That Incorporate The Organization’s Core PhilosophiesThat are Linked To The Company’s Strategic Priorities-For completion Of ObjectivesBudget sufficient To Carry Out The Wellness PlanTo Effectively Promote The Wellness PlanMeasure The Stated Goals And Objectives
AMERICAN COUNCIL FOR INDEPENDENT LABORATORIES WELLNESS PROGRAM WORKSHOP OCTOBER 8, 2012 N E W Y O R K C I T Y, N YP R E S E N T E D B Y: A R V I D R . “ D I C K ” T I L L M A R , TILLMAR CONNECT LLC Not just politically correct, developing a wellness program can save your laboratory real dollars with studies showing that 80 percent of all health care spending is preventable and 50 percent of these potential savings come from wellness, lifestyle and behavioral changes. This presentation will provide a road map to launch a new wellness program or improve an already existing one, so join us to improve your laboratory’s bottom line.
THE NEED FOR WELLNESS Prevention Why? Increase in illnesses
THE NEED FOR WELLNESS 3The biggest threats facing the American work force today are obesity, tobacco use, and stress.Together, these lifestyle factors contribute to lost productivity and absenteeism, among other problems, but a wellness program can work to combat all three
BENEFITS OF WORKSITE WELLNESS PROGRAMS Source: National Business Group on Health,
DIABETES TRENDS AMONG ADULTS IN THE U.S. BRFSS 1990 29No Data <4% 4%-6% 6%-8% 8%-10% >10%
DIABETES TRENDS AMONG ADULTS IN THE U.S. BRFSS 1991-1992 30No Data <4% 4%-6% 6%-8% 8%-10% >10%
DIABETES TRENDS AMONG ADULTS IN THE U.S. BRFSS 1999-1994 31No Data <4% 4%-6% 6%-8% 8%-10% >10%
DIABETES TRENDS AMONG ADULTS IN THE U.S. BRFSS 1995-1996 32No Data <4% 4%-6% 6%-8% 8%-10% >10%
DIABETES TRENDS AMONG ADULTS IN THE U.S. BRFSS 1997 33No Data <4% 4%-6% 6%-8% 8%-10% >10%
DIABETES TRENDS AMONG ADULTS IN THE U.S. BRFSS 1998 34No Data <4% 4%-6% 6%-8% 8%-10% >10%
DIABETES TRENDS AMONG ADULTS IN THE U.S. BRFSS 1999 35No Data <4% 4%-6% 6%-8% 8%-10% >10%
DIABETES TRENDS AMONG ADULTS IN THE U.S. BRFSS 2000 36No Data <4% 4%-6% 6%-8% 8%-10% >10%
DIABETES TRENDS AMONG ADULTS IN THE U.S. BRFSS 1995-1996 37No Data <4% 4%-6% 6%-8% 8%-10% >10%
A WEIGHTY TOLL ON EMPLOYERS 38 Obesity costs U.S. companies $13 billion annually These workers have 36% higher medical costs than fit employees
THE HIGH COST OF SMOKING 39 A smoker costs the employer $3856/yr in added healthcare costs and lost productivity The overall prevalence of tobacco use is about 25% of the population, which can be generalized to any workplace population Calculating the cost of smoking: Assume a workplace with 100 employees Assume 25 employees use tobacco Result = $96,400/yr in business borne costs associated with smoking Because of this high cost, it is estimated more than 6,000 companies now refuse to hire smokers Alaska Airlines requires a nicotine test before hiring people Kalamazoo Valley Community College stopped hiring smokers for full-time positions Union Pacific won’t hire smokers
THE COST OF POOR HEALTH 40 Lost productivity related to absence Presenteeism Medical & presenteeism Lost Costs compared to Productivity 25% 34% STD/LTD/WC medical & 5% pharmacy costs Absenteeism Lost Productivity 36% IBI Research Insights - Single employer example
TOP 10 MOST COSTLY HEALTH CONDITIONS 41 Chronic disease has $1 TRILLION impact on U.S. lost productivity each year.Goetzl, R; JOEM 45(1) 5-14 2003
EXPENSE DRIVERS 42 Health Care System 10% Environment 20% Genetics 20% Lifestyle 50%
