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The opinions expressed in this presentation are those of the speaker. The International Society and International Foundation disclaim responsibility for views expressed and statements made by the program speakers.
Why Workplace Health is as Important as PE,
Recess and School Lunch
Kristy Clark, MPHWellness Account Executive
Parker, Smith & FeekSeattle, Washington
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Agenda
• What schools and worksites have in common that contribute to public health?
• Compare influences to health• Policy Individual Choice
• What worksites can do– See what some employers have done to gain traction
in health promotion– What has the most influence on behavior
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What do schools and worksites have in common regarding public health?
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Social Ecological Model:
*Damis, Brian. A Holistic Approach to Environmental Public Health. National Environmental Health Promotion Network. // September 21, 2011
Use to enable employees and students to take an active role in their health, Targeting Behavior at the Organizational Level
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Worksite
• Americans work an average of 34.5 hours per week, spending 6.8-10 hours a day at their place of work.
• 55% of the population gets health insurance through their employer
• Employer pays 87% of cost• Costs are rising unsustainably• Influence prevalent social norms
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Schools
• Structured environment where students spend large amount time
• Eat meals• Opportunity for physical activity• Teachers and curriculum
influence knowledge• Create social norms
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Public Health Problem
• Obesity trends, Diabetes, Chronic stress
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Why it’s Important
Workplace SchoolsHealth and Safety Health and SafetyProductivity Build foundation for learningAccess to care Access to careAttraction and Retention RetentionEconomy
- Health care 19% of GDP Our Future
– Healthcare and Economy
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Organizational Development Theory
• System-wide process of applying behavioral science knowledge for:– Planned change and development of strategies– Design components– Processes driving organizational effectiveness
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Where to focus change:
• Meet people where they are: – If healthy, keep that
way. – If can lose weight, help
them.– If have chronic disease,
help with management.
Inner and Outer Determinants
Existence of Wellness
Plan
Intentionto
exercise
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Analyze Current State of WellnessStrategy How/Who IndicatorsUnderstand EmployeeClaim costs
Risk stratum • Quarterly healthcare expense report• Quarterly Rx utilization• High $ individual claims
Understand employeerisks
HRA • Aggregated results• Target problem areas
Understand existing environment
Policy and environmental assessment
Employee interest survey • Incentives to increase response rate
Understand Utilization of Existing wellness benefits
Increased Participation:• Smoking cessation programs• Enrollment at health clubs
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Develop Program to Address Environment, Benefits, Risks and Behaviors
Strategy How/Who Indicators
Align benefit structure with health objectives Expert input
Incentivize preventive
Review insurance plan for:Prevention Disease management
Develop new incentives Interest survey HRA, Achievement awards
% Participation
Plan for policy and environmental changes
Comprehensive Campus Wellness Committee
Showers, physical activity facilities, on-site food, bike racks, lighting
Ensure protection of vulnerable employees and security of data
Human Resources
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Evaluating the Program
• Data results from measurement• Participation rates• Satisfaction surveys• Policy/environmental change tracking • Overall healthcare claims spending• Determine measurement of quality
– Can you trust the data?
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Wellness Well-Being Engagement and Culture
Wellness Evolution
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More Comprehensive, new set of standards:1. Health2. Meaning3. Safety4. Connection5. Achievement6. Growth7. Resiliency
Implementing Changes/Focus Areas
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School Safety
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U.S. Education
• Young people faced with a variety of challenges on a daily basis. – Small changes can outsize difference
• Chronic stress—not left at the door– taken to work and school
• Schools are inconsistent with PE, recess and school lunch– Yet data indicates active students learn better
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What Some Schools are Doing
• Epiphany School—Seattle, Washington• Naperville High School—Illinois• Yale—Newtown, Connecticut
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Heart Adventure Course
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Results
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Exercise
• Beat Stress• Lift Mood• Sharpen Intellect• Function Better
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Establish Life Long Behaviors/Habits
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Naperville, Cardio Room
• 17 percent improvement for zero hour PE vs.10 % for those not.
• Schedule hardest classes after PE • Teaches:
– Fitness instead of sports– Lessons will serve for life– Skills– Sense of fun and awareness of how bodies work– Hooked on moving
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Naperville, Cardio Room
• Exercise stimulates neuro growth• Best in world on science test, ahead of
Singapore. • “Gym teachers create the brain cells,
teachers fill them.”• Virginia tech study did not improve test scores
after cutting gym.
