realizing the promise and competitive advantage of a: “thriving, healthy, high-performing and...

Realizing the promise and Competitive Advantage of a:

“Thriving, Healthy, High-Performing and

Sustainable Workplace and Workforce”

January 23, 2014©2014 Edington Associates

Edington Associates LLC

Shared Values-Shared Results, Positive Health and Measure What Matters

©2012 Edington Associates 2

Respect for and by Self, Others and the Organization

• In a stress-producing world, where it seems we can’t control very much. We each can impact our own Health and Lifestyle. And when we do, it makes a difference to others, our family and to the organization.

• Each manager should take a minute out of each day to look into the faces of the people we manage. And to realize that they are our most important resource.

• Each organization should provide supportive leadership, and a supportive environment , climate, and culture. And when they do it makes a difference to everyone in the organization.


Estimated Prevalence of Health Risks

OVERALL RISK LEVELS

Low Risk = 0-2 risks

Medium Risk = 3-4 risks

High Risk = 5 or more

From the UM-HMRC Medical Economics Report

Estimates based on the age-gender distribution of a specific corporate employee population

Health Risk Measure

Body WeightStress Safety Belt UsagePhysical ActivityBlood PressureLife SatisfactionSmoking Perception of Health Illness DaysExisting Medical ProblemCholesterolAlcoholZero Risk

High Risk

41.8%31.8% 28.6% 23.3% 22.8%22.4% 14.4% 13.7%10.9% 9.2% 8.3% 2.9%14.0%

Less than 45 45 to 64 Greater than 650.0%

20.0%

40.0%

60.0%

80.0%

100.0%

3.00% 10.50%18.60%9.50%

32.00%

61.40%

25.30%

56.40%

80.00%

Low Risk

Excess Diseases Associated with Excess Risks (Heart, Diabetes, Cancer, Bronchitis, Emphysema

Percent with Disease

Med Risk

Age Range

High

Musich, McDonald, Hirschland, Edington. Disease Management & Health Outcomes 10(4):251-258, 2002.


Low Risk (0-2 Risks)

HRA Non-Par-ticipant

Medium Risk (3-4 Risks)

High Risk (5+ Risks)

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$840 $1,261

$3,321

Excess Costs

Base Cost

Excess Medical Costs due to Excess Risks

Edington, AJHP. 15(5):341-349, 2001

6©2012 Edington Associates

Natural Flow: by Risk Status

1640 (35.0%)

4,163 (39.0%)

678(14.4%)

High Risk(>4 risks)

Low Risk(0 - 2 risks)

Medium Risk(3 - 4 risks)

2,373 (50.6%)

21,750 (77.8%)

4,546(42.6%)

10,670 (24.6%)

4,691 (10.8%)

27,951 (64.5%)

11,495 (26.5%)

5,226 (12.1%)

26,591 (61.4%)

892(3.2%)

1,961 (18.4%)

5,309 (19.0%)

Modified from Edington, AJHP. 15(5):341-349, 2001

Average of three years between measures

Change in Costs follow Change in Risks

-$600

-$400

-$200

$0

$200

$400

$600

3 2 1 0 1 2 3Co

st

red

uc

edC

os

t in

cre

ase

d

Risks Reduced Risks Increased

Updated from Edington, AJHP. 15(5):341-349, 2001.

Overall: Cost per risk reduced: $215; Cost per risk avoided: $304 Actives: Cost per risk reduced: $231; Cost per risk avoided: $320 Retirees<65: Cost per risk reduced: $192; Cost per risk avoided: $621 Retirees>65: Cost per risk reduced: $214; Cost per risk avoided: $264


Natural Flow of a Population by: Risks-Costs-Age

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

$3,000

$6,000

$9,000

$12,000

$1,776 $2,193 $2,740

$3,734 $4,613

$5,756

$1,414

$2,944

$3,800

$5,212

$6,636

$8,110

$2,565

$3,353

$4,620

$6,625

$7,989

$8,927

$5,114 $5,710

$7,991

$10,785

$11,909 $11,965

Low

Annual Medical Costs

Med Risk

Age Range

High

Non-Participant

Edington. AJHP. 15(5):341-349, 2001


Cluster Analysis

Health MeasureCluster 1:

