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DESIGNING A COMPHREHENSIVE HEALTH PROMOTION PROGRAM
GEORGE J PFEIFFER, MSE, FAWHP
PRESIDENT, THE WORKCARE GROUP, INC.
+ 2Designing a Comprehensive Worksite Health Promotion Program
Understand the value and need of having an integrated, comprehensive approach to employee health promotion.
Identify common elements/practices for designing a comprehensive worksite health promotion program.
Identify common practices using a national accreditation model.
LEARNING OBJECTIVES
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Designing a Comprehensive Worksite Health Promotion Program
Only 24% of large companies (>750) have a comprehensive program as defined by the 2004 National Worksite Health Promotion Survey:
• Health education
• Integration
• Linkage with other programs
• Supportive social and physical environment
• Worksite screening
DID YOU KNOW?
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National Worksite Health Promotion Survey: 2004
Total Companies 6.9%
50-99 employees 4.6%
100-249 employees 6.0%
250-749 employees 11.3%
>750 employees 24.1%
Source: Linnan L, Bowling M, Childress J, Lindsay G, Blakey C, Pronk S, Wieker S, Royall P. Results of the 2004 national worksite health promotion survey. American Journal of Public Health. 2008;98(8):1503-1509.9
Companies Implementing All Five Elements
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National Worksite Health Promotion Survey: 2004
41.3% of all companies linked their health programming to related programs.
29.9% offered supportive social and physical environments.
28.6% integrated their programming into the organizational structure.
26.2% provided health education.
23.5% provided worksite screenings.
Source: Linnan L, Bowling M, Childress J, Lindsay G, Blakey C, Pronk S, Wieker S, Royall P. Results of the 2004 national worksite health promotion survey. American Journal of Public Health. 2008;98(8):1503-1509.9
Companies Implementing Specific Elements
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Designing a Comprehensive Worksite Health Promotion Program
An integrated, comprehensive model to employee health management addresses an organization’s entire population:
• disregards risk status.
• facilitates positive risk migration (e.g., medium/high to low).
• represents a sustainable health management/well-being strategy.
• encourages and facilitates a cross-functional approach to program planning and management.
VALUE PROPOSITION
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Designing a Comprehensive Worksite Health Promotion Program
*$6,000 per employee Direct Medical Costs
Estimated Total Costs $18,000 PEPY
Sources: Loeppke, et.al., JOEM, 2003; 45:349-359 and Brady, et al, JOEM, 1997; 39:224-231
DIRECT COSTS RELATED TO INDIRECT COSTS
■ Estimated $12,000 per Employee Medically Related Productivity Costs
Presenteeism
Absenteeism
Short-term Disability
Long-term Disability
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Designing a Comprehensive Worksite Health Promotion Program
CHANGE OF COSTS RELATED TO CHANGE IN RISKS
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Designing a Comprehensive Worksite Health Promotion Program
Goals
Keep employees healthy
Avoid migration to higher risk levels
Goals
Identify risk factors early
Target risks with appropriate interventions
Goals
Provide appropriate treatment with the greatest benefit at the least risk and cost
Improve treatment compliance/adherence
Goals
Assess outcomes
Reassess total health needs
Goals
Improve decision-making skills regarding care options
Improve provider/patient communication
Pfeiffer, GJ. Stages of the continuum of care. WorkSET Program. 2008.
Goals
Keep employees healthy
Avoid migration to higher risk levels
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Identifying strengths, weaknesses, and gaps along continuum
• Review existing program components against continuum.
• Identify what needs to be fixed.
• What needs to be added/eliminated?
• “Low hanging fruit”?
FIRST STEP: HOW BALANCED ARE YOUR OFFERINGS?
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■ What needs to be done before implementing your new plan?
• Do you need more data?
• Do you need to change your goals/objectives?
• Do you need additional resources?
• Do you need to change your staffing/contracts?
FIRST STEP: HOW BALANCED ARE YOUR OFFERINGS?
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Designing a Comprehensive Worksite Health Promotion Program
Goals
Keep employees healthy
Avoid migration to higher risk levels
Goals
■ Identify risk factors early
■ Target risks with appropriate interventions
Goals
■ Provide appropriate treatment with the greatest benefit at the least risk and cost
■ Improve treatment compliance/adherence
Goals
■ Assess outcomes
■ Reassess total health needs
Goals
■ Improve decision-making skills regarding care options
■ Improve provider/patient communication
Pfeiffer, GJ. Stages of the continuum of care. WorkSET Program. 2008.
Goals
■ Keep employees healthy
■ Avoid migration to higher risk levels
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Designing a Comprehensive Worksite Health Promotion Program
Program/Practice Models
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Designing a Comprehensive Worksite Health Promotion Program
1. Align features and incentives with the organization’s core mission, goals, operations, and administrative structures.
2. Operate at multiple levels.
3. Target the most important health care issues.
4. Tailor components to needs of individuals.
5. Achieve high rates of engagement and participation.
6. Achieve successful health outcomes.
7. Evaluate—scorecards and metrics.
Adapted from: Goetzel RZ, Shechter D, Ozminkowski RJ, et al. Promising practices in employer health and productivity management efforts: findings from a benchmarking study. J Occup Environ Med. 2007;49:111–130.
