Green Beans

1
Green Beans Ice Cream The Recipe for Wellness
Behavior Change ROI

• Bill Sims Jr., President
• The Bill Sims Company Inc.
• www.billsims.com

2
Ask any group of managers if they believe
wellness incentive programs are a good idea

• Why should I PAY people to be healthy? Its for
  their own good!
  
• Wellness programs have never produced any REAL
  ROI! You cant change peoples behavior
  

3
The Other Side of the Coin

• We went from 1 participation to over 70 in
  just 2 years. Deedy Rogers
  
• Our study proves that moving employees from
  burnout to engaged status yields a 6 increase in
  performance. Dr. Dicky Els
  
• We increased fitness center participation by
  72 in 3 monthsBank South
  

4
Healthcare Costs Threaten Profits
Healthcare cost is already more than after-tax
profits at most corporations. Healthcare already
consumes 16 of our Gross Domestic Product in the
U.S.A. It is projected to grow to 20 by 2015.
Source Centers for Medicare and Medicaid
Services, February 2006
5
Where Is the Most Leverage?70 of Medical Claims
Are from Poor Lifestyle Choices! (NEJM)
Source Summex, 2004
6
South African Study
Vitality
Engagement
Distraction
Work Devotion
Mental Distance
Over-commitment
Burnout
Exhaustion
7
Case study results
8
Which Trend Do You Want?
Note Assumes conservative 31 Benefit to Cost
Ratio for each investment in Population Health
Management (PHM).
9
What Are Best Practices of a Wellness Strategy
for Cost Control?

• Health Risk Assessments to identify bad health
  habits
  
• Medical Screening to get engaging, objective
  data
  
• Personal Coaching for all with significant health
  risks
  
• Education and Awareness to promote healthy
  living
  
• Self-Care Guides to avoid unnecessary doctor
  visits
  
• On-Site Medical Care, where possible
• Incentives to drive majority participation
• Health-conscious culture to reinforce good habits

10
Why wellness failed to produce ROI in the 80s

• T-shirts, Water Bottles, Pedometers to VisaCards
  to HealthSavings Accounts
  
• Same old story, different carrots
• Low, Medium High Risk Employees
• The Church of the Here and Now vs. Health
  Savings Accounts
  

11
Which group do you aim for?
High Risk?
Medium Risk
Low Risk
12
Notice the impact of Coaching in recent years
Bank of America Blue Shield of CA BP Amoco Citi
bank Coors Dupont General Foods General Motors
GlaxoSmithKline Indiana BCBS Johnson Johnson
Life Assurance Nortel Prudential Travelers
Cost / Benefit Ratio
Study Number
Source Chapman, Larry, Proof Positive An
Analysis of the Cost-Effectiveness of Wellness,
2005
13
Coaching Intervention Programs the Source of Real
Savings

• For 40-80 with greatest health risk
• Telephone-based coaching with mail or internet
  educational supplements
  
• Professional coaches set goals, build confidence,
  develop plans, motivate and educate
  
• Usually 2-12 coaching sessions/yr.
• Increases odds of success by 170-350!

Health Risks Addressed  Exercise Nutrition Str
ength Weight
Stress Smoking Depression Alcohol
14
Every Health Risk Eliminated Saves 100s per
Employee Every Year!
Depression 2725 High blood sugar 1638 Overw
eight 1348 High stress 1279 Tobacco 80
6 No exercise 801 High blood pressure 734
High cholesterol 513
Source Health Enhancement Research Organization
15
Reduction in Health Risks after First Year of
Coaching
High-risk participants change after 1 year of
health coaching in one vendors program.
n 1,321
Source Summex Health Management
16
Population Health Management Pilot Cut Cost
Increases by Two Thirds
Association of Washington Cities (12K)
17
What Works In Safety Wellness Behavior Change
18
Why recognition works

• The Hawthorne Study
• Dr.Frederick Herzberg
• Top 2 Satisfiers Achievement
• Recognition (long lasting)
• Top 2 Dissatisfiers Unfair Pay (cash award)
  Unfair Boss (favoritism)
  
• Bob Nelson 68
• Motor Convoy Biff Wilson

19
Elements of Behavior Change From Dr. Aubrey
Daniels
AntecedentBehavior Consequence
P.I.C or N.I.C.? Positive, Immediate, Certain w
ins over Negative, Immediate, Certain every time
You have to reinforce behavior multiple times to
sustain it
20
Elements of Behavior Change From Dr. Aubrey
Daniels
Is a gainsharing or team bonus PIC or PFU?
Is a diet/exercise program PIC or NIC?
Krispy Kreme The Marlboro Man
You need a daily,weekly strategy
21
You Did it Right! Card Rewards Behavior Change
Tracks who rewards whom, for what with no abuse
or favoritism
22
Most Popular Excuses NOT to Use Recognition
Programs
23
Excuse 1 Isnt a paycheck enough? Why reward
them for doing what they ought to be doing
anyway?

