Realizing the Promise and Competitive Advantage of a

Thriving and Sustainable Workplace and Workforce

Strategies for 2013 and BeyondThe University of Michigan

Edington Associates

Dee W. Edington

October 10, 2012

Health Promotion – The value of meeting patients where they are

The University of Michigan

Edington Associates

Dee W. Edington

October 10, 2012

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Leadership Buffalo 2012

MissionDedicated to improving the health of people in

Western New York

Goals• Empower all in the WNY community to take responsibility for and act

on their own wellness• Facilitate the development of a community-wide standard for the

promotion of wellness• Work with physicians and provider organizations to enhance access to

care and improve quality of care• Initiate dialog with government leadership to promote policy change

Board of Directors• Kevin Donovan Northeast District Energy Corporation• Donald Boswell WNED-TV Channel 17• Karen Blount, RN, PNP BlueCross BlueShield of WNY• Michael Cropp, MD Independent Health• Michael Edbauer, DO Catholic Medical Partners• Stephen Edges, MD, FACS Roswell Park Cancer Institute• John Fudyma, MD State University of New York at Buffalo • George Gellman The Benchmark Group

• Pastor Richard Hague, Jr Mount Erie Baptist Church• Maureen Hurley Rich Products• Maureen Millane, PhD Daemen College• Debra Quinn Consumer• Patrick Reen Consumer• Thomas Rosenthal, MD State University of New York at Buffalo • Dan Scully Buffalo Medical Group, PC• Arthur Wingerter Univera Healthcare

Three Core Disciplines• Improve the quality of care• Improve access to care• Focus on areas with low socio-economic status

Care Transformation

• Help Communities to understand areas where they need improvement.

• Provide facilitation services, data support, and assistance with resources.

• Promote policy change

Community Health Planning

• Create programs that empower patients to become active partners in their care, and take responsibility for and act on their own wellness.

Health Engagement

Targeted Interventions For Every Aspect of Health

Physical Environment (10%)

• Western New York Community Health Planning Institute

Social and Economic Factors (40%)

• Western New York Health Equity Coalition

• Community Medicaid Collaborative

Clinical Care (20%)

• PCMH Adoption

• Care Transitions of Western New York

• Prostate Cancer Quality Initiative

Health Behaviors (30%)

• Ounce of Prevention

• Living Healthy

• Diabetes Prevention Program

Does low health status present a threat to your

organization or community?

Does high health status present a competitive

advantage for your organization/community?

Business/Community Problem

Currently, most costs associated with workplace, workforce and

community performance are growing at an unsustainable rate

and a threat to the organization/community

How are we going to be successful in this increasingly competitive

world without a healthy and high performing workplace, workforce

and communities?

How can we turn costs into an investment?

What if you worked for the best company you could imagine: an

organization that was a high performing and an employer of

choice.

What words would you use to describe the workplace and

the workforce?

VISION for 2013 and Beyond

Who is your target audience and what to they look like?

Estimated Health Risks

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%

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

Estimated Health ProblemsSelf -Reported

AllergiesBack PainCholesterolHeart Burn/Acid RefluxBlood PressureArthritisDepressionMigraine HeadachesAsthmaChronic PainDiabetesHeart ProblemsOsteoporosisBronchitis/EmphysemaCancerPast StrokeZero Medical Conditions

Health Problems

33.2% 26.9% 16.2% 15.2% 14.5% 14.5% 10.7% 9.4% 7.0% 6.4% 3.8% 3.3% 1.8%

1.7% 1.3% 0.7% 31.9%

From the UM-HMRC Medical Economics Report

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

1640 (35.0%)

4,163 (39.0%)

678(14.4%)

Risk Transitions (Natural Flow)

Time 1 – Time 2 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

23,043 (34.0%)

25,856 (20.3%)

6,936(10.2%)

Cost Transitions(Natural Flow)Time 1 – Time 2

High Cost($5000+)

Medium Cost($1000-$4999)

Low Cost(<$1000)

37,701 (55.7%)

119,271 (74.1%)

75,500(59.1%)

127,644 (35.8%)

67,680 (19.0%)

160,951 (45.2%)

130,785 (36.7%)

73,427 (20.6%)

152,063 (42.7%)

9,438(5.9%)

32,242 (20.0%)

26,288 (20.6%)

N=356,275 Non-Medicare Trad/PPO

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

Low

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

Costs are Associated with Risks and Age

Annual Medical Costs

Med Risk

Age Range

High

Non-Participant

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

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

Disease

HealthRisks

The Economics of the Total Threat to Organizations and Communities relative to High or Low Health Status

Low orNo Risks

Where does the Threat turn into a competitive advantage?

increase

increase

decrease

Medical and Wellness Strategies in 2012 and

Before

Wait for Disease or Health Risks and then Treat

In Quality terms this strategy translates into “wait for defects and then fix the defects”

The world we have made as a result of thelevel of thinking we have done thus far

creates problems we cannot solveat the same level of thinking at which we created them.

