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    Health productivity survey_2012_v7[1] Health productivity survey_2012_v7[1] Document Transcript

    • THE WILLISHEALTH &PRODUCTIVITYSURVEY 2012CHALLENGES – STRATEGIES – OUTCOMES
    • TABLE OF CONTENTS 3 ABOUT THE SURVEY TABLE OF CONTENTS 5 KEY FINDINGS 6 SURVEY FINDINGS 33 FINAL THOUGHTS 35 TECHNICAL APPENDIX
    • ABOUT THE SURVEYA web-based platform was used to collect, satisfaction and how results are measured. As noted above, sincemeasure and analyze data. Complete some participants did not complete the entire survey, theresponses were submitted by 618 number of respondents is not consistent for each question.organizations, with an additional 212completing a portion of the survey for a totalof 830 participants. Respondents represented ADDITIONAL INFORMATIONa cross-section of organization sizes,industries and locations. For additional information about the survey or to share a comment, write to:Willis asked organizations to respond to thesurvey regardless of whether or not they Willis Americascurrently offered a wellness program. Those Human Capital Practice – North Americawith no wellness program were asked if they One Glenlake Parkway, Suite 1100plan to offer one and, if not, what was their Atlanta, GA 30328main reason was for not doing so. willisebsurvey@willis.comThose organizations offering wellness With respect to all charts and tables in this document, not allprograms were asked to detail program sections total 100% due to rounding. A full technical appendixcomponents, incentives, participation, vendor with all survey data is available to Willis clients upon request. ORGANIZATION SIZE NUMBER OF EMPLOYEES Fewer than 100 217 26% A small employer (Fewer than 1,000 employees) 100-499 291 35% 625 500-999 117 14% A large employer (1,000 or more employees) 1,000-4,999 126 15% 205 5,000 or more 79 9% 3 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • PRIMARY INDUSTRYConstruction 48 6%Consulting 12 1%Education 46 6%Financial Services, Banking or Real Estate 49 6%Gaming 3 1%Health Care 86 11%Higher Education 5 1%Hospitality 18 2%Insurance 28 3%Legal Services 31 4%Life Sciences 6 1%Manufacturing 142 18%Not-for-profit 57 7%Public Entities 12 2%Retail 28 3%Service 22 3%Technology 37 4%Telecommunications or Media 12 1%Transportation 24 3%Utilities or Energy 16 2%Other 125 15% 807 100%GEOGRAPHIC REGIONSNortheast region(NY, PA, MD, DE, NJ, CT, RI, MA, NH, VT, ME) 140 17%Southeast region(WV, KY, TN, NC, SC, VA, DC, GA, AL, MS, FL) 189 23%North Central region(MT, ID, WY, ND, SD, NE, KS, MN, MO, WI, IL, MI, IN, OH, IA) 255 32%South Central region(UT, CO, NM, OK, TX, AR, LA) 44 6%West Coast region(AK, AZ, WA, OR, CA, NV, HI) 82 10%Nationwide 97 12% 807 100% 4 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • KEY FINDINGSHEALTH CARE COSTSThe top three challenges identified by participants in controllinghealth care costs: 48% Employees’ poor health 48% High-cost catastrophic cases 36% Underuse of preventive servicesThe following strategies are being used to control rising health care costs: 54% Providing employees tools and resources to become better consumers 50% Actively promoting health improvement programs 48% Implementing a high-deductible health planWELLNESS PROGRAMSOver half (59%) of survey participants indicate they have some type ofwellness program: 25% of respondents describe their program as basic 26% of respondents have an intermediate program 8% of respondents have a comprehensive programINCENTIVESIncentives remain a popular component in a health management strategy: 79% of respondents are offering some type of incentive 23% of respondents have an outcomes-based incentive program in place 5 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • SURVEY FINDINGS CONTROLLING HEALTH CARE COSTS Most organizations indicate their main goal Organizations are currently or planning to address these for implementing a comprehensive challenges by establishing a comprehensive benefits/wellness wellness/health management strategy is to strategy that includes implementing high-deductible health control or manage rising health care costs. plans, actively promoting a health improvement program and Survey respondents indicated that their top resources and providing employees with tools and information three challenges to controlling costs were: to become better health care consumers. n Employee’s poor health habits n High-cost catastrophic cases n Underuse of preventive services WHICH OF THE FOLLOWING ARE YOUR TOP THREE CHALLENGES IN CONTROLLING HEALTH CARE COST? Employees’ poor health habits 360 48% High-cost catastrophic cases 356 48% Underuse of preventive services 266 36% Escalating cost of specialty pharmacy benefits 214 29% Poor employee understanding of how to use the plan 165 22% Poor information on provider costs 88 12% Overuse of care through employees seeking inappropriate care 96 13% Cost of compliance under Health Care Reform 182 24% Higher costs due to new medical technologies 169 23%Overuse of care through providers recommending too many services 77 10% Changes in workplace demographics 108 15% Poor information on provider quality 25 3% | | | | | 0 100 200 300 400 6 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • WHICH OF THE FOLLOWING STRATEGIES IS YOUR ORGANIZATION USING TO ADDRESS RISING HEALTH CARE COST? Provide on-site and/or telephonic health care support 311 66 57 250 Direct your employees to a public or private exchange 559 87 14 14 Tie employee contributions to biometric screening results (health outcomes) 358 184 64 77Eliminate/reduce co-payments for medications and services used to treat chronic conditions 472 73 35 85 Manage prescription drug use 260 83 82 256 Provide employees with tools and information to become better consumers 79 84 152 375 Offer a defined contribution plan 363 60 22 221 Implementation of high-deductible health plan 203 99 53 325 Evaluation of multiple data points to create more targeted strategies 273 125 140 127 Actively promote health improvement programs and resources 123 93 128 348 Establish a comprehensive wellness strategy 158 140 143 254 | | | | | | | | 0 100 200 300 400 500 600 700 nNot considering nPlanning for in the next 3-5 years nPlanning for 2013 nCurrently in place WORK AND LIFE – CONTINUING THE BALANCE ACT Work/life balance programs are useful for employees balancing family care responsibilities, personal health and wellbeing, financial obligations and work. These issues create distractors that not only impact employee health, but also workplace productivity. According to a 2011 report from the Families and Work Institute, men are experiencing more work/family conflicts than in previous decades. The amount of time men spent at work was an indicator in the amount of conflict facing families1. According to the report, both male and female employees are affected by a lack of work/life balance, such as flexible work hours, that provide assistance for all employees in managing the stresses of their personal life while increasing workplace productivity. Employers reported flexible work hours, paid maternity leave and lactation facilities as the top work/life balance programs offered by their organizations, as well as commonly offered fitness and weight loss programs. In comparison to 2011 survey results, flexible work hours remains the most common employer-offered work/life balance option. 7 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • TOP THREE TYPES OF PROGRAMSMULTI-YEAR COMPARISON 100% — 8% 8% 9% 8% 11% 90% — 80% — 32% 30% 39% 70% — 44% 45% 60% — 8% 10% 50% — 7% 40% — 26% 24% 16% 30% — 47% 47% 20% — 30% n Basic 25% 26% n Intermediate 10% — n Comprehensive n No program n Planning to offer 0% — one in the future 2012 2011 2010 2009 2008 8 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • BARRIERS TO IMPLEMENTING A PROGRAMMULTI-YEAR COMPARISON 24% 26% 11% 13% 45% 42% 43% 22% 19% 46% n Budget constraints n Lack of management support n Dispersed staff n Lack of access to a computer 61% 68% n Too small or too few employees n Lack of ROI data 48% n Insufficient time/staff 13% 15% n High stress and lack of time among employees n Not enough staff/time to dedicate to this n No interest in this type of program 2012 2011 2010 2009 2008 9 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • LEVERAGING EXTERNAL RESOURCES Medical carriers, third-party vendors and non-profit entities can assist organizations in developing and enhancing their wellness programs. Often resources from medical carriers and third-party vendors are untapped, even though organizations are essentially “paying into” them through their fees for service. Non-profit organizations (e.g., American Diabetes Association) and community resources (e.g., local hospitals) have tools and resources employers can leverage, such as employer toolkits, speakers and communication content, and preventive care and health screenings promotion materials. HOW EFFECTIVE IS YOUR ORGANIZATION AT LEVERAGING THE FOLLOWING RESOURCES TO DRIVE THE HEALTH AND PRODUCTIVITY WITH YOUR WORKFORCE? Health insurance carrier 99 239 229 60 24 Employee Assistance Program 54 152 234 96 83Community resources (fitness center, grocery store, hospitals, etc.) 14 96 213 180 109 Non-profit organizations (American Diabetes Association, American Heart Association, Red Cross, etc.) 12 68 170 209 131 Third-party wellness vendor(s) 31 105 152 153 144 Internal staff and/or resources 53 174 226 88 69 Insurance broker/consultant 101 224 204 58 41 Grants 10 17 41 141 347 College/university resources 9 28 62 145 321 | | | | | | | | 0 100 200 300 400 500 600 700 nVery effective nEffective nSomewhat effective nNot effective nNot at all effective Survey respondents reported their effectiveness at leveraging the following resources: n Health insurance carriers (37%) and insurance broker/consultant (36%) n Employee assistance programs (38%) and community resources (35%) When asked about leveraging the resources of the grants, college/universities, non-profit organizations, and third- party wellness vendors, respondents stated they felt either “not effective” or “not effective at all.” Communication materials/resources were used to a moderate extent with approximately 34% of organizations using employee communication materials from medical carriers to communicate health insurance benefits. 