Risk taking(N=6688)

Cluster 2:Low Risk(N=3164)

Cluster 3:Biometrics(N=3100)

Cluster 4:Psychological

(N=3927)

Baunstein, Yi, Hirschland, McDonald, Edington. Am. J. Health Behavior. 25(4):407-417, 2001

SmokingAlcoholPhysical activitySafety belt usageBody mass indexSystolic blood pressureDiastolic blood pressureCholesterolHDL cholesterolSelf-perceived healthLife satisfactionStressIllness days

Overall RisksLow risk (0-2 risks)Medium risk (3-4 risks)High risk (5+ risks)Average Number of risks

50.2%35.7%14.1%

2.8

97.6%2.4%

00.6

26.5%48.9%24.7%

3.6

18.9%35.9%45.2%

4.4

31%10%28%36%27%9%5%

19%34%13%4%9%

21%

0%0%0 %0 %

25 %0 %0 %

19 %10 %0 %0 %0 %0 %

16%3%

19%22%38%81%61%27%33%9%2%2%

12%

27%5%

26%31%27%23%20%22%24%28%73%76%26%

Development and Consequences of Metabolic Syndrome

Risks: Waist Circumference Hypertension Glucose Intolerance Triglycerides HDL Cholesterol

Pre-Metabolic Syndrome

Metabolic Syndrome

Heart Disease

Diabetes RetinopathyNeuropathyNephropathy

Costs to Individual: Quality of Life Morbidity Mortality

Costs to Employers: Health care costs Productivity costs

Where do you want to intervene in the process?


Development and Consequences of Mental Health Issues

Risks: Perception of Health Life Satisfaction Job Satisfaction Stress Job Related Non-Job Related Illness Days

Pre-Mental Health Issues

Mental Health

Syndrome

Job Issues

Family Issues

Serious Mental Health Diagnoses

Costs to Individual: Quality of Life Morbidity Mortality

Costs to Employers: Health care costs Productivity costs




Medical and Drug Cost (Paid)*

2001 2002 2003 2004$1,500

$2,000

$2,500

$3,000

$3,500

$4,000

Non-Impr

Improved

Year

Pai

d

Improved=Same or lowered risks


Total Value of Health Medical/Hospital Drug Absence Disability Worker’s Comp Effective on Job Recruitment Retention Morale

Disease

HealthRisks

The Economics of Total Population Engagement and the Total Value of Health

BeyondLow or No Risks

Where does cost turn into an investment?

increase

increase


Wellness Strategies: 2013 and Before

HealthierPerson

BetterEmployee

Gains for theOrganization

Health Status Life Expectancy Disease Care Costs Health Care Costs Productivity Absence Disability Worker’s

Comp. Presenteeism Recruitment/Retention Company Visibility Social Responsibility

1981, 1995, 2000, 2006, 2008 Dee Edington

Lifestyle Change

Health and Disease Management Programs

Behavior Change (Wellness)

Treating Disease (Medical)


Disease Emphasis results in

1. Focus on Treatment of Disease

2. Emphasis on Whose is at fault?

Government, Health Plans, Providers, Employers, Individuals

3. Leads to Lowest Cost Solutions and to Higher Numbers of Uninsured


What’s Next?

Change the questions

Get to a new level of thinking

Adjust our vision of the future

Have foresight to change our definitions

Have the courage to change our beliefs


Health Strategies for 2013 and Beyond

Integrate the Whole Person into the Environment and Culture and

Engage in Population Health(Follow the lead of Safety and Quality)

(…in Quality terms this strategy translates into “fix the systems that lead to the

defects”)(Deming, Drucker, Blanchard)


Thriving and Sustainable Workplace and Workforce for 2013 and Beyond: Strategic

Create a Thriving and Healthy Workforce

Champion Company

Gains inOrganizational Objectives

Health Status Economics Absence Worker’s Comp. Presenteeism Financial Metrics Engaged Workers