PREVENTABLE CAUSES OF DEATH IN WISCONSIN 43 Tobacco: 8,100 +/- deaths per year in Wisconsin Poor diet: Physical inactivity: 6,900 +/- deaths per year in Wisconsin Microbial agents: 1,700 +/- deaths per year in Wisconsin Alcohol: 1,600 +/- deaths per year in Wisconsin Toxic agents: 1,000 +/- deaths per year in Wisconsin Medical errors: 1,300 +/- deaths per year in Wisconsin Motor Vehicles: 800 +/- deaths per year in Wisconsin Firearms: 400 +/- deaths per year in Wisconsin Sexual behavior: 400 +/- deaths per year in Wisconsin Uninsurance: 300 +/- deaths per year in Wisconsin Illicit drug use: 300 +/- deaths per year in Wisconsin TOTAL: 22,800
Six Unhealthy Truths Tell the Story of the Rise of Chronic Disease and It’s Impact on Health and Health Care 44Truth #1: Chronic Diseases are the #1 cause of death and disability in the U.S.Truth #2: Chronic diseases account for 75% of the nation’s health care spending.Truth #3: About two-thirds of the rise in health care spending is due to the rise in the prevalence of treated chronic disease.Truth #4: The doubling of obesity between 1987 and today accounts for nearly 30% of the rise in health care spending.Truth #5: The vast majority of cases of chronic disease could be better prevented or managed.Truth #6: Many Americans (five in six) are unaware of the extent to which chronic disease harms their health – and their wallets. www.fightchronicdisease.org
IMPACT OF HEALTH RISK FACTORS ON PRODUCTIVITY 45Risk Factors considered in study include: 30% Tobacco Use 25.9% BMI <18.5 or >24.9 25% Presenteeism Physical inactivity Absenteeism Mean Lost Productivity 20%Lack of emotional fulfillment, 15% High stress 10% High blood pressure 6.3% High cholesterol 5% 0.0% Alcohol use 0% Overdue preventive visits 0 risks 1 risk 2 risks 3 risks 4 risks 5 risks 6 risks 7 risks 8 risks Diabetes Boles M, Pelletier B, Lynch W. The Relationship Between Health Risks and Work Productivity.
AS HEALTH RISKS INCREASE, SO DO EXCESSIVE COSTS 46 $6,000 Average Annual Medical Cost Excess Costs $5,000 Base Cost $4,000 $3,321 $3,000 $1,261 $840 $2,000 $1,000 These represent the maximum $0 Low Risk (0-2 HRA Non- Medium Risk (3-4 High Risk (5+ Risks) savings Risks) Participant Risks) opportunity if you $1,500 Average Annual Disability Cost moved people Excess Costs Base Cost from High (6+ risks) to $1,000 $757 Low (0-2 risks) $292 $175 $500 $0 Low Risk (0-2 HRA Non- Medium Risk (3-4 High Risk (5+ Risks) Risks) N=685 Participant N=4,649 Risks) N=520 N=366Chart Sources: Medical Edition: Edington. AJHP. 15(5):341-349, 2001; Disability: Wright, Beard, Edington. JOEM. 44(12): 1126-1134, 2002
AS HEALTH RISKS INCREASE, SO DO EXCESSIVE COSTS 47 Sample XYZ Company Summary Report - Percentage of employees who: Have at least 1 coronary risk factor 75% Were rated poor for nutrition practices 70% Have high blood pressure 60% Smoke 57% Are 20% over their ideal body weight 40% Exercise Regularly 20% -There were 3 complicated pregnancies last year that cost the company $300,000 -The interest survey indicated that the majority of employees would like to participate in programs with their families, would like aerobics classes during the day and would like a weight control class at work. A few employees indicated they wish to quit smoking. -An additional survey showed that almost all managers were supportive of the proposed wellness program. It further indicated that managers would participate and encourage others to as well.