- Albert Einstein

Where do we need to go in 2013 and beyond?

TO A NEW LEVEL OF THINKING…(Deming, Drucker, Blanchard…)

Vision for Zero Trends

“…organizations ensure a

sustainable and thriving workplace and workforce…”

Zero Trends was written to be a

transformational approach

Based upon over 800 Publications and

Presentations

Strategies for 2013 and Beyond

Integrate the Whole Person into the Environment and

Culture(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)

Characteristic of a Champion Company and Community

Strategic Vision

Systematic Strategy

Systemic Solutions

Sustainable Policies

VISION: “…organizations ensure a sustainable and thriving workplace and

workforce”

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, 2011 Dee W. Edington

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

Thriving and Sustainable Workplace and Workforce for 2013 and Beyond:

Strategic

Five Fundamental Next Practice Pillars

Pillar 3: Self-

Leadership

Pillar 4: Reward Actions

Pillar 5: Quality

Assurance

Pillar 1: Senior

Leadership

Pillar 2: Operations Leadership

Strong Vision Committed Leadership

Courage

Build Culture of Wellness

Build the BrandTrain all Levels

Create WinnersOne step at a timeDon’t get worse Build Self-EfficacyBuild Self-Leaders

Reward Positive Actions

Reinforce Every Touch Point

Continuous Improvement

FeedbackSustainable

Strategic, Systematic, Systemic and Sustainable

Communication and

Enrollment

Engagement and

Culture

Economics PerformancePrevention

and Wellness

CaseManagement

Disease Management

Programs Along the Health Continuum

Program Impact

Champion Company

Self-leadersHealth Status

Communication, Engagement &Culture

Lifestyle Scale for Individuals and Populations: Self-Leaders

ChronicSigns &

SymptomsFeeling OK

PrematureSickness, Death & Disability

High-Level Wellness, Energy and Vitality

Edington. Corporate Fitness and Recreation. 2:44, 1983, Modified 2009

Supportive Self-Leader

Supportive

Community

Supportive Family

and Friends

Supportive Workplace

21st Century Living and Thriving

Assessment

Determinates of Living and Thriving

Living and Thriving Assessment

Self-Leadership and High Performance

•Personal Control

• Optimism

Self-leadership

• Resilience

•Confidence/ Self-efficacy

• Self-esteem

•Knowledge •Health Literacy•Negotiation Skills

• Vitality/energy/Vigor

•Consumerism•Engagement

• Social Support

– Colleagues– Community – Family

•Environment and culture

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

•Low-Risk Health Status

•Purpose-Values-Mission-Vision

©2010: Edington Associates

Implementation

CEO Training Courses Senior Leaders Human Resource

GAP All Managers Analysis Wellness Champions

All Employees Metrics Environmental Audit Resilience

Concepts of ChangeVision Decision Making

Perception of Culture Self-LeadershipCommitment

Wellness Programs Focus Groups

Reward Positive Actions

Steering Attention to Gaps Team

ES and Outcome Integrated Database

Corporate Positioning System

Enterprise Strategy

Corporate Positioning System•Where do you want to go? (Vision Objectives)•Are we there yet ? (Success Metrics)•Where are you today? (Gap Analysis)•How do you get there ? (Training, Modules, Wellness)•Roadblocks, Detours ? (Ongoing Evaluation)•Are you on track? (Real Time Tracking)

Online platform with views for all stakeholders in the organization• Senior Leaders• Operations Leaders• Managers• All Employees

Summary

Summary advice for Organizations and

Communities

Don’t get worse

Help the healthy people stay healthy

© 2011 Edington Associates, LLC

What’s Your Vision? Create a Strategy

Vision from

LeadersHealthy

System & Culture

Champion

Everyone a Self-Leader

Reward Sustained

Results

Progress in All Areas

Comprehensive

Traditional

Do Nothing

Speech from

LeaderReduction in Risks

Reduce Health Risks

Reward Achievement

Change in Risk &

Sick Costs

Inform Leader

Programs Targeting

Risks

Health Risk

Awareness

Change in Risks

Status Quo

Senior Leadership

Operational Leadership

Self-Leadership

Reward Positive Actions

Quality Assurance

Status Quo Status Quo Status Quo Status Quo

Reward Enrollment

What’s the Point

Thank you for your attentionPlease contact us if you have any questions

Phone: (734) 998-8326

Email: dwe@edingtonassociates.com

Website: www.edingtonassociates.com

Edington Associates LLC North Campus Research Center 1600 Huron Parkway , Ann Arbor MI 48109 Twitter, Facebook, LinkedIn