10 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • ONSITE FLU VACCINATIONS WERE THE SECOND MOST COMMON WELLNESS OFFERING (82%). THIS PERCENTAGE REMAINS UNCHANGED FROM OUR 2011 SURVEY RESULTS. EMPLOYERS MAY CONSIDER A “PREVENTION PUSH” DURING THESE ONSITE CLINICS. SHARING INFORMATION RELATED TO AGE AND GENDER-APPROPRIATE PREVENTIVE SCREENINGS WHILE YOU HAVE A CAPTIVE AUDIENCE RECEIVING THEIR FLU SHOT IS A GREAT WAY TO PROMOTE PREVENTIVE SCREENING.MAKING THE MOST OF YOUR EAP AND FLU VACCINATIONS…MOVING BEYOND BASIC SERVICESEmployee assistance programs (EAP) remain the top wellness offering among respondents. However, historically, theuse of these programs has been low. Often this is due to a lack of communication or employee awareness as well as thefear or stigma associated with their use. In order to increase participation in your EAP program, consider marketing theprogram services under your wellness program umbrella and highlighting “real world” scenarios of how the EAPservices can assist employees.Onsite flu vaccinations were the second most common wellness offering (82%). This percentage remains unchangedfrom our 2011 survey results. Employers may consider a “prevention push” during these onsite clinics. Sharinginformation related to age and gender-appropriate preventive screenings while you have a captive audience receivingtheir flu shot is a great way to promote preventive screening. 11 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • TO WHAT EXTENT DO YOU USE THE FOLLOWING SERVICES OFFERED THROUGH YOUR MEDICAL CARRIER TO SUPPORT WELLNESS INITIATIVES? Health Risk Assessment (HRA) 91 68 81 77 291 Biometric Screenings 79 54 66 62 329Disease Management/Case Management 46 78 152 119 213 Nurse Line 51 68 147 144 196 Employee Assistance Program (EAP) 44 75 137 110 235 Employee Portal 44 93 151 124 192 Communication Materials/Resources 61 126 217 136 92 | | | | | | | | 0 100 200 300 400 500 600 700 nTo a very large extent nTo a large extent nTo a moderate extent nTo a small extent nTo a very small extent Many respondents this year are new to wellness with approximately 65% having programs in place for three years or less. As in years past, physical activity tops the list with 90% of respondents stating they offer programs that address physical activity. Since physical activity is often touted as the “gateway” for many individuals to behavior change, this seems like a logical approach for employers when getting started. The next most common program offering addresses nutrition, which, when combined with physical activity, reflects the recommendation for improving public health to “eat better, and move more” and directs all individuals toward better health. “THESE RESPONSES ALL SUGGEST AN OPPORTUNITY FOR MEDICAL CARRIERS EITHER TO PROVIDE MORE (OR MORE EFFECTIVE) SERVICES OR TO INTEGRATE (FOR EXAMPLE, DATA AND COMMUNICATION) MORE EFFECTIVELY WITH EMPLOYERS’ OTHER SERVICE VENDORS. MORE OR BETTER SERVICES OR MERE DATA INTEGRATION WILL NOT BE ENOUGH. THE KEY WILL BE TO CONVERT DATA TO INFORMATION, INFORMATION TO KNOWLEDGE, AND KNOWLEDGE THOMAS J. VAN GILDER, MD, JD, MPH TO ACTION.” NATIONAL MEDICAL DIRECTOR, WELLNESS|HEALTH & PRODUCTIVITY SOLUTIONS, HUMANA 12 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • TOP FOUR SERVICES OFFERED THROUGH YOUR MEDICAL CARRIER TO SUPPORT WELLNESS INITIATIVESMULTI-YEAR COMPARISON 250% — 200% — 71% 64% 150% — 53% 55% 48% 100% — 65% 62% 49% 48% 111% 50% — 53% 64% 66% 50% n Weight management n Physical activity n Tobacco cessation 0— n Lunch and learns 2012 2011 2010 2009 2008 13 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • WHAT RESOURCES ARE EMPLOYERS USING?Employers use a variety of resources to help implement their wellness programs and often look to partner with a third-party vendor to help provide solutions for a comprehensive program. Year after year, we find that many companies areturning to a third-party vendor, with 26% reporting that they use a third-party vendor to support their wellnessprogram efforts. Most of these organizations are looking for comprehensive program offerings and support with moreservices, regular reporting data and incentive design flexibility and fulfillment. Over half have had a third-party solutionin place for two years or less with the majority (79%) indicating they have some level of satisfaction with their vendor.ADDRESSING TOBACCO USEAs organizations continue to look for ways to improve the health of their populations, tobacco cessation remains at thetop of the list of their current wellness program initiatives. Clients are still concerned with tobacco use among theiremployees and want to know what other organizations are doing in the area of tobacco cessation. More and moreorganizations are providing resources for tobacco cessation through their medical carrier or third-party vendor.Compared to the Willis 2011 survey results, there was a 4 % increase for nicotine testing and a 3% increase in tobaccofree campuses. HOW DO YOU ADDRESS TOBACCO USE AS AN ORGANIZATION?   PLEASE MARK ALL THAT APPLY. We do not hire tobacco users 10 3% We conduct cotinine testing among our employees 26 7% We ask employees to sign or complete an affidavit of their tobacco use 71 19% We offer coverage, subsidy or reimbursement for over-the-counter tobacco 69 18% cessation products (gum, patch, etc.) We offer coverage, subsidy or reimbursement for prescription tobacco 109 29% cessation medications under our medical or pharmacy benefits We reimburse some or all of the costs of tobacco cessation programs 95 25% We offer a tobacco cessation program through a third-party vendor or community provider 85 22% We offer a tobacco cessation program through our health insurance carrier 160 42% We are completely tobacco-free on our worksite campus(es) 131 35% We have designated smoking areas on our worksite campus(es) 183 48% Our tobacco policy includes banning the use of electronic cigarettes 27 7% We have a written policy regarding tobacco use 196 52% We do not address it 37 10% | | | | | 0 50 100 150 200 14 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • EMPLOYERS. . . SEEM TO BE RELYING ON STANDARD METHODS VERSUS EMERGING MEANSOF COMMUNICATION. . . THE PRIMARY AVENUE FOR REACHING EMPLOYEES IS E-MAIL(87%), PRINTED MATERIALS (67%) AND NEWSLETTERS (60%). ALTHOUGH THE USE OFSOCIAL MEDIA CONTINUES TO RISE, ONLY 4% OFRESPONDENTS ARE USING SOCIAL AND EVEN LESS, JUST 1%, ARE USING TEXT MESSAGING. . .MEDIAHOW  DO YOU COMMUNICATE  YOUR WELLNESS PROGRAM?  PLEASE MARK ALL THAT APPLY. Mail to employees’ homes 85 23% Bulletin boards 183 49% Open enrollment 204 54% Dedicated web portal 73 19% Social  media – Twitter, Facebook, blogs, etc. 16 4% Text messaging 3 1% Wellness committee members share information to their departments or locations 142 38% Intranet resources 211 56% Printed materials  – flyers, posters, paycheck stuffers 255 68% Newsletters 225 60% Emails 328 87% Town hall meetings 58 15% Departmental staff meetings 140 37% | | | | | | | | 0 50 100 150 200 250 300 350 15 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • COMMUNICATIONEffective communication is a key factor in reaching target populations and engaging employees. Many respondents(40%) report branding their program, which helps the organization formalize their efforts and can increase overallrecognition and employee participation. Over half of respondents (54%) are including an explanation of their wellnessprogram in both recruitment and the new hire orientation process.Employers continue to rely on inexpensive ways to reach their employees but seem to be relying on standard methodsversus emerging means of communication. This year again, the primary avenue for reaching employees is e-mail (87%),printed materials (67%) and newsletters (60%). Although the use of social media continues to rise, only 4 % of respondentsare using social media and even less, just 1%, are using text messaging to reach potential wellness program participants.Many employers (40%) are communicating information about their wellness programs on a monthly basis, although66% of respondents feel their communication efforts are only somewhat or not effective. A comprehensive and creativecommunication strategy, including soliciting employee feedback, may be warranted to improve the overall effectivenessof program communication and may ultimately improve employee engagement. HOW OFTEN DO YOU COMMUNICATE YOUR WELLNESS PROGRAM OFFERINGS TO EMPLOYEES?  