health, well-being and productivity improvement in the workplace

Tracy Brower, Ph.D., MM, MCR

Michael Parkinson, MD, MPH, FACPM

What it really takes: Health, well-being & productivity improvement in the workplace

It’s totally possible.

Today’s speaker

Dr. Michael Parkinson | Principal | P3 Health

•Key medical advisor for Limeade •Principal of P3 Health, EVP and CMO of Lumenos •Previous President of American College of Preventive Medicine • MD from George Washington University, MPH from John

Hopkins and AB from Cornell University

Overview

Welcome

Understanding the drivers

Laying out the roadmap

Putting it into action

Where corporate wellness fits

#WhatItReallyTakes

@Limeade

Q&A

Understand the drivers of health and productivity in the workplace, and how to address them in your own organization.

Goals

What are we trying to do anyway?

$2.8T on healthcare:

75% behaviors30% waste

Framework: Workforce well-being & business performance

Well-being status Workplace practices

Individual well-being

Individual performance

Org performance

* Adapted from Sherman BW, Lynch DL. Am J Managed Care 2014: 20(2) 155-120

Work factors

Workplace Culture

Healthy| Minimal preventable illness and injury

Productive| Contributes to the corporate mission and achieves personal goals

Ready| Responds to changing demands

Resilient| Adjusts to setbacks or unusual challenges

Do you have a healthy workforce?

Adapted from IOM: Integrating Employee Health: A Report for NASA 2007

Determinants of health

Social environment

Physical environment

Genetic environment

Health Disease Healthcare

Individual response Well-being Prosperity

“Live, learn, work and play”

Evans, R. G., Barer, M. L., & Marmor, T. R. (1994)Why Are Some People Healthy and Others Not?. New York: Aldine De Gruyter

19-34 35-44 45-54 55-64 65-74 75+$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$7,000

Medium RiskHigh Risk

Non-ParticipantLow risk

Behaviors drive ALL costs

Edington. Am J Health Promotion 15(5):341-349, 2001

IOM 2011: The Healthcare Imperative: Lowering Costs and Improving Outcomes

Unnecessary services

Inefficient delivery

Excess admin costs

Excessive prices

Missed prevention

Fraud

Where’s the waste?

30%excess waste

$750Bin waste

Laying out the roadmap

Employer health & productivity roadmap™*

IncreaseHealthy

Behaviors

OptimizeEnvironment

OptimizeChronic

Care

Speed Care

Transitions

Minimize Acute Care

ReduceExcessiveSurgeryReduceExcess Surgery

*Parkinson MD. Employer Health and Productivity Roadmap™ Strategy, JOEM 55 (12) Supp Dec 2013.

Putting it into action

Optimize the environment2

Culture| Policies, leadership

Programs & health| Wellness program, resources, communications

Roles, responsibilities & rewards| Policy alignment, compensation and benefit alignment

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Optimize the environment2

Alignment of rewards and responsibilities leads to:

| Reduce medical spend by $2,500 PPPY

| Decrease STD up to 50%

| Decrease worker's compensation up to 65%

| Decrease turnover for top performers up to 50%

| Increase revenue up to 35%

|

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Increase healthy behaviors

Incentivized health management program or consumer-directed health plan

2Competency based programs address root cause of disease & costs

|Tobacco cessation |Physical activity |Stress management|Weight management

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Minimize acute care

Healthy people use less acute care| Traditional and alternative care

| Virtual visits

| Costs and on-site care options

| Prevalence of acute visits

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Optimize chronic care

2

2

| Condition prevalence

| ID & referral process

| Disease management coaching

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Coaching

2

2

|Prepare to make changes

|Set goals

|Facilitate problem solving

|Develop self-efficacy & gain support

|Build skills

|Engage in medical decision-making with doctor

|

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Coaching and tools

Lifestyle improvement

NutritionTobacco cessation

Physical activityStress management

Chronic disease

Cardiovascular conditionsDepressionDiabetes Maternity

Shared decision support

Back & knee painBreast cancerHeart disease

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Reduce excess surgery

2

2

25%of all surgeries

are unnecessary (RAND)

O’Connor et al. 2003, Armstrong et al 2012; Lee et al 2013*Whelan et al. 2004; Kennedy et al. 2002; Murray et al. 2001; Deyo et al. 2000;

Morgan et al. 2000; Bernstein et al. 1998; Barry et al. 1997; Street et al. 1995

| Shared decision-making before surgery| Reduce:- # of surgeries- Advanced imaging rate

| Expand to more discretionary surgeries| Utilize decision aids

|

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Informing patients

*Foundation for Informed Medical Decision Making survey, 2009 (n=462)

Managing conditions

Changing behaviors

Taking new Rx's

Surgery

Cancer screenings

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Patients actually informed Important for patients to be Informed?

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“Patient activation” – why it matters

| Better health behaviors| Better clinical care and

clinical outcomes| Overall lower cost

* J Gen Int Med 2012;27:52026 and Health Aff 2013;32:216-222

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Speed care transitions

Incentivized health management program or consumer-directed health plan

2

Goal: Get employees back to work

| Address conditions that drive employees away from work

| Reduce frequency of absences

| Monitor return to function and work by major condition

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Where corporate wellness fits

Invest in employees’ well-being

| Support & reward behavior change

| Tools & resources

| Biometric screenings

| Interventions & coaching

Workplace wellness programs tie it together

ImproveHealth

Well-BeingPerformance

| Engaging in wellness is a must

| Employees & families want it their way

| Technology is changing the game| Mobile, devices, self-monitoring,

bio feedback, virtual coaching

How technology is driving the future

| Cash/gift cards

| Nudge messaging

| Loss aversion

| Default option

| Commitment contract

| Peer support group

| Tech/web support

New vocabulary of behavioral economics

CMS RFI “Beneficiary engagement, incentives and behavioral insights” due Sep 15, 2014

| Recognize financial stakes

| Emphasis on preventive care

| Less medical service overuse

Consumer directed healthcare

“It’s my health and my money, and I’m going to take better care

of both.”

Physical activity

Attitude of self, sense of purpose

Whole-food, plant-based diet

What I eat, how I move, what I think

The 3 fundamentals of health

Whole person approach

• Benefit design/incentive driven

• Clinical engagement program

• Member services• 24/7 nurse line

• Employee assistance program

• Worksite health clinics• Central leave management• Disability

• Coaching• Physical condition

management• Behavior condition

management

“ “

Q&A

About Limeade

Incentivized health management program or consumer-directed health plan

2Limeade is a corporate wellness technology company that measurably improves employee health, well-being and performance, while building cultures that support well-being.

limeade.commarketingteam@limeade.com