Recruitment Retention

Happiness Company Visibility Social Responsibility

1981, 1995, 2000, 2006, 2008, 2012 Edington Associates

Create a Supportive Environment and Culture

Create the Vision and Strategy

Move Healthy Well-Being into the Culture

•Senior Leadership •Operations Leadership •Self-Leadership •Recognize Positive Acts •Quality Assurance

19

Senior Leadership Lack of supportLack of clear vision

Operations Leadership Supervisor lack of supportLack of supportive cultureIncomplete communications

Self Leadership Don’t understand why, what, how

Lack of self-efficacy Lack of time, convenience

Recognize Strengths Lack of positive recognition

Quality Assurance Lack of feedback on progress

Lack of shared values, vision

Previous Barriers during Implementation

©2013 Edington Associates


Journey towards a Shared Values Company

Communication and

Outreach

Enrollment and

Engagement

Prevention and

Wellness

RiskManagement

Disease Management

Workforce• Engaged• Thriving

Best Place to Work

Workplace• Shared Values•Positive Return

Clear Vision, Metrics, Culture and Environment

Vision, Commitment,

Leadership

Supportive Culture and

Environment

Workforce• Engaged• ThrivingPrevention

and Wellness

RiskManagement

Disease Management

Initiatives Along the Health Continuum

Program Impact

Best Place to Work


Enterprise Commitment and Support

Impactful Thriving, Healthy and Well-Being Programs

Sustainable Initiative to support the Vision

C


Committed , vocal and enthusiastic leadership promotes:•Increased awareness•More motivated employees •Shared Values•Clear Vision and Metrics

Levers of Program Success: Pillar 1-Strategic

Pillar 1: Senior

LeadershipStrong Vision

Visible Committed Leadership

Communication and

Outreach

Enrollment and

Engagement

Prevention and

Wellness

RiskManagement

Disease Management


Best Place to Work



Vision, Commitment,

Leadership


Environment


and Wellness

RiskManagement

Disease Management


Program Impact

Best Place to Work





C

22

Vision

Vision for a Culture of Health

“… a sustainable culture of health where individual’s happiness, quality of life, state of well-being and engagement in family and the organization are thriving”


Supportive culture and environment:•Create supportive employee health in

the Environment and Culture •Reduce barriers to self-leadership•Further increases participation and

strengthens engagement•Support for self-leadership

Pillar 1: Senior



Pillar 2: Operations Leadership

Culture of Health

Supportive Environment

Communication and

Outreach

Enrollment and

Engagement

Prevention and

Wellness

RiskManagement

Disease Management

Levers of Program Success: Pillar 2-Systematic


Best Place to Work



Vision, Commitment,

Leadership


Environment


and Wellness

RiskManagement

Disease Management


Program Impact

Best Place to Work





C

24

Clear goals established by Senior Leaders

Well communicated goals Understand the culture gaps and

create employee work teams to fix the gaps

Train everyone on how to achieve a high-quality, healthy and thriving culture

Wellness program audit to align goals Corporate scorecard available to all employees

How Do You Add Health to the Culture?


Promote self-leadership •Greater self efficacy• Increased commitment to stick to it

•Develop Life Skills•Promote Engagement

Pillar 1: Senior

Leadership


Strong VisionVisible

Committed Leadership

Culture of Health

Supportive Environment

Communication and

Outreach

Enrollment and

Engagement

Prevention and

Wellness

RiskManagement

Disease Management

Levers of Program Success: Pillar 3-Systemic

Pillar 3: Self-

LeadershipCreate Winners• Help Employees Not Get Worse• Help Healthy People Stay Healthy


Best Place to Work



Vision, Commitment,

Leadership


Environment


and Wellness

RiskManagement

Disease Management


Program Impact

Best Place to Work





C

© 2012 Edington Associates 26

What is SELF-LEADERSHIP?