Only as needed during campaigns 92 25% Daily 5 1% Weekly 30 8% Monthly 151 40% Quarterly 48 13% Twice a year 21 6% Annually/at open enrollment 29 8% | | | | | 0 50 100 150 200 HOW EFFECTIVE DO YOU FEEL YOUR COMMUNICATION EFFORTS ARE AT DISSEMINATING KEY PROGRAM INFORMATION SUCH AS UPDATES AND EVENTS? Not effective 25 7% Somewhat effective 222 59% Effective 111 30% Very effective 18 5% | | | | | | 0 50 100 150 200 250 16 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • COMMUNICATION CHALLENGES The leading communication challenges employers sited are: n Lack of time/interest among employees 62% n Employees spread out at various geographic locations 53% n Employees without computer access at work 45% Additionally, survey results for both this year and last reflect that 41% of respondents identify reaching spouses as a challenge. As more employers recognize the value of including spouses and dependents in their health promotion efforts, creative solutions will need to be explored as well as a modified communication strategy implemented. WELLNESS BUDGET WHEN THINKING ABOUT YOUR WELLNESS PROGRAMS STRATEGY WHICH STATEMENTS MOST CLOSELY REFLECT YOUR ORGANIZATIONS APPROACH? We want to reward employees who are 142 160 43 13 6 taking steps towards health improvement We have implemented penalties to employees who 29 56 32 121 126 are not taking steps towards health improvement We have aligned our worksite culture to 59 147 101 52 5 support employee health improvement We want to improve employee health andoffer programs that address their personal health risks 237 114 10 3 | | | | | | | | | 0 50 100 150 200 250 300 350 400 nStrongly agree nAgree nNot sure nDisagree nStrongly disagree 17 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • Best practices dictate that visible leadership support and dedicated financial support of a worksitewellness program are essential to a successful program. The majority of respondents (86%) provide acompany-funded wellness program. Avenues of program funding were reported to include: n Company funded 86% n Carrier funded 18% n Employee contributions 8% n Other 7%Despite the research that supports the necessity of a financial investment to realize a return or benefitfrom the worksite wellness program, 40% of respondents do not have a defined budget for worksitewellness. Additionally: n 24% of respondents invest $50 or less per employee per year in their programs n 16% of respondents invest $51 to $100 per employee per year in their programs n 4% of respondents invest between $101 to $149 per employee per year in their programs n 17% of respondents invest $150 or more per employee per year in their programsWHAT IS  THE COMPANYS  ESTIMATED PER EMPLOYEE PER YEAR COST FOR THE WELLNESSPROGRAM INCLUDING INCENTIVES, STAFFING, VENDORS, ETC.? No defined budget for worksite wellness 149 40% 40 11% $25 or less $26 to $50 47 13% $51 to $75 30 8% $76 to $100 28 8% $101 to $149 14 4% $150 or more 62 17% | | | | 0 50 100 150 18 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • HEALTH ASSESSMENTS AND BIOMETRIC SCREENINGS Offering health assessments has become a common component in many organizations’ wellness programs, from those with a basic program to those that offer comprehensive programs. The aggregate data received helps organizations understand the health risks of their employee population, plan targeted programs and observe changes in risks over time. The majority of respondents (74%) stated that they understand the value of offering this type of assessment and most use the health assessment tool offered through their medical carrier. While incentives are also more common today than ever, many employers struggle to determine what the right incentive is for driving employees toward the desired behavior. We have captured the most frequently used types of incentives that employers are offering to drive health assessment participation throughout the last five years of the Willis survey. Year after year, more organizations are using their medical plan contribution strategy as the incentive for meeting wellness program criteria; more specifically, implementing a premium differential as the wellness program incentive.WHAT IS  YOUR HEALTH ASSESSMENT PARTICIPATION RATE? 76% or more 74 28% 51% to 75% 56 21% 26% to 50% 66 25% 25% or less 73 27% | | | | 0 25 50 75 19 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • DO YOU OFFER A HEALTH RISK QUESTIONNAIRE AS PART OF YOUR WELLNESS PROGRAM? Yes, through a free web-based tool 9 3% Yes, through a third party vendor (e.g. wellness vendor) 108 30% Yes, through our medical carrier 153 42% No 94 26% | | | | | | | 0 25 50 75 100 125 150 WHAT IS THE INCENTIVE(S) FOR HEALTH ASSESSMENT COMPLETION?  PLEASE MARK ALL THAT APPLY.No incentive(s) offered for completing the health assessment 55 20% Require completion to receive health insurance coverage 20 7% Contribution to health account (health FSA, HRA or HSA) 32 12%Lower employee cost (premium contribution) for medical plan 91 34% Lower plan deductible, co-insurance or co-pays 10 4% Accumulate points for prizes 19 7% Cash/gift cards 80 30% Raffle for larger prizes 27 10% Smaller prizes for each participant 9 3% Paid time off 7 3% Other 7 3% | | | | | 0 25 50 75 100 JUST AS ORGANIZATIONS ARE PROVIDING AN INCENTIVE FOR HEALTH ASSESSMENT COMPLETION, THEY ARE ALSO OFFERING INCENTIVES TO THOSE EMPLOYEES THE THAT PARTICIPATE IN BIOMETRIC SCREENINGS. ONCE AGAIN WE FOUND THAT MOST POPULAR INCENTIVE OFFERED IS A PREMIUM DISCOUNT. 20 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • TOP FIVE INCENTIVES FOR HEALTH ASSESSMENT PARTICIPATIONMULTI-YEAR COMPARISON 100% — 90% — 18% 20% 20% 18% 16% 80% — 70% — 30% 40% 22% 60% — 21% 33% 50% — 40% — 30% — 31% 34% 38% 29% 20% — 28% n Lower premium contribution 10% — n Contribution to HSA, HRA n Raffle for large prize n Cash 0% — n No incentive 2012 2011 2010 2009 2008 21 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • DO YOU OFFER BIOMETRIC SCREENINGS AS PART OF YOUR WELLNESS PROGRAM? No 129 36%Yes, through a local provider (e.g.hospital system or public health department) 31 9% Yes, through our medical carrier 74 21% Yes, through a third party vendor (e.g. wellness vendor) 90 25% Yes, through a lab vendor (e.g. Concentra, Quest, other) 16 4% Yes, through on-site practitioner/clinic 21 6% | | | | | | | 0 25 50 75 100 125 150 WHAT IS  YOUR BIOMETRIC SCREENING PARTICIPATION RATE? 76% or more 55 24% 51% to 75% 54 23% 26% to 50% 76 33% 25% or less 47 20% | | | | 0 25 50 75 WHAT IS  THE INCENTIVE(S) FOR BIOMETRIC SCREENINGS?  PLEASE MARK ALL THAT APPLY. No incentive(s) offered for biometric screenings 50 22% Require completion to receive health insurance coverage 13 6% Contribution to health account (health FSA, HRA or HSA) 24 10% Lower employee cost (premium contribution) for medical plan 79 34% Lower plan deductible, co-insurance or co-pays 8 3% Accumulate points to earn prizes 24 10% Cash/gift cards 54 23% Raffle for larger prizes 27 12% Smaller prizes for each participant 8 3% Paid time off 6 3% Other 8 3% | | | | | 0 25 50 75 100 22 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • INCENTIVES Overall incentive usage is on the rise with 79% of respondents offering some type of incentive to their employees as part of their wellness initiatives. As in years past, the most common types of incentives reported by employers include cash or gift cards (48%) and a premium discount for the health plan (40%). Of those employers offering health plan premium discount, the most common criteria to earn the incentives are: n Completion of a health risk assessment (HRA) (68%) n Completion of a biometric screening (63%) n Tobacco use status (37%) n Completion of an annual physical/wellness visit (35%) The amount of the premium discount being offered has remained constant over the past several years, with the majority of respondents offering a monthly premium discount between $11-$50 per month for a single plan and $51-$101 per month in premium reductions. WHAT TYPES OF INCENTIVES DO YOU OFFER FOR PARTICIPANTS WHO MEET PROGRAM CRITERIA?Contribution to a health savings account (health FSA, HRA or HSA) 36 14% Lower employee cost (premium cost) for medical plan 103 40% Lower plan deductible, co-insurance or co-pays 13 5% Small prizes 67 26% Raffle for larger prizes 61 24% Cash/gift card 124 48% Paid time off 22 9% Other 20 8% | | | | | | 0 25 50 75 100 125 23 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • OUTCOMES-BASED INCENTIVE DESIGNThe typical goal of many worksite wellness programs is to provide employees, and often spouses, with the toolsand resources to improve their personal health with the desired outcome being a healthier employee populationand reduced health care costs. Offering incentives