Improving the Bottom Line by Improving Employee Health

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Improving the Bottom Line by Improving Employee
Health

• Steven Aldana, Ph.D.
• CEO WellSteps

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Who

• Delivers basic medical care inexpensively
• Delivers it to the masses, not via house calls
• Does not work with insurance or TPAs
• Developed and used disease identification tools
  and methodologies
• Has substantial clinical lab work expertise
• Delivers health content to 130,000 lives everyday

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• Delivers basic medical care inexpensively
• Delivered to the masses, not via house calls
• Do not work with insurance or TPAs
• Developed and used disease identification tools
  and methodologies
• Gained substantial clinical lab work expertise
• Touches 130,000 lives everyday

Onsite clinics
HRA
Biometric Screening
Wellness Web portal
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U.S. Health Care as a Percentage of the GDP
Today 16 of GDP
US Military uses 3.2
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Employer Health Benefits 2005 Annual Survey
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Bureau of Labor Statistics
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U.S. Health Care as a Percentage of the GDP
Today 16 of GDP
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U.S. Health Care as a Percentage of the GDP
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U.S. Health Care as a Percentage of the GDP
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U.S. Health Care as a Percentage of the GDP
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U.S. Health Care as a Percentage of the GDP
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Doctor Day, January 1, 2226
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The Bottom Line
Unhealthy behaviors
Health risks
Chronic disease
Health care costs
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Obesity Trends Among U.S. Adults1985
No Data lt10 1014
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Obesity Trends Among U.S. Adults1986
No Data lt10 1014
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Obesity Trends Among U.S. Adults1987
No Data lt10 1014
20
Obesity Trends Among U.S. Adults1988
No Data lt10 1014
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Obesity Trends Among U.S. Adults1989
No Data lt10 1014
22
Obesity Trends Among U.S. Adults1990
No Data lt10 1014
23
Obesity Trends Among U.S. Adults1991
No Data lt10 1014
1519
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Obesity Trends Among U.S. Adults1992
No Data lt10 1014
1519
25
Obesity Trends Among U.S. Adults1993
No Data lt10 1014
1519
26
Obesity Trends Among U.S. Adults1994
No Data lt10 1014
1519
27
Obesity Trends Among U.S. Adults1995
No Data lt10 1014
1519
28
Obesity Trends Among U.S. Adults1996
No Data lt10 1014
1519
29
Obesity Trends Among U.S. Adults1997
No Data lt10 1014
1519 20
30
Obesity Trends Among U.S. Adults1998
No Data lt10 1014
1519 20
31
Obesity Trends Among U.S. Adults1999
No Data lt10 1014
1519 20
32
Obesity Trends Among U.S. Adults2000
No Data lt10 1014
1519 20
33
Obesity Trends Among U.S. Adults2001
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. Adults2002
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. Adults2003
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. Adults2004
No Data lt10 1014
1519 2024 25
37
Obesity Trends Among U.S. Adults2005
No Data lt10 1014
1519 2024 2529
30
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Obesity Trends Among U.S. Adults2006
No Data lt10 1014
1519 2024 2529
30
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Obesity Trends Among U.S. Adults2007
No Data lt10 1014
1519 2024 2529
30
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Percent of adults who are overweight or obese
67
2/3 of adults are overweight or obese
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Percent of adults who are overweight or obese
86
Obesity July, 2008
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Excess Body Weight and Reduction of Lifespan
-3.1
-3.3
-5.8
-7.1
Ann Intern Med. 200313824-32
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Diabetes Among Adults in the U.S.,BRFSS 1990
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Diabetes Among Adults in the U.S.,BRFSS 1992
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Diabetes Among Adults in the U.S.,BRFSS 1994
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Diabetes Among Adults in the U.S.,BRFSS 1996
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Diabetes Among Adults in the U.S.,BRFSS 1997
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Diabetes Among Adults in the U.S.,BRFSS 1998
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Diabetes Among Adults in the U.S.,BRFSS 1999
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Diabetes Among Adults in the U.S.,BRFSS 2000
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Diabetes Among Adults in the U.S.,BRFSS 2001
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Diabetes and Reduction in Lifespan
-14.3 yrs
-11.6 yrs
JAMA 20032901884-1890
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How did we get this way?
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5-a-day 1 million
Food Marketing 25 Billion
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Texas Double Whopper
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The Bottom Line
Unhealthy behaviors
Health risks
Chronic disease
Health care costs
67
1,500-3,500 in Excess Claims for Each
Additional Health Risk
Source Dee Edington, Health Management Research
Center
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Average 2003 Medical Care Costs
N1,706
Source StayWell Health Management
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Average 1997-1999 Medical Care Costs
N43,687
Source StayWell Health Management
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Days Absent in 2003
N941
Source StayWell Health Management
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Percent with Workers Comp Claims in 2003
N23,916
Source StayWell Health Management
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Percent with STD Claims in 2004
N23,916
Source StayWell Health Management
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Return on Investment (ROI)
32 studies
14 studies
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How to Build a Wellness Program
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5 Steps