Self-leadership is the process of purposefully…

engaging in change

making thoughtful decisions

having resilience

which builds on strengths and is continuously learning and growing

in thriving relationships

27

Incorporate Determinates of Health

IndividualSupportiveCommunity

Supportive Family and

Friends

Supportive Workplace

ThrivingEmployee

©2012 Edington AssociatesLiving and Thriving Assessment


Vision for Self-Leadership

Personal Control

Optimism

Self-Leadership

Resilience

Confidence/ Self-efficacy

Self-Esteem

Knowledge Health Literacy Negotiation Skills

Vitality/Vigor

Consumerism Engaged

patient role

Social Support− Colleagues− Community − Family

Environment and culture

Other characteristics: Change, Integrity, Trust, Thrive, Enthusiasm, Ethical, Spiritual, Creative, Flexible,

Low-Risks and Behaviors

Purpose, Values, Mission, Vision

Positive Outlook

Happiness

Brain Health

Emotions & Intuitions

Mental

Shortcuts and Biases

Environment

Values

Purpose

Vision

Focusing on Strengths

Positive

Reframing

Creating a Plan for Change

Fundamental Skills for Self-Leaders


Interactive Activities – Example (Values)


Recognize positive actions:• Reinforces healthy,

well-being behaviors• Promote Shared Values• Develop intrinsic

motivation• Promote Self- Efficacy

Pillar 4: Recognize

Actions

Pillar 1: Senior



Recognize Champions Reinforce at every touch

point


Vision, Commitment,

Leadership


Environment


and Wellness

RiskManagement

Disease Management


Program Impact

Best Place to Work



Levers of Success: Pillar 4-Systemic

Pillar 3: Self-

Leadership

Pillar 2: Operations LeadershipCulture of

HealthSupportive

Environment

Create Winners• Help Employees Not Get Worse• Help Healthy People Stay Healthy

C



©201s Edington Associates 34

Pillar 5: Quality Assurance

Continuous Improvement

Continuous feedback of information about program

processes and outcomes

Communication and

Enrolment

Engagement and

Culture

Prevention and

Wellness

CaseManagement

Disease Management

Levers of Program Success: Pillar 5-Sustainable

Pillar 3: Self-

Leadership

Pillar 4: Recognize

Actions

Pillar 1: Senior

Leadership



Best Place to Work



Vision, Commitment,

Leadership


Environment


and Wellness

RiskManagement

Disease Management


Program Impact

Best Place to Work





C

Systemic, Sustainable

Reinforce the Culture of Health

•Align recognition with the vision

• Reward champions

• Set incentives for what matters

• Reinforce at every touch point“What is rewarded is what is sustained”

Principles of Positive Actions

35©2010: Health Transformation Group, LLCNot for Distribution

Step #4

Sustainable• Integrate all data

• Measure What Matters

• Provide feedback on how progress was obtained and steps to get to vision

• Feedback on leadership, culture, self-leadership, positive actions, economic outcomes“Supports decisions with evidence”

Principles of Quality Assurance

36©2010: Health Transformation Group, LLCNot for Distribution

Step #5


Vision for Your Organization

Summary

3 Strategic Vision from

Leaders

Systematic & Thriving

Culture

Systemic Engage all

in the Culture

Recognize Positive Actions,

WorkTeam

Sustained Progress

in all areas

2 Speech from

Leader

Internal Wellness Program

Screenings & Reduce High-Risks

Coaching

Incent High-Risk Reduction

Change in Risks, ROI

1 Inform Leader

Out-source Wellness

Screenings & Reduce High-Risks

Incent High-Risk Reduction

Change in Risks

0 Do Nothing

Do Nothing

Do Nothing

Do Nothing

Do Nothing

Pillar 1 Pillar 2 Pillar 3 Pillar 4 Pillar 5

Which Sustainability Level is for YouSustainability Rating

Do Nothing

Core to the Organization

Comprehensive

Traditional

Senior Leadership

Operations Leadership

Self-Leadership

Rewards for Positive

Actions

Quality Assurance

Five Pillars


Vision for Your Organization

What’s the Point?


Phone: 734.998.8326 (USA)

Email: [email protected]@edingtonassociates.com

[email protected]@edingtonassociates.com

Website: www.edingtonassociates.com

Address: Edington Associates LLC University of Michigan North Campus Research Center 1600 Huron Parkway Ann Arbor MI 48109

Thank you for your attention

realizing the promise and competitive advantage of a: “thriving, healthy, high-performing and...

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