has become an integral part of these worksite wellnessprograms with the hope of motivating people toward behavior change. Many organizations continue to strugglewith questions (e.g., how much, what type or what criteria) that arise when developing their incentive strategy.What motivates employees to participate in programs varies significantly based on a multitude of variables thatmay include organization culture, concerns regarding confidentiality or personal readiness to change.As the prevalence of worksite wellness programs continue to grow, so do the challenges associated with trulydriving behavior change versus simply promoting participation. Many employers are seeking new or innovativestrategies to increase engagement or, more importantly, new levers that will influence a more desirable outcome.This has created significantly heightened interest from many employers in adopting an outcomes-based incentivedesign into their programs.An outcomes-based incentive program as defined by the “Guidance for a Reasonably Designed, Employer-Sponsored Wellness Program Using Outcomes-Based Incentive,” JOEM, July 7, 2012, includes any effort inwhich “a reward or penalty is tied to an individual achieving or making progress toward a standard related to ahealth factor.”While there are limited recommendations regarding the amount and type of health factors that employers shouldbe considering, guidance released by the Department of Labor in a 2008 Field Assistance Bulletinrecommended four biometric categories: n Weight-related standard (or body fat percentage) n Cholesterol n Blood pressure n Tobacco useResearch indicates that most employers using an outcomes-based approach incorporate one or all of these fourcategories as the criteria for their incentive design.Our survey results align with these recommendations; the top criteria used as part of respondents’ outcomes-based designs were most commonly reported as tobacco use status and blood pressure target measures. 24 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • KNOW YOUR NUMBERS/KNOW THE LAWSEmployers using an outcomes-based program design and offering a contribution or premium discount as theincentive must establish wellness programs that satisfy the specific requirements outlined in the 1996 HealthInsurance Portability and Accountability Act (HIPAA) wellness regulations. While most employers are familiarwith the HIPAA regarding privacy, security and portability rules, there seems to be less awareness of the HIPAAnondiscrimination provisions. HIPAA’s nondiscrimination provisions prohibit a health plan or insurer fromdiscriminating against individuals with respect to eligibility, premiums or contributions on the basis of a“health status-related factor.” Here are the details:HIPAA GUIDELINESIN 2006, THE DEPARTMENTS OF TREASURY, LABOR, AND HEALTH AND HUMAN SERVICESISSUED CLARIFICATIONS AND FINAL REGULATIONS ON WELLNESS PROGRAMS THAT FALLUNDER HIPAA NON-DISCRIMINATION RULES. THE FIVE HIPAA GUIDELINES ARE:n LIMIT ANY REWARD OFFERED UNDER THE PROGRAM TO 20% OF THE COST OF EMPLOYEE-ONLY COVERAGE. IF DEPENDENTS (SUCH AS SPOUSES AND/OR DEPENDENT CHILDREN) PARTICIPATE IN THE WELLNESS PROGRAM, THE REWARD MUST NOT EXCEED 20% OF THE COST OF THE COVERAGE IN WHICH AN EMPLOYEE AND ANY DEPENDENTS ARE ENROLLED.n OFFER AN ANNUAL OPPORTUNITY FOR PARTICIPANTS TO QUALIFY FOR THE PROGRAM.n BE REASONABLY DESIGNED TO PROMOTE HEALTH OR PREVENT DISEASE.n PROVIDE A REASONABLE ALTERNATIVE TO INDIVIDUALS WHO MEDICALLY CANNOT MEET THE REQUIRED STANDARD. FOR EXAMPLE, ASSUME AN EMPLOYER IMPLEMENTS A WELLNESS PROGRAM THAT ESTABLISHES CERTAIN BODY MASS INDEX (BMI) REQUIREMENTS; HOWEVER, AN EMPLOYEE HAS A THYROID CONDITION THAT MAY HINDER HIM FROM MEETING THE REQUIREMENT. RATHER THAN MEET THE BMI REQUIREMENT, THE EMPLOYEE MAY BE ASKED TO DOCUMENT THE USE OF THYROID REGULATING DRUGS AND PHYSICIAN FOLLOW-UP VISITS. NOTE THAT THE PLAN MAY ASK FOR VERIFICATION (E.G., A DOCTORS NOTE) THAT A HEALTH FACTOR MAKES IT UNREASONABLY DIFFICULT FOR A WELLNESS PROGRAM PARTICIPANT (OR EMPLOYEE) TO MEET A PARTICULAR HEALTH STANDARD.n DISCLOSE THE AVAILABILITY OF THE ALTERNATIVE STANDARD. 25 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • While an outcomes-based incentive program may seem tooaggressive or may not align with your organization’s culture,using this approach to drive outcomes is working for someorganizations and may be a route worth considering. Whenrespondents were asked what results their organizations haverealized from their current outcomes-based program, the IMPORTANTmajority (52%) indicated that it is too early to assess the impact,but roughly 20% stated that health risks are improving and 13% QUESTIONS TOstated that claim costs are decreasing/below trend.No matter what incentive design structure your organization ASK YOURemploys, we know that behavior change is extremely difficult.The challenges continue to exist in creating a culture andenvironment that supports health and wellness. Helping your VENDORemployees identify their personal motivators to make andmaintain healthy lifestyle changes will impact both personal PARTNERShealth risks and employers’ bottom lines. n IS YOUR PROGRAM HIPPAA WORD ON ALTERNATIVE STANDARDS COMPLIANT?Our survey results indicated that almost 42% of those n DO YOU HAVE THE ABILITY TOrespondents with an outcomes-based program in place do not ADMINISTER AN EMPLOYEEoffer an alternative standard for those employees unable to APPEALS PROCESS?meet the defined criteria. This leads us to the conclusion thatthere may be a lack of understanding regarding the applicationof the HIPAA provisions or that employers are not receiving n WILL YOU PROVIDE GUIDANCEadequate guidance in the planning and implementation of these ON DEFINING HEALTHoutcomes-based incentive programs. For those respondents STANDARD METRICS?reporting that they do offer an alternative standard, roughly37% offer the completion of a specific lifestyle behavior program n DO YOU PROVIDE GUIDANCEas their alternative standard, while 27% offer improvement OR MATERIALS ONcriteria and 30% allow a note from their physician. To ensurethat your program is compliant, be sure to discuss incentive COMMUNICATING ANcompliance with your vendor partners. OUTCOMES-BASED PROGRAM? n DO YOUR COMMUNICATION MATERIALS INCLUDE THE ALTERNATIVE STANDARD LANGUAGE? n DO YOU PROVIDE AN INCENTIVE QUALIFICATION REPORT? 26 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • “Reasonable alternatives for wellness programs that are tied to group medical plans must be part of any program that uses health status as part of its program. The reasonable alternative is for those participants for whom meeting the particular health status goal would be medically unreasonable. The reasonable alternative must be made available and the fact that there is a reasonable alternative must be communicated to the participants to HOWEVER, THERE IS NO meet the HIPAA requirements.REQUIREMENT THAT THE PLAN OR THEEMPLOYER SPELL OUT JUST WHATTHAT REASONABLE ALTERNATIVE IS INADVANCE. Instead, it is acceptable (and likely required) for the employer to make an accommodation that fits the needs of the individual who cannot otherwise meet the requirements of the wellness program in order to obtain the same incentive. For example, if someone is addicted to nicotine and that renders it medically unreasonable for the person to be tobacco-free, the employer and the individual can design an individual alternative that would be reasonable. For instance, attending a smoking cessation program might be reasonable for one person but not for another (such as a single parent who cannot leave his child while he attends the program). So, perhaps the second person would be given the option to comply with his physician’s instructions, or something similar. The important factor is that a one-size-fits-all approach is not necessary, but some alternative needs to be communicated and offered.” Jay Kirschbaum, JD, LLM, FLMI Practice Leader, National Legal & Research Group Willis Human Capital Practice 27 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • PROGRAM EVALUATION AND MEASURING SUCCESSThe most common barriers reported to measuring success are: n Hard-to-determine influence of wellness program versus other factors impacting health care costs (44%) n Too early to measure impact (40%) n Insufficient data (37%) n Not enough staff time dedicated to this (36%)These barriers vary little from previous years’ surveys. Althoughprogram evaluation remains a challenge for many, it is still anexercise worth pursuing. Determining the evaluation metrics andmeasures to quantify program success during the planning stagescan ease this confusing process and help organizations identifyvendor partners that can meet their reporting and evaluationneeds.Survey respondents report management support, a stronginternal leader championing wellness and a culture of health asthe most influential factors in the success of their wellnessprograms. These three factors differ a bit from the results of the2011 survey, with culture of health climbing into the top threefactors rating average. 