum savings opportunity if you moved people from High (6+ risks) to Low (0-2 risks) $1,000 $757 $500 $175 $292 $0 Low Risk (0-2 Risks) N=685 HRA Non- Participant N=4,649 Medium Risk (3-4 Risks) N=520 High Risk (5+ Risks) N=366 Chart Sources: Medical Edition: Edington. AJHP. 15(5): , 2001; Disability: Wright, Beard, Edington. JOEM. 44(12): , 2002

47 AS HEALTH RISKS INCREASE, SO DO EXCESSIVE COSTS 47 Sample XYZ Company Summary Report - Percentage of employees who: Have at least 1 coronary risk factor 75% Were rated poor for nutrition practices 70% Have high blood pressure 60% Smoke 57% Are 20% over their ideal body weight 40% Exercise Regularly 20% -There were 3 complicated pregnancies last year that cost the company $300,000 -The interest survey indicated that the majority of employees would like to participate in programs with their families, would like aerobics classes during the day and would like a weight control class at work. A few employees indicated they wish to quit smoking. -An additional survey showed that almost all managers were supportive of the proposed wellness program. It further indicated that managers would participate and encourage others to as well.

48 IMAGINE IF YOU COULD SAVE 25% OFF YOUR RISING HEALTH CARE COSTS 48 25% savings off of Rising Health Care Costs Annual employer health care cost per employee $10,000 $8,000 $6,000 $4,000 $2,000 $0 $7,379 $7,832 $6,348 $6,918 $5,162 $5,758 $1,587 $1,730 $1,845 $1,958 $4,320 $4,604 $1,080 $1,151 $1,291 $1, Year

49 WELLNESS PROGRAMS 49 EFFICACY & CASE STUDIES

50 NUMEROUS STUDIES DOCUMENT STRONG ROI A multitude of studies show ROI averages of $3 for every $1 invested One recent study had the return as high as 10 to 1 Companies must be patient. Worksites typically don t realize returns until about three years into the program. If an organization is willing to wait two or three years, it will be capable of achieving this magnitude (3 to 1) of ROI. A review of 32 studies found claims costs were reduced by 27.8%, physician visits by 16.5%, hospital admissions by 62.5%, disability costs by 34.4% and incidence of injury by 24.7% 50

51 WELLNESS WORKS, ACCORDING TO ROI STUDIES 51 From a review of 73 published studies of worksite wellness programs Average $3.50-to-$1 savings-to-cost ratio in reduced absenteeism and health care costs From a meta-review of 42 published studies of worksite wellness programs Average 28% reduction in sick leave absenteeism Average 26% reduction in health care costs Average 30% reduction in workers compensation and disability management claims costs Average $5.93-to-$1 savings-to-cost ratio A comprehensive health management program at Citibank $4.56-$4.73-to-$1 savings-to-cost ration in reduced total health care costs

52 WELLNESS PROGRAMS 52 BUSINESS CASE & IMPLEMENTATION

53 DEFINING HEALTH RISKS & RISK LEVELS 53 Health Risk Measure Alcohol High Risk Criteria > 14 drinks per week Blood Pressure Systolic >139 mmhg/diastolic >89 mmhg Body Weight BMI =/>27.5 Cholesterol Existing Medical Problem HDL Illness Days Life Satisfaction Perception of Health Physical Activity Safety Belt Usage Smoking Stress Overall Risk Levels Low Risk Medium Risk High Risk >239 mg/dl Heart, Cancer, Diabetes, Stroke <335 mg/dl >5 days last yr Partly or not satisfied Fair or Poor <1 time per week Using safety belts <100% of time Current smoker High 0 to 2 high risks 3 to 4 high risks 5 or more high risks

54 GET WELL OR PAY NOT TO 54 Consumers may be able to improve their health and bottom line by participating in company sponsored wellness programs. More employers are offering cash, discounts and even lower health insurance premiums to entice workers to participate in a variety of programs. Starting next year, employees could have further incentives to get healthy as more companies add penalties to insurance premiums for workers who don t partake. It s an opportunity to get cash for doing what s right for you. Despite cutbacks amid the recession, 58% of large U.S. companies now offer lifestyle-improvement programs, up from 43% in 2007, according to a Watson Wyatt Study. And 56% provide health coaches, compared with 44% in Health-risk appraisals are offered at 80% of companies, up from 72% in 2007.

55 DISCOUNTS AND FREEBIES 55 Employees may be able to get $200 to $300 for participating in health-risk appraisals, smoking-cessation, weight management and preventive care classes. Other offerings include heavily discounted weight loss programs and free or discounted gym memberships. At some companies, employees who participate are rewarded with gift cards or lower insurance premiums.

