Ben Leedle Wellmark 09/23/10
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Ben Leedle Wellmark 09/23/10 Ben Leedle Wellmark 09/23/10 Presentation Transcript

  • Activating Your Community for Well-Being Ben Leedle, Chief Executive Officer, Healthways Inc.
  • The Problem… and a Solution Source: Centers for Diseases Control and Prevention, University of California at San Francisco, Institute for the Future. Reprinted from Advances, Robert Wood Johnson Quarterly Newsletter, 2000; 1:1 Influencers of Health Access to Care Environment Genetics Health Behaviors Health Behaviors U.S. Healthcare Expenditures 88% Other Access to Care (treatment) 4% 8% 10% 20% 20% 50% 22
  • Discussion Topics
    • Progress towards Improved Well-Being
    • Evolution of the science
    • Implications and action steps you can take
    Intent is to frame a broad and deep set of discussions today into a pragmatic set of action steps and take-aways
    • Progress towards Improved Well-Being
  • Individuals ● Experts ● Environments ● Relationships Improve Well-Being
    • 25-year commitment, initiated January 2, 2008
    • Telephonic-based for “community” survey
    • 1,000 completed surveys per day/7 days/week
    • Almost one million completed surveys to date
      • For results based on this sample of respondents, the maximum 95% margin of sampling error is ±0.3 percentage points
    • Science-based design, support and oversight
    • Healthways Well-Being Assessment TM :
      • Hybrid of HRA and WBI; Independently validated
      • Web-based (businesses and individuals)
      • Over 600,000 WBA’s completed
    • Six Domains:
    • Life Evaluation
    • Emotional Health
    • Physical Health
    • Healthy Behavior
    • Work Environment
    • Basic Access
    The Gallup-Healthways Well-Being Index
  • Well-Being at the National Level Source: Gallup-Healthways Well-Being Index Community Survey 2009, n=353,849 2009 2008 Fourth Quintile Third Quintile Second Quintile Top Quintile Ranking: Bottom Quintile
  • Well-Being at the Regional Level 199 200 173 174 Des Moines Cedar Rapids Mason City Davenport Pierre Sioux Falls Rapid City Fourth Quintile Third Quintile Second Quintile Top Quintile Ranking: Bottom Quintile 295 241 South Dakota Iowa 2008 Congressional District Ranking by Well-Being Index (out of 436 Districts) Source: Gallup-Healthways Well-Being Index Community Survey 2008, n=352,549
  • Well-Being at the Regional Level 40 50 133 66 Des Moines Cedar Rapids Mason City Davenport Pierre Sioux Falls Rapid City Fourth Quintile Third Quintile Second Quintile Top Quintile Ranking: Bottom Quintile 156 194 2009 Congressional District Ranking by Well-Being Index (out of 436 Districts) South Dakota Iowa Improvement by one quintile from 2008 to 2009 Source: Gallup-Healthways Well-Being Index Community Survey 2009, n=353,849
  • Cedar Rapids, Iowa, June 15 2008
  • The Transformational Recovery (I) Impact of 2008 Floods on Cedar Rapids and Surrounding Regions Cedar Rapids FEMA Public Asssistance and Hazard Mitigation Payments and DOT Payments Per Capita (2008) Overlaid on Congressional District Quintiles by Well-Being Index (2009) Very High High Moderate Low 6 4 12 77 77% 7% 9% 8% 74% 5% 9% 11% 93% 1% 4% 2% County Impact Number of Counties Household Losses Public Sector Losses Business Losses Loss Intensity Ratio 2.0 + 1.0 – 2.0 0.5 – 1.0 < 0.5 Source: FEMA Individuals and Households Program, Small Business Administration’s Disaster Loan Program, Uninsured Losses Declared by Iowa State income tax filers (2008), FEMA Public Assistance Program, FEMA Hazard Mitigation Program, U.S. Department of Transportation Repairs to transportation infrastructure per capita, Small Business Administration’s Disaster Loan program per capita, agriculture crop peril payments per square mile; Evaluating Direct and Indirect Economic Outcomes of the 2008 Iowa Weather-Related Disasters, Swanson et al., Iowa State University Staff Report, August 2010; Gallup-Healthways Well-Being Index Community Survey 2009, n=353,849 Weather Related Loss Estimates Housing and business structures Infrastructure Educational facilities Cultural and historic landmarks Agriculture and the environment Total estimated losses $1.33B 0.66 0.30 0.28 0.93 $3.50B