28 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • TOP FIVE METHODS FOR MEASURING SUCCESS OF A WELLNESS PROGRAMMULTI-YEAR COMPARISON 100% — 90% — 43% 28% 25% 59% 60% 80% — 70% — 60% — 64% 44% 71% 57% 44% 50% — 40% — 30% — 86% 20% — n Participation 47% 41% 41% 84% n Participation in the health assessment n Claims 10% — n Utilization of services – wellness program n Participation in 0% — biometric screenings 2012 2011 2010 2009 2008 29 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • TOP FIVE BARRIERS TO MEASUREMENTMULTI-YEAR COMPARISON 100% — 19% 90% — 39% 40% 32% 40% 80% — 70% — 50% 60% — 30% 40% 44% 43% 50% — 40% — 30% — n Too early to measure return 56% n Insufficient data 20% — 45% n Hard to determine 40% 41% 38% influence of wellness vs. the factors which impact 10% — health care costs n Not enough staffing/time dedicated to this 0% — n Unreliable 2012 2011 2010 2009 2008 30 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • When asked about measuring program impact, respondents report the followingtrends with regard to population health risks: n Health risks are improving 29% n Health risks are getting worse 4% n No change in population health risks 46% n Claim costs have been steady/in line with trend 20% n Claim costs have been decreasing/below trend 16% n Claim costs have been increasing/above trend 10%Despite the challenges reported in measuring success of a wellness program, themajority of employers are reporting that health risks are improving or areunchanged. While improvement is the ultimate goal, the philosophy of “don’t getworse,” prescribed by Dee W. Edington, formerly of the University of MichiganHealth Management Research Center, is also worth noting. According toEdington, “Even when risk status stays the same rather than getting worse, costsremain constant or are even reduced.” Zero Trends-Health as a Serious EconomicStrategy, 2009. 31 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • PROGRAM GOALS AND NEXT STEPS Engaging employees, program expansion/adding resources and improving management engagement and support continue to be the top three program goals that employers are focused on for the future. In this year’s survey, as in 2011, improving employee participation is the number one goal for organizations’ strategies looking forward (72% in 2012, 76% in 2011). Employers stated they plan to invest in their wellness initiatives by adding programs and resources (56%) despite the uncertain economic environment. Other goals and next steps include: WHAT ARE YOUR GOALS OR NEXT STEPS FOR YOUR WELLNESS PROGRAM STRATEGY? PLEASE MARK ALL THAT APPLY. Program evaluation 161 46% Expansion – add programs and resources 197 56%Enhance benefit design strategy to align with wellness program goals 127 36% Improve management engagement and support 166 47% Improve employee participation and engagement 253 72% Increase or establish budget 96 27% Partner with a third-party vendor 41 12% Move to/add outcomes-based model 89 25% Designate or hire an internal program leader 13 4% Form a wellness committee 64 18% Assess our corporate culture for opportunities to integrate wellness 95 27% Develop/expand a formal communication plan/strategy 110 31% No plans to change program  – maintain current effort 34 10% Other, please specify 10 3% | | | | | | | 0 50 100 150 200 250 300 32 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • TWENTY-FIVE YEARS AGO, IN THE INFANCY OF HEALTH PROMOTION, THERE WERE ONLY FIVE STUDIES PUBLISHED ON THE FINANCIAL IMPACT OF HEALTH PROMOTION. NOW, MORE THAN 62 STUDIES VALIDATE THE BUSINESS CASE FOR HEALTH PROMOTION PROGRAMS. HOWEVER, AN ENORMOUS OPPORTUNITY REMAINS IN THE FIELD OF HEALTH PROMOTION TO TAKE A PRESCRIPTIVE APPROACH, AS MORE EMPLOYERS SEEK TO QUANTIFY THE IMPACT AND EFFECTIVENESS OF WORKPLACE WELLNESS PROGRAMS.FINAL THOUGHTSREVISITING BEST PRACTICESAs more organizations are focused on the impact of Health Care Reform and controlling escalating health care costs,the prevalence of workplace wellness programs has continued to grow as one of the primary strategies for controllingcosts. Employer-sponsored wellness programs have been around for several decades, although in past years were oftendeveloped by trial and error, focused primarily on physical health and included minimal program evaluation. Twenty-five years ago, in the infancy of health promotion, there were only five studies published on the financial impact ofhealth promotion. Now, more than 62 studies validate the business case for health promotion programs. However, anenormous opportunity remains in the field of health promotion to take a prescriptive approach, as more employersseek to quantify the impact and effectiveness of workplace wellness programs.What are the programs and activities that make the difference for employers of all sizes? What percentage ofparticipation is required to make a cost impact? What is the best and most effective incentive structure? These are alltoo familiar questions because the future for health promotion and workplace wellness is slow to reveal definitiveanswers due to variables, such as organizational culture and norms, employee engagement, and many others that cansignificantly impact program outcomes.While many variables can impact program effectiveness, today we have clearly defined best practices for workplacewellness programs. Many organizations continue to expand their offerings to include comprehensive programs thatsupport physical, mental, intellectual and spiritual health as well as integrating programs to support a work/lifebalance for their employees. For many employers, workplace wellness programs have become part and parcel of theoverall benefits package highly promoted to contribute to attracting and retaining quality talent and often extendingthese benefits to family members as well.Several highly regarded resources have made it their mission to improve the health of the U.S. workforce by researchingand developing best practices in health promotion and workplace wellness. These organizations include The NationalBusiness Group on Health (NBGH), Wellness Councils of America (WELCOA), The Health Enhancement ResearchOrganization (HERO), American Journal for Health Promotion as well as many business and health thought leaderswho have contributed their experience and expertise to these organizations. 33 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • In reviewing the most respected sources for workplace wellness bestpractices, there is significant overlap or duplication with the mostcommonly cited best practice benchmarks being: n Program support n n Strategic planning Cultural support THE COMMON n Appropriate programs/interventions GOAL IN n n Engagement strategies Measurement and evaluation DEVELOPING BEST PRACTICEOne of the most important, although frequently overlooked standardsis the concept of approaching workplace wellness as an integratedorganizational strategy, building health into the organizational GUIDANCE IS TO IDENTIFY AND PUBLISHculture. In his landmark book, Zero Trends: Health as a Serious STANDARDS THAT ASSISTEconomic Strategy, Dee Edington, PhD., Director of the University of PROGRAM PLANNERS INMichigan Health Management Research Center (HMRC) draws on his30-plus years of experience and research to show how organizations CREATING AND SUSTAININGcan manage escalating health care costs while keeping their RESULTS-ORIENTED PROGRAMSworkforces healthy and productive. “Our goal is to convince THAT ULTIMATELY IMPROVEorganizations to make health an integral part of their corporate POPULATION HEALTH. THESEculture.” He goes on to state that helping companies recognize that GUIDELINES TYPICALLY IDENTIFYthey can create economic value by investing in healthy and productive PROGRAM COMMONALITIES THATpeople has been at the core of the HMRC’s work since its inception. HAVE CONTRIBUTED TOMore organizations have come to the understanding that a healthy SUSTAINABLE AND EFFECTIVEand productive workforce is not only a cost controlling mechanism WORKPLACE WELLNESSbut offers a competitive edge necessary for sustainability in an era of PROGRAMS.economic uncertainty. But we must keep in mind that healthyorganizations do not occur in a vacuum and are not created overnight.Developing programs that are integrated into all aspects of theorganization’s mission, providing comprehensive resources to allemployees and their family members while creating a health-supporting environment, should be some of the overarching goals.Striving to align your workplace wellness programs with best practicebenchmarks can increase the likelihood of creating successfulprograms that support employee behavior change and yield positivehealth outcomes.1 Aumann K, Galinsky E, & Matos K. The New Male Mystique: Family and WorkInstitute; 2011. 