IMAGINE IF YOU COULD SAVE 25% OFF YOUR RISING HEALTH CARE COSTS 48 25% savings off of Rising Health Care Costshealth care cost per $10,000 Annual employer $7,379 $7,832 $8,000 $6,348 $6,918 employee $5,758 $1,958 $6,000 $4,604 $5,162 $1,587 $1,730 $1,845 $4,320 $1,440 $4,000 $1,151 $1,291 $1,080 $2,000 $0 1999 2000 2001 2002 2003 2004 2005 2006 Year
NUMEROUS STUDIES DOCUMENT STRONG ROI 50 A multitude of studies show ROI averages of $3 for every $1 invested One recent study had the return as high as 10 to 1 Companies must be patient. “Worksites typically don’t realize returns until about three years into the program. If an organization is willing to wait two or three years, it will be capable of achieving this magnitude (3 to 1) of ROI.” A review of 32 studies found claims costs were reduced by 27.8%, physician visits by 16.5%, hospital admissions by 62.5%, disability costs by 34.4% and incidence of injury by 24.7%
WELLNESS WORKS, ACCORDING TO ROI STUDIES 51 From a review of 73 published studies of worksite wellness programs Average $3.50-to-$1 savings-to-cost ratio in reduced absenteeism and health care costs From a meta-review of 42 published studies of worksite wellness programs Average 28% reduction in sick leave absenteeism Average 26% reduction in health care costs Average 30% reduction in workers’ compensation and disability management claims costs Average $5.93-to-$1 savings-to-cost ratio A comprehensive health management program at Citibank $4.56-$4.73-to-$1 savings-to-cost ration in reduced total health care costs
WELLNESS PROGRAMSBUSINESS CASE 52 &IMPLEMENTATIO N
DEFINING HEALTH RISKS & RISK LEVELS 53 Health Risk Measure High Risk Criteria Alcohol > 14 drinks per week Blood Pressure Systolic >139 mmHG/Diastolic >89 mmHG Body Weight BMI =/>27.5 Cholesterol >239 mg/dl Existing Medical Heart, Cancer, Diabetes, Stroke Problem HDL <335 mg/dl Illness Days >5 days last yr Life Satisfaction Partly or not satisfied Perception of Health Fair or Poor Physical Activity <1 time per week Safety Belt Usage Using safety belts <100% of time Smoking Current smoker Stress High Overall Risk Levels Low Risk 0 to 2 high risks Medium Risk 3 to 4 high risks High Risk 5 or more high risks
GET WELL OR PAY NOT TO 54 Consumers may be able to improve their health and bottom line byparticipating in company sponsored wellness programs. More employers are offering cash, discounts and even lower healthinsurance premiums to entice workers to participate in a variety of programs. Starting next year, employees could have further incentives to get healthy asmore companies add penalties to insurance premiums for workers who don’tpartake. “It’s an opportunity to get cash for doing what’s right for you. Despite cutbacks amid the recession, 58% of large U.S. companies now offerlifestyle-improvement programs, up from 43% in 2007, according to a WatsonWyatt Study. And 56% provide health coaches, compared with 44% in 2007.Health-risk appraisals are offered at 80% of companies, up from 72% in 2007.
DISCOUNTS AND FREEBIES 55 Employees may be able to get $200 to $300 forparticipating in health-risk appraisals, smoking-cessation, weight management and preventivecare classes. Other offerings include heavily discountedweight loss programs and free or discounted gymmemberships. At some companies, employeeswho participate are rewarded with gift cards orlower insurance premiums.
WELLNESS PROGRAMS 56 EMPLOYERS’EXPERIENCES WITH ROI
HISTORICAL PERSPECITIVE ON SAVINGS 57 Johnson & Johnson Started in 1979 Invested $30M, 94% participation rate Cholesterol, activity and smoking Results of $224 per year savings per employee ($8.5M annually) Pitney Bowes Analysis 1991; Health Care University started in 1993 2.8:1 ROI for participants in HCU Increased productivity, less absenteeism for gym members Ergonomics showed a 5.1 ROIUnion Pacific Winner of C. Everett Koop Award 1994, 1997, 2001 Smoking down from 40% to 28% over 10 years 10% decrease in lifestyle related healthcare costs equating to $53.6M dollar difference in 2001
... AND TODAY’S EXPERIENCE 582008 PRICEWATERHOUSE COOPER’S HEALTHAND WELLNESS TOUCHSTONE SURVEYRESULTS: 69% of 561 companies have a wellness program Less than 30% of members participate: the use of incentives increases participation 52% of respondents don’t believe wellness programs are effective at mitigating healthcare costs, improving performance/productivity, or enhancing employee engagement/loyalty. They do believe they are effective at reinforcing corporate responsibility and image Only 37% of respondents integrate occupational health with their wellness