  • The Transformational Recovery (II) Well-Being at the Local Level 2008 2009 Metropolitan Statistical Area (MSA) Ranking by Well-Being Index and Composite Sub-Indices (out of 187 MSAs) Fourth Quintile Third Quintile Second Quintile Top Quintile Bottom Quintile Cedar Rapids Source: Gallup-Healthways Well-Being Index Community Survey 2009, n=353,849 Overall Rank 150 12 Life Evaluation 121 42 Emotional Health 170 1 Physical Health 64 5 Healthy Behavior 182 46 Work Environment 144 144 Basic Access 39 4 63.2 I learned or did something interesting yesterday 2009 66.5 I did not experience sadness yesterday 2009 Examples of Emotional Health Geographic Disparities Relative to National Composite Score for MSAs 66.5 80.2 Examples of Healthy Behavior Geographic Disparities Relative to National Composite Score for MSAs I ate healthy all day yesterday % who don’t smoke 2009 2009
  • The Transformational Recovery (II) Well-Being at the Local Level 2008 2009 etropolitan Statistical Area (MSA) Ranking by Well-Being Index and Composite Sub-Indices (out of 187 MSAs) Fourth Quintile Third Quintile Second Quintile Top Quintile Bottom Quintile Cedar Rapids Source: Gallup-Healthways Well-Being Index Community Survey 2009, n=353,849 Overall Rank 150 12 Life Evaluation 121 42 Emotional Health 170 1 Physical Health 64 5 Healthy Behavior 182 46 Work Environment 144 144 Basic Access 39 4 57.4 My supervisor treats me like he/she is my partner 2009 Examples of Work Environemnt Geographic Disparities Relative to National Composite Score for MSAs
  • The Transformational Recovery (III) Families Retained, Some Employment Losses but Well Managed Shares of Statewide Population Gains K-12 Public School Enrollment (Baselined to October 2005) 102% 101% 98% 96% 100% 2005 2006 2007 2008 2009 2007 2008 2009 +3% +2% +1% 0% -1% -2% -3% -4% Employment Changes 2007-2009 High Impact Counties Nonfarm Job Changes: Cedar Rapids vs. New Orleans Source: Evaluating Direct and Indirect Economic Outcomes of the 2008 Iowa Weather-Related Disasters, Swanson et al., Iowa State University Staff Report, August 2010
    • Evolution of the Science
  • Chronic Disease Productivity Impact: ~3x Health Care Cost Impact Chronic Disease Economic Impact in the U.S. 2003 (Annual Costs) Total Cost $1.3 Trillion Source: Milken Institute 2007 Treatment Expenditures 21% Lost Productivity Cost 79% $0.3 Trillion $1.0 Trillion
  • Science Linkages Confirming the Value Examples of Recent Publications on Risk Reduction 10 — 25% Risk Reduction $0.4T — $1.1T 10 Year Impact 10 — 50% Risk Reduction $0.6T — $1.4 T 10 Year Impact
  • Emerging Science (I) Well-Being Relationship to Medical Events 0-50 (n=109) >50-60 (n=151) >80-90 (n=683) >70-80 (n=582) >60-70 (n=347) >90-100 (n=363) Admission ER Visit Percent Well-Being Score (Composite) Low High Impact of Well-Being on Event Frequency -83% -49% Source: Wellmark Data, Healthways Center for Health Research Analysis (n=2,235) 0 5 10 15 20