34 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • TECHNICAL APPENDIX WHICH OF THE FOLLOWING ARE YOUR TOP THREE CHALLENGES IN CONTROLLING HEALTH CARE COST? Employees’ poor health habits 360 48% High-cost catastrophic cases 356 48% Underuse of preventive services 266 36% Escalating cost of specialty pharmacy benefits 214 29% Poor employee understanding of how to use the plan 165 22% Poor information on provider costs 88 12% Overuse of care through employees seeking inappropriate care 96 13% Cost of compliance under Health Care Reform 182 24% Higher costs due to new medical technologies 169 23%Overuse of care through providers recommending too many services 77 10% Changes in workplace demographics 108 15% Poor information on provider quality 25 3% | | | | | 0 100 200 300 400 35 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • WHICH OF THE FOLLOWING STRATEGIES IS YOUR ORGANIZATION USING TO ADDRESS RISING HEALTH CARE COST? Provide on-site and/or telephonic health care support 311 66 57 250 Direct your employees to a public or private exchange 559 87 14 14 Tie employee contributions to biometric screening results (health outcomes) 358 184 64 77Eliminate/reduce co-payments for medications and services used to treat chronic conditions 472 73 35 85 Manage prescription drug use 260 83 82 256 Provide employees with tools and information to become better consumers 79 84 152 375 Offer a defined contribution plan 363 60 22 221 Implementation of high-deductible health plan 203 99 53 325 Evaluation of multiple data points to create more targeted strategies 273 125 140 127 Actively promote health improvement programs and resources 123 93 128 348 Establish a comprehensive wellness strategy 158 140 143 254 | | | | | | | | 0 100 200 300 400 500 600 700 nNot considering nPlanning for in the next 3-5 years nPlanning for 2013 nCurrently in place 36 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • WHICH OF THE FOLLOWING WORK-LIFE BALANCE PROGRAMS DOES YOUR ORGANIZATIONOFFER? PLEASE MARK ALL THAT APPLY. Paid maternity leave 274 39% Paid paternity leave 109 16% Flexible work hours 367 52% Telecommuting/working from home 260 37% Lactation facilities 272 39% Childcare/daycare center on-site 26 4% Family planning services 29 4% Concierge services 32 5% Restaurant/cafe on-site 129 18% None 160 23% Other 61 9% | | | | | 0 100 200 300 400 37 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • HOW EFFECTIVE IS YOUR ORGANIZATION AT LEVERAGING THE FOLLOWING RESOURCES TO DRIVE THE HEALTH AND PRODUCTIVITY WITH YOUR WORKFORCE? Health insurance carrier 99 239 229 60 24 Employee Assistance Program 54 152 234 96 83Community resources (fitness center, grocery store, hospitals, etc.) 14 96 213 180 109 Non-profit organizations (American Diabetes Association, American Heart Association, Red Cross, etc.) 12 68 170 209 131 Third-party wellness vendor(s) 31 105 152 153 144 Internal staff and/or resources 53 174 226 88 69 Insurance broker/consultant 101 224 204 58 41 Grants 10 17 41 141 347 College/university resources 9 28 62 145 321 | | | | | | | | 0 100 200 300 400 500 600 700 nVery effective nEffective nSomewhat effective nNot effective nNot at all effective WHO IS YOUR PRIMARY MEDICAL CARRIER? Aetna 56 12% Cigna 56 12% United Healthcare 98 21% The Blues 268 56% Other 193 40% | | | | 0 100 200 300 38 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • TO WHAT EXTENT DO YOU USE THE FOLLOWING SERVICES OFFERED THROUGH YOUR MEDICAL CARRIER TO SUPPORT WELLNESS INITIATIVES? Health Risk Assessment (HRA) 91 68 81 77 291 Biometric Screenings 79 54 66 62 329Disease Management/Case Management 46 78 152 119 213 Nurse Line 51 68 147 144 196 Employee Assistance Program (EAP) 44 75 137 110 235 Employee Portal 44 93 151 124 192 Communication Materials/Resources 61 126 217 136 92 | | | | | | | | 0 100 200 300 400 500 600 700 nTo a very large extent nTo a large extent nTo a moderate extent nTo a small extent nTo a very small extent 39 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • HOW WOULD  YOU  DESCRIBE YOUR ORGANIZATION’S WELLNESS PROGRAM? PLEASE CHOOSE THE OPTION THAT MOST CLOSELY DESCRIBES YOUR CURRENT PROGRAM FROM THE DESCRIPTIONS BELOW. Comprehensive: Offer most of the components of an intermediate program plus offertargeted behavior change interventions, have significant wellness incentive design. Offer program to spouses, tracking wellness program data year to year and focused on 51 8% evaluating the impact of the wellness program. Intermediate: Have a designated wellness committee or internal program coordinator. Offer most of the components of a Basic program plus health risk assessments, on-sitebiometric screenings, health coaching and/or a wellness web portal. Some incentives for 169 26% program participation and a designated wellness budget.Basic: Just getting started with a wellness program, offer a few voluntary activities such 165 25%as lunch and learns, health fair and team challenges. Operate with minimal or no budget. Plan to offer one in the future 76 12% No current program 200 30% | | | | 0 100 200 300 40 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • WHAT IS THE MAIN REASON FOR NOT OFFERING A WELLNESS PROGRAM?  No program yet - but planning for the future 56 20% Budget constraints 35 13% Do not perceive a need for such a program 14 5% Lack of  support from  management 21 8% No interest in this type of program from employees 35 13% Too few/small group of employees 31 11% Not enough time/staff to dedicate to this 52 19% High employee turnover 5 2% Employees are in various geographic locations 15 5% Legal/compliance issues a concern 1 1%Lack of return on investment statistics to justify investment 2 1%Fear that wellness in the worksite will be viewed as intrusive 2 1% Other 7 3% | | | | | | | 0 10 20 30 40 50 60 41 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • HOW LONG HAS YOUR ORGANIZATION HAD AN ACTIVE WELLNESS PROGRAM IN PLACE? Less than 1 year 74 19% 1 - 3 years 178 46% 4 or more years 133 35% | | | 0 100 200WHICH OF THE FOLLOWING TOPICS DOES YOUR ORGANIZATION ADDRESS THROUGH ITSWELLNESS PROGRAM?  PLEASE MARK ALL THAT APPLY. Preventive Care 309 80% Asthma 106 28% Diabetes 186 48% Tobacco Cessation 261 68% Nutrition 316 82% Stress Management 279 73% Physical Activity 347 90% Financial Wellness 145 38% | | | | | 0 100 200 300 400 42 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • WHICH OF THE FOLLOWING TYPES OF PROGRAMS DOES YOUR ORGANIZATION OFFER/SUPPORT TO ADDRESS THE TOPICS IN THE PREVIOUS QUESTION?  PLEASE MARK ALL THAT APPLY. Events organized by the company (walks, runs or bike rides, on-site yoga, aerobics, etc.) 205 53% Subsidized gym memberships (external) 137 36% Fitness facility/activities on-site 120 31% Team or individual based behavioral change challenges/competitions 164 43% Policies and procedures that support health (tobacco free worksite, flex time for physical activity, etc.) 167 43% Physical activity programs such as on-site classes, pedometer programs, fun run/walks, stairwell promotion 224 58% Peer support groups 39 10% On-site pharmacy 22 6% On-site fitness facility or designated space for activity programs 102 27% On-site clinic or health care practitioner 55 14% Nurse Line 214 56% Lunch and Learn/educational seminars 204 53% Health/wellness employee web portal 177 46% Health fairs 192 50% Health coaching – telephonic, online, or on-site 215 56% Health advocacy (provider selection support, prescription drug guidance, etc.) 111 29%Food service changes to include healthier options (vending, cafeteria, catering, organization meeting menus, etc.) 161 42% On-site flu shots 316 82% Employee Assistance Program 311 81% Disease/case management 195 51% Alternate commuter program (bike/walk to work) 49 13% | | | | | 0 100 200 300 400 43 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • TOP THREE TYPE OF PROGRAMS100% — 8% 8% 9% 8% 11%90% —80% — 32% 30% 39%70% — 44% 45%60% — 8% 10%50% — 7%40% — 26% 24% 16%30% — 47% 47%20% — 30% n Basic 25% 26% n Intermediate 10% — n Comprehensive n No program n Planning to offer 0% — one in the future 2012 2011 2010 2009 2008 44 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • BARRIERS TO IMPLEMENTING A PROGRAM 24% 26% 11% 13% 45% 42% 43% 22% 19% 46% n Budget constraints n Lack of management support n Dispersed staff n Lack of access to a computer 61% 68% n Too small or too few employees n Lack of ROI data 48% n Insufficient time/staff 13% 15% n High stress and lack of time among employees n Not enough staff/time to dedicate to this n No interest in this type of program 2012 2011 2010 2009 2008 45 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • TOP FOUR SERVICES OFFERED THROUGH YOUR MEDICAL CARRIER TO SUPPORT WELLNESS INITIATIVES250% —200% — 71% 64%150% — 53% 55% 49%100% — 65% 62% 49% 48% 111%50% — 53% 64% 66% 50% n Weight management n Physical activity n Tobacco cessation 0— n Lunch and learns 2012 2011 2010 2009 2008 46 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • HOW DO YOU ADDRESS TOBACCO USE AS AN ORGANIZATION?   PLEASE MARK ALL THAT APPLY. We do not hire tobacco users 10 3% We conduct cotinine testing among our employees 26 7% We ask employees to sign or complete an affidavit of their tobacco use 71 19% We offer coverage, subsidy or reimbursement for over-the-counter 69 18% tobacco cessation products (gum, patch, etc.) We offer coverage, subsidy or reimbursement for prescription tobacco 109 29% cessation medications under our medical or pharmacy benefits We reimburse some or all of the costs of tobacco cessation programs 95 25%We offer a tobacco cessation program through a third-party vendor or community provider 85 22% We offer a tobacco cessation program through our health insurance carrier 160 42% We are completely tobacco-free on our worksite campus(es) 131 35% We have designated smoking areas on our worksite campus(es) 183 48% Our tobacco policy includes banning the use of electronic cigarettes 27 7% We have a written policy regarding tobacco use 196 52% We do not address it 37 10% | | | | | 0 50 100 150 200 HAS YOUR COMPANY BRANDED/NAMED ITS WELLNESS PROGRAM? No 225 60% Yes 151 40% | | | | | | 0 50 100 150 200 250 47 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • HOW  DO YOU COMMUNICATE  YOUR WELLNESS PROGRAM?  