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College
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Parker Smith & Feek
• Parker Smith & Feek• Koop Award Winners• Cleveland Clinic
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Wellness Components at PSF
1. Medical Outcomes
Earn Dollars for 2019Medical HRA/HSA Accounts
2.Activity-basedprograms
Earn Gift Card and Days Off in 2019
3. Tobacco$25 Surcharge for tobacco useon Medical Premiums 2018
2018
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Introduced New Vendor
What we liked:• Broad panel blood draw (no finger stick)
– Can take to your physician; do not have to repeat– Expanded panel to include PSA, A1C
• Easily understood Health score 0-100 scale • 2019 Incentives will reward progress, not perfection • Personalized reporting • Challenges - fewer, different • Earn points and rewards• Will manage Reasonable Alternative (appeals) process
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Objective, Easy to Understand Scoring
• Developed and reviewed by a panel of physicians
• Designed to reward health improvement across all risk levels
• Detailed, personalized report highlighting risk level
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Activity Incentives
Wellness Portal• Provides the ability to
plan, track, and manage participation:– Individual and Team Challenges– Lifestyle Rewards– Volunteering– Participation in Fitness Events– Device Integration
• Pair your activity tracker
Intention for these challenges to promote health or culture
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Claims Results
Costs have remained relatively flat,Wellness participation rates have ranged from 60-78%
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What Some Workplaces are Doing
• Parker Smith & Feek• Koop Award Winners• Cleveland Clinic
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Charles Everett Koop Award
• American Pediatric Surgeon and Public Health Administrator
• 13th Surgeon General of United States, served under Ronald Reagan
• Honored by award in his name promoting employer achievement in improving population health cost effectively
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• Reduce need and demand for medical services• Share objectives of Healthy People’s workplace
health promotion targets• Prove net health care and/or productivity cost
reductions as a result of improving population health.
Koop Award Criteria
BEHAVIOR CHANGE + RISK REDUCTION + COST SAVINGS= KOOP NATIONAL HEALTH AWARD
JOEM. Volume 58, Number 1 // January 2016, Ron Z. Goetzel, Raymond Fabius, et al.
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Koop Award Industries
Health careIndustrialFinancialTechnologyUtillitiesMaterialsEnergyConsumer
JOEM. Volume 58, Number 1 // January 2016, Ron Z. Goetzel, Raymond Fabius, et al.
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C. Everett Koop National Health Awards
• 1-4 winners a year• Initially invested $10,000 equally among 15
companies• Programs in place for at least 3 years• If acquired, removed from portfolio
JOEM. Volume 58, Number 1 // January 2016, Ron Z. Goetzel, Raymond Fabius, et al.
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Value
• Koop Award winners outpaced S&P 500– Tracked 14 year period (2000-2014)– S&P Results
325% appreciation (compared to market 105%) 2.35/1.0
– Many companies are realizing that workers health extends beyond individual choices. Polices, programs, and practices at organizations can influence health.
JOEM. Volume 58, Number 1 // January 2016, Ron Z. Goetzel, Raymond Fabius, et al.
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What Some Workplaces are Doing
• Cleveland Clinic– Cleveland, Ohio
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Components of Clinic Program
• Cost and travel barriers removed with convenient and free access to fitness centers
• Premium Incentive
• Sign up deadlines and participation requirements
Employee Premium Level DiscountGOLD – Meet the health goals 30%SILVER – Participate, but do not meet goals 15% Bronze – Choose not to take part None
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Categories to Earn Premium Incentive
– Shape Up and GoHealthy Coordinated Care
– Hypertension – Diabetes – Hyperlipidemia – Asthma– Weight Management – Current Tobacco Use
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Current Status
• Participation: 16,621 Bronze,5,600 Silver, 11,000 Gold
• Of employees identified with chronic conditions, 57% enrolled in Coordinated Care Programs
• 2012 cost avoidance Employee Health Plan of $15 million • Costs leveling or decreasing for those enrolled in Healthy
Choice, rest of participants continue to increase• Spouses eligible to enroll in 2014, increasing impact
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Lessons Learned
• Clinic uniquely poised as provider and payer • Workplace wellness proved effective at
improving outcomes • Quality Measurement helped focus on specifics
to change• Even with reduced barriers, incentives and
efficient processes, Ultimately behavior change is up to the individual.
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What has the most influence on behavior?
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Influencers for Behavior Change
• If you can’t go “all in” with wellness, provide some of these features (AMSO)
Michael O’Donnell, Health Promotion in the Workplace 5th Edition, 2017
Awareness
Motivation
Skills
Opportunity 40%
30%
5%
25%
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Outcomes
Short-term results Increased knowledge and awareness
Intermediate results
Revised attitudes, perceptions, and beliefs
Long-term results Changed behaviors, actions and norms
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2018 Employer Priorities
First year that reducing health care costs is not #1 in employer priority 1. Increase employee
engagement2. Increase employee retention3. Reducing healthcare costs
Source: 2017 Virgin Pulse survey
Individual Results
Business Results
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Quality of life improvesHealth care utilization is reduced
Wellbeing behaviors
Outcomes
Benefits Impact and Performance
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Key Takeaways
• Implications of providing health literacy and a culture of health at work and school
• Understanding the landscape of workplaces in targeting behavior and accessing health care
• Learn some practical places to start; You do not need to be “all in” with wellness to impact lives
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Thank You
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