• 1. How to Get Started
• 2. Assessing Your Worksite
• 3. Plan and implement wellness strategies
• 4. Change the worksite culture and environment
• 5. Evaluating Your Program

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1. Leadership Support

• Get leadership support
• Wellness is a business strategy
• Wellness Committee

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Cost of Poor Employee Health
Absenteeism 6
Edington, Burton. A Practical Approach to
Occupational and Environmental Medicine 140-152.
2003.
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Absenteeism 6
Workers Comp 9
Edington, Burton. A Practical Approach to
Occupational and Environmental Medicine 140-152.
2003.
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Absenteeism 6
Health Care Cost 25
Workers Comp 9
Edington, Burton. A Practical Approach to
Occupational and Environmental Medicine 140-152.
2003.
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Presenteeism 60
Absenteeism 6
Health Care Cost 25
Workers Comp 9
Edington, Burton. A Practical Approach to
Occupational and Environmental Medicine 140-152.
2003.
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Your Wellness Committee
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• Adds credibility and importance to your efforts
• Provide program PR
• Team lightens the load
• Provides stability

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What does the committee do?

• Decide to use vendors or go it alone
• Oversees the wellness efforts
• Establishes the vision and operating plan
• Decides on goals and outcomes to measure

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2. Assessing Your Worksite
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• Health Risk Appraisal
• Free?
• Vendor?
• Clinical risk measures?

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• Health Risk Appraisal
• Free?
• Vendor?
• Clinical risk measures?

An HRA is NOT a wellness program!
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Q and A
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How long will it take to get the program going?

• The planning process can take from 3-7 months
• Data collection, risk, health care costs,
  pharmaceuticals, behaviors
• Look at worksite health culture
• Understand the benefits package and how wellness
  fits in. What will the package look like with a
  wellness program?

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Whats it going to cost?

• What does your insurance company offer?
• What does your health care provider offer?
• What about vendors?
• Can it be done for free?
• Lets take a poll.

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Whats it going to cost?
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3. Plan and implement wellness strategies
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Behavior Drives Everything
Employee related costs
Unhealthy culture and behaviors
Health risks
Chronic disease
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Behavior Change Requires
Policy and Environment
Skills and Tools
Motivation
Awareness and Education
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Individual
Family
Worksite
Community
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• Flyers
• Posters
• Email notifications
• Television/video programs
• Books

• Payroll stuffers
• Internet sites
• Magazines
• Lunch and learns
• Special speakers
• Newsletters

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Behavior Change Programs..

• Move It!
• The Culprit and The Cure
• TV Timeout
• Random Acts of Kindness
• The Fast Food Guide
• Maintain Dont Gain
• Food Makeover

• Earth Wise
• What's Your Pressure
• Good to the Bone
• Silver Buckle
• Fall into Fitness
• Drive Sober
• Chopping Block
• Finding Fiber
• Fat Fighters

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• Low hanging fruit
• Preventive screenings
• Flu shots
• Seat belts
• High hanging fruit
• Onsite fitness facility
• One-on-one coaching/training

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Motivate

• Before/after stories in newsletters
• Incentives can jump start some employees, but
  dont create an entitlement mentality
• 101 ways to use incentives
• Small incentives with each program
• Work toward a larger, benefit-based incentive

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Build Skills (How do I do this?)

• How to overcome barriers
• How to strategies
• Goal setting, contracts
• Healthy substitutions
• Making healthy choices
• How to make healthy foods
• Finding inexpensive healthy foods

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4. Change the worksite culture and environment

• Physical Environment
• Policy
• Culture

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Wellness requires benefits plan changes

• Different health care plan for participants
• Lower copays, deductibles and premiums for
  participants
• Contribute to FSA or HRA with participation
• Others

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• Policies
• Medical coverage for preventive services
• No smoking policies
• Flex time
• Time on the clock to be healthy
• Free from overly stressful work

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Supportive Environments

• Physical environments
• Healthy food in cafeteria
• Healthy food in vending machines
• Farmers market
• Realistic work demands
• Opportunities to be physically active
• Walking paths
• Time to exercise
• Onsite shower or lockers

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5. Evaluation

• Participation and satisfaction
• HRA data (behavior and biometric)

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5 Steps

• 1. Leadership support
• 2. Assessing your worksite
• 3. Plan and implement wellness strategies
• 4. Change the worksite culture and environment
• 5. Evaluating your yrogram

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www.welcoa.org
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Why Should I Care?
Morbidity
Lifespan in years
76
0
critical illness
Ann Intern Med, 2003139455-459
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Morbidity
Lifespan in years
0
?
76
86
critical illness
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End of Life Benefits
Morbidity
Lifespan in years
10-20 Years
Morbidity
Lifespan in years
121
End of Life Benefits
Morbidity
Lifespan in years
122
End of Life Benefits
Morbidity
Lifespan in years
123
End of Life Benefits
Morbidity
Lifespan in years
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End of Life Benefits
Morbidity
Lifespan in years
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