ASSOCIATION OF RISK LEVELS WITH SEVERAL CORPORATE COST MEASURES 59 Research conducted at the University of Michigan has shown that the low riskemployees (1-2 risk factors) have lower cost for short term disability, workers’ comp,absence and health care costs whereas high risk employees (5+risk factors) have highercosts. Source: Wright, Beard, Edington, JOEM 44 (12): 1126-1134
WELCOA’s 7 BENCHMARKS Benchmark #1 - Capturing CEO Support Benchmark #2 - Creating Cohesive Wellness Teams Benchmark #3 - Collecting Data To Drive Health Efforts Benchmark #4 - Carefully Crafting An Operating Plan Benchmark #5 - Choosing Appropriate Interventions Benchmark #6 - Creating A Supportive Environment Benchmark #7 - Carefully Evaluating Outcomes
WHAT DOESN’T WORK ONE SIZE DOES NOT FIT ALL! Health Assessments alone Low budget, low intensity, low participation rates Programs that focus on what’s in it for the organization, not the individual participant “Under the radar” initiatives NIH (not invented here) philosophy Huge incentives that would be better used for programming HERO Panel: EHM – What Really Works? HERO Forum for Employee Health Management Solutions New Orleans, Louisiana -- October 2007 Ron Z. Goetzel, Ph.D. Cornell University and Thomson Medstat
BEST CRITERIA FOR WELLNESS PROGRAMS Employ features and incentives that are consistent with the organization’s core mission, goals, operations, and administrative structures; Operate at multiple levels, simultaneously addressing individual, environmental, policy, and cultural factors in the organization; Target the most important health care issues among the employee population; Engage and tailor diverse components to the unique needs and concerns of individuals; Achieve high rates of engagement and participation, both in the short and long term; Achieve successful health outcomes, cost savings, and additional org. objectives; Are evaluated based upon clear definitions of success, as reflected in
DR. ROBERT LUSTIGRobert H. Lustig, MD, UCSF Professor of Pediatrics in the Division ofEndocrinology, explores the damage caused by sugary foods. He argues thatfructose (too much) and fiber (not enough) appear to be cornerstones of theobesity epidemic through their effects on insulin. Series: UCSF Mini MedicalSchool for the Public [7/2009] [Health and Medicine] [Show ID: 16717] http://www.youtube.com/watch?v=dBnniua6-oM
WELL WORKPLACE Sample Comprehensive Report Sample Executive Summary
(double click on documents to bring up full PDF versions)http://www.welcoa.org/wwpcheckli st/
ESSENTIAL ELEMENTS: WELLNESS PROGRAMS1. A Vision/Mission Statement for The Wellness Program2. Specific Goals and Measurable Objectives3. Timelines For Implementation4. Roles And Responsibilities5. Itemized Budget6. Appropriate Marketing Strategies7. Evaluation Procedures
THE EFFECTS OF AN EFFECTIVE WELLNESS PROGRAM Click image below to read full article
THE USE OF INCENTIVES Companies are now using incentives to drive participation in health programs Of nearly 2,000 U.S. surveyed employers, 84% offer employees incentives to participate in a health risk questionnaire (HRQ) and 64% of those offer an incentive for participation screening. 51% provide incentives to employees who participate in health improvement and wellness programs. The use of monetary incentives, in particular, has increased dramatically in 2012. A growing number of employers are beginning to link incentives to a result.
SMART GOALS & OBJECTIVESThe need to have SMART goals & objectives for your Wellness Programs:
WHO’S TO BLAME IF YOU’RE FAT? Click image below to read full article
REFERENCE GUIDES Emphasis of Preventative Care in the Affordable Care Acthttp://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html Well City Milwaukee www.wellcitymilwaukee.org
RETHINK YOUR DRINK 75 48 Teaspoons Sugar 52 oz 64 oz 44 oz 32 oz16 oz
A YEAR OF SODA: 44.7 GALLONSHere’s what carbonated soft drinkconsumption – sugared and diet sodas –looked like in 2010. Average Americanchugged the equivalent of 48 two-literbottles and 206 12 – ounce cans of softdrinks in one year. Teaspoon of Sugar1. 4.2 grams of sugar = 1 teaspoon of sugar2. Before you order a drink, ask how much sugar is in the beverage – it is listed in grams on the ingredients list3. After you do the math, simply divide the number of grams of sugar by 4 – and ask yourself if almost 10 or more teaspoons of sugar is really what you want.