“PROMISING PRACTICES”
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Level 4 – Special Needs
Disease management, EAP, behavior health, health concierge, prenatal education, work hardening, ergonomics
Level 3 – Risk Reduction
Targeted interventions, health coaching, risk specific online & print applications, topic specific workshops/support groups
Level 2 – Risk Avoidance/Well-being
Screenings, HRA’s, health coaching, benefit education, online resources, benefit education, self-care
Level 1 – Organizational Readiness and Engagement
Business alignment, total leadership support, benefit design, policies, environmental supports, incentives
Pfeiffer, GJ. Worksite Health International. 2011
Operational Pyramid Planning Model
+US Healthiest HealthLead™ Workplace Accreditation Program
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Copyright 2012 Alliance to Make US Healthiest
: Business Sustainability Model? on Places of WorkBusiness Sustainability
+Medal Criteria Based on Comprehensiveness and Impact™ Planned
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■ Organizational Engagement and Alignment■ Population Health Management and Well-being■ Outcomes Reporting
© US Healthiest/HealthLead™ 2010. All rights reserved
US HEALTHIEST HEALTHLEAD™ HEALTHIEST WORKPLACE ACCREDITATION PROGRAM
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Business Alignment Leadership Alignment Data Alignment Policy Alignment Employee Benefits Alignment Environmental Alignment Communications Alignment Administrative/Operations Alignment
© US Healthiest/HealthLead™ 2010. All rights reserved
Organizational Engagement and Alignment
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Business Alignment Is your program aligned with your organization’s business
goals? Specific mission statement and related goals/objectives?
Leadership Alignment “C-Suite”/Senior leadership? Middle-management/Supervisory Lay-leadership Wellness committees?
© US Healthiest/HealthLead™ 2010. All rights reserved
Organizational Engagement and Alignment
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Data Management Alignment Data sources aligned with defined goals/objectives? Standard collection/evaluation processes? Dashboard?
Policy Alignment Tobacco-free, vending? Policies that reduce access/cost barriers?
Physical activity On/off the clock Flex-time
© US Healthiest/HealthLead™ 2010. All rights reserved
Organizational Engagement and Alignment
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Employee Benefits Alignment Affordable healthcare? Value-based benefit design? Incentive programs? Well-being: personal leave, education, financial health,
retirement?
Environmental Alignment Physical activity? Nutrition? Ergonomics? Lactation rooms?
© US Healthiest/HealthLead™ 2010. All rights reserved
Organizational Engagement and Alignment
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Communications Alignment Branding? Know leverage formal/informal networks Health literacy? Multiple media/channels?
Administrative/Operations Alignment Dedicated staff? Wellness committee? Performance standards internal/external? Quality control?
© US Healthiest/HealthLead™ 2010. All rights reserved
Organizational Engagement and Alignment
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Primary Prevention and Health Maintenance Risk Factor Intervention/Modification Decision Support/Medical Management Well-being and Information Support Services Work Safety Community Engagement
© US Healthiest/HealthLead™ 2010. All rights reserved
Population Health Management/Well-being
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Primary Prevention and Health Maintenance Health risk assessment/biometrics? Lifestyle and well-being management? Incentives? Safety?
Risk Factor Intervention/Modification Risk identification/targeting? Personalized programming? Incentives?
© US Healthiest/HealthLead™ 2010. All rights reserved
Population Health Management/Well-being
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Decision Support/Medical Management Health benefit support? Health literacy? Medical consumerism/self-care? Disease management?
Well-being and Information Support Services Resiliency? Work/life balance information and support EAP Continuing education?
© US Healthiest/HealthLead™ 2010. All rights reserved
Population Health Management/Well-being
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Work Safety Culture of safety—job/personal? Compliance with federal/local safety regulations? Ongoing education/cross-training wellness?
Community Engagement Leverage community resources? Engaged in health-related issues? Support employee volunteerism? “Leading by Example”—locally, nationally,
internationally?
© US Healthiest/HealthLead™ 2010. All rights reserved
Population Health Management/Well-being
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Process Outcomes
Risk Outcomes
Clinical Outcomes
Financial Outcomes
© US Healthiest/HealthLead™ 2010. All rights reserved
Outcomes Reporting
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What percentage of your population:
Eligible?
Complete HRA?
Complete biometric screening?
Know your program by name/logo?
© US Healthiest/HealthLead™ 2010. All rights reserved
Outcomes Reporting/Process Outcomes
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What percentage of your population:
Are considered low-risk?
Continue to be low-risk after second HRA?
Are engaged in targeted risk interventions?
© US Healthiest/HealthLead™ 2010. All rights reserved
Outcomes Reporting/Risk Outcomes
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What percentage of your population:
Comply with preventive screenings?
Medication adherence for leading chronic conditions?
Comply with minimum health measures regarding: Activity, BMI, Fruits/Vegetables, Tobacco Free, Alcohol?
© US Healthiest/HealthLead™ 2010. All rights reserved
Outcomes Reporting/Clinical Outcomes
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What is your organization’s three-year trend:
Direct medical costs?
Medical-related sick-days?
Short-term disability?
Workers compensation?
© US Healthiest/HealthLead™ 2010. All rights reserved
Outcomes Reporting/Financial Outcomes
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Designing a Comprehensive Worksite Health Promotion Program
We address our entire population.
We address all levels of risk.
We address the “total worker.”
We have a “total leadership” model.
We work cross-functionally.
Our program is aligned with our business: mission, goals, and objectives.
CHECKLIST
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Designing a Comprehensive Worksite Health Promotion Program
We attempt to integrate our services and data rather than segmenting our services.
We align policies, benefits, and environmental supports.
We continually communicate.
We try to identify and reduce barriers to participation and engagement.
We provide meaningful data to our key stakeholders.
CHECKLIST
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Further Information
www.ushealthiest.org
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ARE THERE ANY QUESTIONS?