56 WELLNESS PROGRAMS 56 EMPLOYERS EXPERIENCES WITH ROI

57 HISTORICAL PERSPECITIVE ON SAVINGS Johnson & Johnson 57 Started in 1979 Invested $30M, 94% participation rate Cholesterol, activity and smoking Results of $224 per year savings per employee ($8.5M annually) Pitney Bowes Analysis 1991; Health Care University started in :1 ROI for participants in HCU Increased productivity, less absenteeism for gym members Ergonomics showed a 5.1 ROI Union Pacific Winner of C. Everett Koop Award 1994, 1997, 2001 Smoking down from 40% to 28% over 10 years 10% decrease in lifestyle related healthcare costs equating to $53.6M dollar difference in 2001

58 ... AND TODAY S EXPERIENCE 2008 PRICEWATERHOUSE COOPER S HEALTH AND WELLNESS TOUCHSTONE SURVEY RESULTS: 58 69% of 561 companies have a wellness program Less than 30% of members participate: the use of incentives increases participation 52% of respondents don t believe wellness programs are effective at mitigating healthcare costs, improving performance/productivity, or enhancing employee engagement/loyalty. They do believe they are effective at reinforcing corporate responsibility and image Only 37% of respondents integrate occupational health with their wellness strategy

59 ASSOCIATION OF RISK LEVELS WITH SEVERAL CORPORATE COST MEASURES 59 Research conducted at the University of Michigan has shown that the low risk employees (1-2 risk factors) have lower cost for short term disability, workers comp, absence and health care costs whereas high risk employees (5+risk factors) have higher costs. Source: Wright, Beard, Edington, JOEM 44 (12):

60 WELLNSS PROGRAM SAVINGS

61 WELLNSS PROGRAMS So, how do you do it?

62 WELCOA s 7 BENCHMARKS Benchmark #1 - Capturing CEO Support Benchmark #2 - Creating Cohesive Wellness Teams Benchmark #3 - Collecting Data To Drive Health Efforts Benchmark #4 - Carefully Crafting An Operating Plan Benchmark #5 - Choosing Appropriate Interventions Benchmark #6 - Creating A Supportive Environment Benchmark #7 - Carefully Evaluating Outcomes

63 WHAT DOESN T WORK ONE SIZE DOES NOT FIT ALL! Health Assessments alone Low budget, low intensity, low participation rates Programs that focus on what s in it for the organization, not the individual participant Under the radar initiatives NIH (not invented here) philosophy Huge incentives that would be better used for programming HERO Panel: EHM What Really Works? HERO Forum for Employee Health Management Solutions New Orleans, Louisiana -- October 2007 Ron Z. Goetzel, Ph.D. Cornell University and Thomson Medstat

64 BEST CRITERIA FOR WELLNESS PROGRAMS Employ features and incentives that are consistent with the organization s core mission, goals, operations, and administrative structures; Operate at multiple levels, simultaneously addressing individual, environmental, policy, and cultural factors in the organization; Target the most important health care issues among the employee population; Engage and tailor diverse components to the unique needs and concerns of individuals; Achieve high rates of engagement and participation, both in the short and long term; Achieve successful health outcomes, cost savings, and additional org. objectives; Are evaluated based upon clear definitions of success, as reflected in scorecards and metrics agreed upon by all relevant constituencies.

65 DR. ROBERT LUSTIG Robert H. Lustig, MD, UCSF Professor of Pediatrics in the Division of Endocrinology, explores the damage caused by sugary foods. He argues that fructose (too much) and fiber (not enough) appear to be cornerstones of the obesity epidemic through their effects on insulin. Series: UCSF Mini Medical School for the Public [7/2009] [Health and Medicine] [Show ID: 16717]

66 WELL WORKPLACE Sample Comprehensive Report Sample Executive Summary

67 (double click on documents to bring up full PDF versions)

68 ESSENTIAL ELEMENTS: WELLNESS PROGRAMS 1. A Vision/Mission Statement for The Wellness Program 2. Specific Goals and Measurable Objectives 3. Timelines For Implementation 4. Roles And Responsibilities 5. Itemized Budget 6. Appropriate Marketing Strategies 7. Evaluation Procedures

69 THE EFFECTS OF AN EFFECTIVE WELLNESS PROGRAM Click image below to read full article

70 THE USE OF INCENTIVES Companies are now using incentives to drive participation in health programs Of nearly 2,000 U.S. surveyed employers, 84% offer employees incentives to participate in a health risk questionnaire (HRQ) and 64% of those offer an incentive for participation screening. 51% provide incentives to employees who participate in health improvement and wellness programs. The use of monetary incentives, in particular, has increased dramatically in A growing number of employers are beginning to link incentives to a result.

71 SMART GOALS & OBJECTIVES The need to have SMART goals & objectives for your Wellness Programs:

72 WHO S TO BLAME IF YOU RE FAT?

73 WHO S TO BLAME IF YOU RE FAT? Click image below to read full article

74 REFERENCE GUIDES Emphasis of Preventative Care in the Affordable Care Act Well City Milwaukee

75 RETHINK YOUR DRINK Teaspoons Sugar 16 oz 32 oz 44 oz 52 oz 64 oz

76 A YEAR OF SODA: 44.7 GALLONS Here s what carbonated soft drink consumption sugared and diet sodas looked like in Average American chugged the equivalent of 48 two-liter bottles and ounce cans of soft drinks in one year. Teaspoon of Sugar grams of sugar = 1 teaspoon of sugar 2. Before you order a drink, ask how much sugar is in the beverage it is listed in grams on the ingredients list 3. After you do the math, simply divide the number of grams of sugar by 4 and ask yourself if almost 10 or more teaspoons of sugar is really what you want.

77 QUESTIONS & ANSWERS

78 THANK YOU! Arvid R. Dick Tillmar Health Advocate 8820 West Cleveland Ave West Allis, Wisconsin (414) Web: LinkedIn:

79 ALBERT EINSTEIN INTELLECTUALS SOLVE PROBLEMS, GENIUSES PREVENT THEM.