• Not if you want to change behavior
• You must provide PICS to offset the NICS of
  exercise, diet change

24
Incentive Programs
Behavior Change is what you want
25
Elements of Behavior Change

• Green Beans Ice Cream
• Train
• Recognize

26
Effective Training.

• Make it Custom not Canned
• 91 of all training is forgotten
• Measure Training Effectiveness by Middle Manager
  Employee
  
• Use training to find Low, Med, High Risk

Smartcard
27
Reaching the FAMILY is key.
The Learning Pyramid
Average retention of material presented in
different ways
(according to an investigation by National
Training Laboratories Bethel, Maine)
Lecture
5
Reading Text
10
Audio-visual representation
20
Demonstration
30
Discussion group
50
Learning by doing
75
Teaching others
(immediate conversion of
90
what you have learned)
28
Effective Recognition

• What does it look like?
• The Welcoa Survey shows 75 of all wellness
  programs use incentives

Smartcard
29
Are you reaching the high medium risk
population?
Bill Sims Welcoa Incentive Survey Results 2007
2
30
Sims Incentive Survey 2007
Cash Awards 210 PEPY 70 Participate 3 per Pe
rcentage Point

Healthcare Discounts 450 PEPY 50 Participate

9 per Percentage Point
Merchandise Sweepstakes 3 PEPY 32 Participat
e
.10 per Percentage Point
And the winner is.. Merchandise Sweepstakes! T
hey deliver vastly greater participation per
dollar spent..
10
31
Elements of Behavior ChangeBehavior is a
Result of ConsequencesPIC versus NICPIC
versus PFUKrispy Kreme is PICDiet/Workouts
are NICAre Healthcare discounts PIC?
Bill Sims Research
6
32
Why Cash Isnt King

• Is Cash all it takes?
• University of Waterloo
• IBM and the Six Figure Suggestion Award Winners

33
Logo Awards Survey

• Have you ever received a gift that you didnt
  want/need/use? Maybe a logod t-shirt for
  instance?
  
• Yes? Or No?
• Did you say Thank You?
• Yes or No?
• Is it possible that many times the giver assumes
  the recipient values the gift but they do not?
  

34
Tangible Reinforcers are most cost effective,but
only when a selection are offered Variable Win
Strategieshave highest impactBeyond T-Shirts
Water Bottles..Matching Risk Stratification to
Rewards and delivered thru a Health CoachHigh
Risk Employees will need greater incentives (more
PICS) to change behavior than low risk,
intrinsically motivated people
So what have we learned?
7
35
Effective Recognition is

• Tax Free/Non-Cash
• Offer a wide choice of non wellness items
• Provides PICS to offset NICS
• Weighted by Health Risk

Smartcard
36
Conclusions

• Cash is a dis-satisfier
• Recognition is a satisfier
• Show employees that you CARE they MATTER
• The Blue Ribbon Story

37
The Blue Ribbon
A teacher gave each of her students three blue
ribbons and instructed them to go out and spread
this acknowledgment ceremony. Then they were to
follow up on the results, see who honored whom
and report back to the class in about a week.
One of the boys in the class went to a junior ex
ecutive in a nearby company and honored him for
helping him with his career planning. He gave him
a blue ribbon and put it on his shirt. Then he
gave him two extra ribbons, and said, "We're
doing a class project on recognition, and we'd
like you to go out, find somebody to honor, give
them a blue ribbon then give them the extra blue
ribbon so they can acknowledge a third person to
keep this acknowledgment ceremony going. Then
please report back to me and tell me what
happened."
38
The Blue Ribbon
Later that day the junior executive went in to
see his boss, who had been noted, by the way, as
being kind of grouchy fellow. He sat his boss
down and he told him that he deeply admired him
for being a creative genius. The boss seemed very
surprised. The junior executive asked him if he
would accept the gift of the blue ribbon and
would he give him permission to put it on him.
His surprised boss said, "Well, sure." The junior
executive took the blue ribbon and placed it
right on his boss's jacket above his heart.
As he gave him the last extra ribbon, he said, "
Would you do me a favor? would you take this
extra ribbon and pass it on by honoring somebody
else? The young boy who first gave me the ribbons
is doing a project in school and we want to keep
this recognition ceremony going and find out how
it affects people."
39
The Blue Ribbon Story
That night the boss came home to his 14-year-old
son and sat him down. He said, "The most
incredible thing happened to me today. I was in
my office and one of the junior executives came
in and told me he admired me and gave me a blue
ribbon for being a creative genius. Imagine. He
thinks I'm a creative genius. He gave me an extra
ribbon and asked me to find somebody else to
honor. As I was driving home tonight, I started
thinking about whom I would honor with this
ribbon and I thought about you. I want to honor
you. "My days are really hectic and when I come
home I don't pay a lot of attention to you.
Sometimes I scream at you for not getting good
enough grades in school and for your bedroom
being a mess, but somehow tonight, I just wanted
to sit here and, well, just let you know that you
do make a difference to me. besides your mother,
you are the most important person in my life.
You're a great kid and I love you!" The startled
boy started to sob and sob, and he couldn't stop
crying. He handed the gun under his bed to his
father, while his whole body shook. He looked up
at his father and said through his tears, "I was
planning on committing suicide tomorrow, Dad,
because I didn't think you loved me. Now I don't
need to."
40
Free Research DVD
For a free dvd with the research from this
seminar, please email us at bill_at_8006901860.com
or visit
-www.billsims.com