PLEASE MARK ALL THAT APPLY. Mail to employees’ homes 85 23% Bulletin boards 183 49% Open enrollment 204 54% Dedicated web portal 73 19% Social media: Twitter, Facebook, blogs, etc. 16 4% Text messaging 3 1%Wellness committee members share information to their departments or locations 142 38% Intranet resources 211 56% Printed materials – flyers, posters, paycheck stuffers 255 68% Newsletters 225 60% Emails 328 87% Town hall meetings 58 15% Departmental staff meetings 140 37% | | | | | | | | 0 50 100 150 200 250 300 350 48 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • HOW OFTEN DO YOU COMMUNICATE YOUR WELLNESS PROGRAM OFFERINGS TO EMPLOYEES? Only during campaigns 92 25% Daily 5 1% Weekly 30 8% Monthly 151 40% Quarterly 48 13% Twice a year 21 6% Annually/at open enrollment 29 8% | | | | | 0 50 100 150 200HOW EFFECTIVE DO YOU FEEL YOUR COMMUNICATION EFFORTS ARE AT DISSEMINATING KEYPROGRAM INFORMATION SUCH AS UPDATES AND EVENTS? Not effective 25 7% Somewhat effective 222 59% Effective 111 30% Very effective 18 5% | | | | | | 0 50 100 150 200 250 49 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • WHAT ARE YOUR COMMUNICATION  BARRIERS REGARDING THE WELLNESS PROGRAM?    PLEASE MARK ALL THAT APPLY. Employees spread out at various geographic locations 200 53% Employees without computer access at work 170 45% Employees concerned with invasion of privacy/confidentiality 134 36% Lack of trust/poor morale among employees 52 14% Lack of time/interest among employees 234 62% Lack of resources to develop communication materials 67 18% Different employee shifts/work hours 120 32% High turnover 42 11% Non-English speaking employees 52 14% Reaching spouses and dependents outside the workplace 155 41%Supervisors/managers not sharing wellness program information with employees 93 25% No significant concerns 31 8% | | | | | | 0 50 100 150 200 250 50 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • DO YOU INCLUDE AN EXPLANATION OF THE WELLNESS PROGRAM IN YOURRECRUITMENT/NEW HIRE ORIENTATION PROCESS? Yes 203 54% No 173 46% | | | | | | 0 50 100 150 200 250HAVE YOU UPDATED YOUR MARKETING AND COMMUNICATIONS STRATEGIES SINCE THE INITIALWELLNESS PROGRAM LAUNCH? Yes 199 53% No 177 47% | | | | | 0 50 100 150 200 51 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • WHEN THINKING ABOUT YOUR WELLNESS PROGRAMS STRATEGY WHICH STATEMENTS MOST CLOSELY REFLECT YOUR ORGANIZATIONS APPROACH? We want to reward employees who are 142 160 43 13 6 taking steps towards health improvement We have implemented penalties to employees who 29 56 32 121 126 are not taking steps towards health improvement We have aligned our worksite culture to 59 147 101 52 5 support employee health improvement We want to improve employee health andoffer programs that address their personal health risks 237 114 10 3 | | | | | | | | | 0 50 100 150 200 250 300 350 400 nStrongly agree nAgree nNot sure nDisagree nStrongly disagree 52 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • WHAT IS  THE COMPANYS  ESTIMATED PER EMPLOYEE PER YEAR COST FOR THE WELLNESS PROGRAM INCLUDING INCENTIVES, STAFFING, VENDORS, ETC.? No defined budget for worksite wellness 149 40% 40 11% $25 or less $26 to $50 47 13% $51 to $75 30 8% $76 to $100 28 8% $101 to $149 14 4% $150 or more 62 17% | | | | 0 50 100 150 HOW IS THE WELLNESS PROGRAM BUDGET FUNDED?  PLEASE MARK ALL THAT APPLY. Company funded 319 86% Carrier funded 69 19%Employee contributions 31 8% Other 28 8% | | | | | | | | 0 50 100 150 200 250 300 350 53 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • DO YOU USE A THIRD PARTY VENDOR/SOLUTION TO SUPPORT YOUR WELLNESS PROGRAM, AND IF SO, WHO DOES YOUR ORGANIZATION USE? Alere 2% American Specialty Health 309 1% Bravo Wellness 309 1% Ceridian 309 1% CHC Wellness 309 1% Engagement Health 309 0% Healics 309 1% Health Force Partners 309 1% HealthFitness 309 1% Healthways 309 1% IHS 2% Keas 309 1% Limeade 309 0% MyHealthCheck - Lifetime Fitness 309 1% Optum 309 1% Preventure 309 1% Principal Wellness 309 0% Propel Wellness 309 0% Provant 309 1% Recess wellness 309 0% RedBrick Health 309 1% Staywell 309 1% Tri Wellness 309 0% Trotter Wellness 309 1% US Wellness 309 1% Vielife 309 0% Vitality 3% Viverae 4% WebMD 309 1% Well Source 309 1% WellCall 309 1% Wellness & Prevention Inc. (J&J) 309 1% Wellness Corporate Solutions 309 0%We do not use a third party vendor/solution 40% Other (please specify) 34% | | 0 100 54 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • HOW LONG HAVE YOU HAD THIS THIRD PARTY VENDOR IN PLACE? Less than 1 year 50 34% 1 to 2 years 48 32% 3 to 5 years 36 24% 5 to 8 years 10 7% 9 to 10 years 3 2% More than 10 years 1 1% | | | | 0 20 40 60HOW SATISFIED ARE YOU WITH THE SERVICES/SOLUTIONS PROVIDED BY THE THIRD PARTYVENDOR? Extremely satisfied 14 10% Very satisfied 53 36% Somewhat satisfied 49 34% Dissatisfied 8 6% Very dissatisfied 3 2% Too early to tell 19 13% | | | | 0 20 40 60 55 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • HOW DO YOU OBTAIN EMPLOYEE FEEDBACK OR SATISFACTION REGARDING YOUR WELLNESS PROGRAM DESIGN? Annual survey 44 12% Focus group 3 1% 71 20%Wellness committee involvement Program evaluation 66 18% General suggestion box 18 5% We do not solicit feedback 140 39% Other 22 6% | | | | | | | 0 25 50 75 100 125 150 WHAT LEVEL OF INFLUENCE DOES THE EMPLOYEE FEEDBACK THAT YOU OBTAIN INFLUENCE YOUR PROGRAM STRATEGY? Very influential 17 5% Influential 134 37% Some influence 130 36% Little influence 32 9% No influence 51 14% | | | | | | | 0 25 50 75 100 125 150 56 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • TOP FIVE INCENTIVES FOR HEALTH ASSESSMENT PARTICIPATION100% —90% — 18% 20% 20% 18% 16%80% —70% — 30% 40% 22%60% — 21% 33%50% —40% —30% — 31% 34% 38% 29%20% — 28% n Lower premium contribution 10% — n Contribution to HSA, HRA n Raffle for large prize n Cash 0% — n No incentive 2012 2011 2010 2009 2008 57 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • DO YOU OFFER A HEALTH RISK QUESTIONNAIRE AS PART OF YOUR WELLNESS PROGRAM? Yes, through a free web-based tool 9 3%Yes, through a third party vendor (e.g. wellness vendor) 108 30% Yes, through our medical carrier 153 42% No 94 26% | | | | | | | 0 25 50 75 100 125 150 WHAT IS  YOUR HEALTH ASSESSMENT PARTICIPATION RATE? 76% or more 74 28% 51% to 75% 56 21% 26% to 50% 66 25% 25% or less 73 27% | | | | 0 25 50 75 58 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • WHAT IS THE INCENTIVE(S) FOR HEALTH ASSESSMENT COMPLETION?  PLEASE MARK ALL THAT APPLY.No incentive(s) offered for completing the health assessment 55 20% Require completion to receive health insurance coverage 20 7% Contribution to health account (health FSA, HRA or HSA) 32 12%Lower employee cost (premium contribution) for medical plan 91 34% Lower plan deductible, co-insurance or co-pays 10 4% Accumulate points for prizes 19 7% Cash/gift cards 80 30% Raffle for larger prizes 27 10% Smaller prizes for each participant 9 3% Paid time off 7 3% Other 7 3% | | | | | 0 25 50 75 100 59 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • DO YOU OFFER BIOMETRIC SCREENINGS AS PART OF YOUR WELLNESS PROGRAM? No 129 36%Yes, through a local provider (e.g.hospital system or public health department) 31 9% Yes, through our medical carrier 74 21% Yes, through a third party vendor (e.g. wellness vendor) 90 25% Yes, through a lab vendor (e.g. Concentra, Quest, other) 16 4% Yes, through on-site practitioner/clinic 21 6% | | | | | | | 0 25 50 75 100 125 150 WHAT IS  YOUR BIOMETRIC SCREENING PARTICIPATION RATE? 76% or more 55 24% 51% to 75% 54 23% 26% to 50% 76 33% 25% or less 47 20% | | | | 0 25 50 75 60 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • WHAT IS  THE INCENTIVE(S) FOR BIOMETRIC SCREENINGS?  PLEASE MARK ALL THAT APPLY. No incentive(s) offered for biometric screenings 50 22% Require completion to receive health insurance coverage 13 6% Contribution to health account (health FSA, HRA or HSA) 24 10%Lower employee cost (premium contribution) for medical plan 79 34% Lower plan deductible, co-insurance or co-pays 8 3% Accumulate points to earn prizes 24 10% Cash/gift cards 54 23% Raffle for larger prizes 27 12% Smaller prizes for each participant 8 3% Paid time off 6 3% Other 8 3% | | | | | 0 25 50 75 100 WHO IS ELIGIBLE TO EARN WELLNESS INCENTIVES? We do not offer wellness incentives 103 29% Employees, spouses and dependents 25 7% Employees and spouses 53 15% Employees 180 50% | | | | | | | | | 0 25 50 75 100 125 150 175 200 61 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • WHAT CRITERIA MUST BE MET TO EARN INCENTIVES?  