health, well-being and productivity improvement in the workplace
TRANSCRIPT
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.