PLEASE MARK ALL THAT APPLY. Combination 58 22% Outcomes-based 38 15% Progress-based 22 9% Program completion 111 43% Participation only 146 56% | | | | | | | 0 25 50 75 100 125 150 WHAT TYPES OF INCENTIVES DO YOU OFFER FOR PARTICIPANTS WHO MEET PROGRAM CRITERIA?Contribution to a health savings account (health FSA, HRA or HSA) 36 14% Lower employee cost (premium cost) for medical plan 103 40% Lower plan deductible, co-insurance or co-pays 13 5% Small prizes 67 26% Raffle for larger prizes 61 24% Cash/gift card 124 48% Paid time off 22 9% Other 20 8% | | | | | | 0 25 50 75 100 125 62 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • DOES YOUR ORGANIZATION OFFER A WELLNESS PROGRAM INCENTIVE THAT PROVIDES DISCOUNTED INSURANCE PREMIUMS? No 240 67% Yes 120 33% | | | | | | 0 50 100 150 200 250 HOW CAN EMPLOYEES EARN DISCOUNTED PREMIUM CONTRIBUTIONS? PLEASE MARK ALL THAT APPLY. Participation in a worksite biometric screening event 75 63% Participation in a combination of activities and events 34 28% Participation in a health improvement program (such as tobacco cessation or weight loss) 36 30% Completion of a health risk assessment 82 68% Completion of an annual well visit/physical 42 35%Completion of age/gender appropriate preventive screenings (mammogram, colonoscopy, etc.) 21 18% Completion of a health coaching program 23 19% Completion of disease management program 10 8% Tobacco use status 44 37% Health assessment score – improvements or maintenance of healthy score 19 16%Meeting or improving targeted biometric values such as weight, blood pressure and cholesterol 19 16% Other, please specify 4 3% | | | | | 0 25 50 75 100 63 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • WHAT IS THE MAXIMUM DISCOUNT  CONTRIBUTION EMPLOYEES CAN EARN PER MONTHON A SINGLE PLAN? $10 or less 20 17% $11 to $25 34 28% $26 to $50 34 28% $51 to $75 13 11% $76 or more 19 16% | | | | | 0 10 20 30 40WHAT IS THE MAXIMUM DISCOUNTED CONTRIBUTION EMPLOYEES CAN EARN PER MONTHON A FAMILY PLAN?  $10 or less 15 13% $11  to $25 22 18% $26 to $50 30 25% $51 to $75 18 15% $76 to $100 15 13% $101 or more 20 17% | | | | 0 10 20 30 64 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • AS DEFINED BY THE “GUIDANCE FOR A REASONABLY DESIGNED, EMPLOYER-SPONSORED WELLNESS PROGRAM USING OUTCOMES-BASED INCENTIVE,” JOEM, JULY 7, 2012, AN OUTCOMES-BASED INCENTIVE PROGRAM INCLUDES ANY EFFORT IN WHICH “A REWARD OR PENALTY IS TIED TO AN INDIVIDUAL ACHIEVING OR MAKING PROGRESS TOWARD A STANDARD RELATED TO A HEALTH FACTOR.”  IS YOUR INCENTIVE PROGRAM OUTCOMES-BASED? No 279 78% Yes 81 23% | | | | | | | 0 50 100 150 200 250 300HOW LONG HAS YOUR OUTCOMES-BASED WELLNESS PROGRAM BEEN IN PLACE? Less than 1 year 28 35% 1-2 years 26 33% 3-5 years 18 23% More than 5 years 7 9% | | | | | | | 0 5 10 15 20 25 30 65 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • WHICH HEALTH FACTOR(S) IS CURRENTLY PART OF YOUR OUTCOMES-BASED INCENTIVE STRUCTURE? PLEASE MARK ALL THAT APPLY. Blood pressure 44 11 7 17 Blood Mass Index 21 11 8 39 Tobacco use 47 9 7 16 Total cholesterol 40 10 8 21 HDL 30 8 11 30 LDL 30 8 11 30 Fasting blood sugar 32 9 6 32 Body composition/body fat percentage 27 12 7 33 Metabolic syndrome parameters 8 7 8 56 Achieving a defined wellness score 28 6 10 35Improving the wellness score by a defined amount 19 7 14 39 | | | | | | | | | 0 10 20 30 40 50 60 70 80 nCurrently in place nPlanning for 2013 nPlanning for in the next 3 to 5 years nNot considering using 66 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • IF PARTICIPANTS DO NOT MEET DEFINED PARAMETERS, WHAT ALTERNATIVES DO YOU OFFER? PLEASE MARK ALL THAT APPLY. We don’t offer alternatives 33 42% Note from their physician 24 30% Improvement over previous year’s results 21 27%Completion of specific lifestyle behavior programs (tobacco cessation, 29 37% weight management, health coaching, DM, etc.) | | | | | | | | 0 5 10 15 20 25 30 35 WHAT GUIDELINE(S) ARE THE OUTCOMES-BASED HEALTH FACTOR CRITERIA BASED ON? PLEASE MARK ALL THAT APPLY. Wellness committee developed recommendations  28 35% Directive from Senior Management 18 23% Carrier developed recommendations 17 22% Vendor developed recommendations 31 39% Applied research from CDC, NIH, JOEM, etc. 14 18% Other, please specify 7 9% | | | | | | | 0 5 10 15 20 25 30 35 67 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • WHAT RESULTS HAS YOUR ORGANIZATION REALIZED FROM THE CURRENT OUTCOMES-BASED PROGRAMS? Too early to assess impact 41 52% Claims cost have been increasing/above trend 1 1%Claims costs have been decreasing/below trend 10 13%Claims costs have been steady/in line with trend 5 6% No change in health risks 6 8% Health risks are getting worse 0% Health risks are improving 16 20% | | | | | | | | | | 0 5 10 15 20 25 30 35 40 45 68 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • WHAT METRICS ARE YOU USING TO DETERMINE WELLNESS PROGRAM SUCCESS? PLEASE MARK ALL THAT APPLY. Health assessment participation 203 57% Wellness score 59 17% Biometric participation 154 44%Biometric measures (i.e. weight, cholesterol, blood pressure, etc.) 113 32% Health risks 75 21% Challenge/campaign evaluations 75 21% Overall employee satisfaction 121 34% Claims data 165 47% Workmens compensation statistics 25 7% Absenteeism 34 10% Productivity/presenteeism 28 8% Short term disability 20 6% Long term disability 19 5% Other, please specify 39 11% | | | | | | | | | | 0 25 50 75 100 125 150 175 200 225 69 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • FROM THE WELLNESS PROGRAM REPORTING AVAILABLE TO YOU FROM THE HEALTHASSESSMENT, SCREENING OR CLAIMS DATA, WHAT HAS BEEN THE OVERALL TREND WITHYOUR POPULATIONS HEALTH RISKS? PLEASE MARK ALL THAT APPLY. Claims costs have been increasing/above trend 35 10% Claims costs have been decreasing/below trend 57 16% Claims costs have been steady/in line with trend 69 20% No change in population health risks 163 46% Health risks are getting worse 13 4% Health risks are improving 101 29% | | | | | | | | 0 25 50 75 100 125 150 175 70 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • WHAT ARE THE BARRIERS PREVENTING YOUR ORGANIZATION FROM EVALUATING THE IMPACT OF YOUR WELLNESS PROGRAM?  PLEASE MARK ALL THAT APPLY. Insufficient data 130 37%Hard to determine influence of wellness versus other factors which impact health care costs 153 44% Too early to measure impact 139 40% Not enough dedicated staff/time 126 36% HIPAA privacy concerns with obtaining more detailed data reports 50 14% No access to or budget for an integrated data warehouse 47 14% Participant group too small to measure accurately/reliably 36 10% Third party vendor does not supply data 8 2% Not sure how to measure 78 22% No interest at this time 15 4% No barriers exist 21 6% | | | | | | | | 0 25 50 75 100 125 150 175 71 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • HOW INFLUENTIAL ARE THE FOLLOWING FACTOR(S) IN THE SUCCESS OF YOUR PROGRAM? Employee satisfaction/engagement 9 53 132 157 Assessing program outcomes/evaluation statistics 38 80 137 96Strong partnership with vendor/satisfaction with services 42 83 150 76 Active wellness committee 62 90 115 84 Sustainability of program 21 72 152 106 Communication/marketing of programs 11 67 146 127 Incentives for employee participation 30 77 141 103 Culture of health 13 61 168 109 Strong internal leader championing wellness 18 42 135 156 Management support 14 56 108 173 | | | | | | | | 0 50 100 150 200 250 300 350 nNot influential nSomewhat influential nInfluential nEssential 72 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • TOP FIVE BARRIERS TO MEASUREMENT100% — 19%90% — 39% 40% 32% 40%80% —70% — 50%60% — 30% 40% 44% 43%50% —40% —30% — n Too early to measure return 56% n Insufficient data20% — n Hard to determine influence 40% 41% 38% 45% of wellness vs. the factors which impact health care 10% — costs n Not enough staffing/time dedicated to this 0% — n Unreliable 2012 2011 2010 2009 2008 73 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • TOP FIVE METHODS FOR MEASURING SUCCESS OF A WELLNESS PROGRAM100% —90% — 43% 28% 25% 59% 60%80% —70% —60% — 64% 44% 71% 57% 44%50% —40% —30% — 86%20% — n Participation 47% 41% 41% 84% n Participation in the health assessment n Claims 10% — n Utilization of services – wellness program n Participation in biometric 0% — screenings 2012 2011 2010 2009 2008 74 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012
    • WHAT ARE YOUR GOALS OR NEXT STEPS FOR YOUR WELLNESS PROGRAM STRATEGY? PLEASE MARK ALL THAT APPLY. Program evaluation 161 46% Expansion – add programs and resources 197 56%Enhance benefit design strategy to align with wellness program goals 127 36% Improve management engagement and support 166 47% Improve employee participation and engagement 253 72% Increase or establish budget 96 27% Partner with a third-party vendor 41 12% Move to/add outcomes-based model 89 25% Designate or hire an internal program leader 13 4% Form a wellness committee 64 18% Assess our corporate culture for opportunities to integrate wellness 95 27% Develop/expand a formal communication plan/strategy 110 31% No plans to change program – maintain current effort 34 10% Other, please specify 10 3% | | | | | | | 0 50 100 150 200 250 300 75 THE WILLIS HEALTH & PRODUCTIVITY SURVEY 2012