  • Well-Being Relationship to Medical Costs 0-50 (n=109) >50-60 (n=151) >80-90 (n=683) >70-80 (n=582) >60-70 (n=347) >90-100 (n=363) Annual Costs ($) Well-Being Score (Composite) Low High Impact of Well-Being on Claims and Rx Costs Claims Rx Total Source: Wellmark Data, Healthways Center for Health Research Analysis (n=2,235) 0 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000
  • Emerging Science (II) Well-Being Relationship to Performance Productivity Loss by Emotional Health 10 9 8 7 6 5 4 3 2 1 0 Low High 0 5 10 15 20 25 30 35 40 Productivity Loss (%) Emotional Health Source: Effects on Well-Being of Healthways Effective LifeStyle Programs Phase II, Evers, KE, Prochaska, JO, Castle, P. & Prochaska, JM. 2010 (under review), n=4100
  • Well-Being Relationship to Performance Continued Productivity Loss by Physical Health 0 5 10 15 20 25 30 35 40 Productivity Loss (%) 10 9 8 7 6 5 4 3 2 1 0 Physical Health Low High Source: Effects on Well-Being of Healthways Effective LifeStyle Programs Phase II, Evers, KE, Prochaska, JO, Castle, P. & Prochaska, JM. 2010 (under review), n=4100
  • Emerging Science (III) Market Research About Well-Being
    • Mixture of family situations/living arrangements
    • Preliminary segmentation:
      • Influencer, Someday, Start/Stopper, Caretaker
    • Range of motivational levels
    • Two hours or more per week online
    Source: Healthways MeYou Health, Essential Research March 2010
  • They Were Asked . . . “What are Your Goals?” fitness nutrition job/career relationships big dreams emotional mental health life events hobby/skill development financial physical health time management weight loss school spiritual stress personal time environment goal for others quitting learning People reported a surprisingly complex tapestry of connected topics Source: Healthways MeYou Health, Essential Research March 2010
      • Physical
        • exercise, rest/sleep
        • “ staying young”
        • diet (self & others)
      • Emotional
        • relationships: work & home
        • socializing , having friends
        • helping others
        • dinner with family
    • Intellectual
      • going back to school
      • learning something new
      • dean’s list
      • travel, culture
    • Spiritual
      • “ thanking whoever is up there for this day,” faith
      • meditation
      • “ getting out of my head”
    Holistic Deeply held views surfaced, mapping to the Gallup-Healthways Well-Being Index: “ What Does Well-Being Mean to You?” Source: Healthways MeYou Health, Essential Research March 2010
  • Different Well-Being “Personas” Emerged Excuse Maker Me-Time Impoverished Idle Enabled Aware and Achieving Enlightened & Discovering External Validation Seeker Source: Healthways MeYou Health, Essential Research March 2010
    • Fresh, diverse content
    • New challenges, self-assigned goals (more rigorous)
    • Options to coach others
    • Social outlet
    • Guilt free
    • Valuable use of time
    • Provide benefits for dependants
    • Numbers, metrics
    • Standards for personal comparison
    • Reason for challenges
    • Challenges they don’t do already
    • Knowledge and inspiration
    • Not interested in points
    • Challenges must be fail-proof
    • Extrinsic motivation to return
    • Do with partner or group
    • Anonymity and privacy—to eliminate shame
    • Social groups based on same life situation
    • Light-hearted approach
    • Goals are “wants”
    • Fast results
    • Ability to have a personal coach or sponsor keep tabs on them
  • Putting Science into Practice (I) Healthways Behavioral Change Science
    • Social Networks
        • A social structure of “nodes” which are connected by one or more specific types of interdependency, such as friendship, kinship, common interest, knowledge, etc.
    Decision Making Behavioral Economics Emotional and Social Health Social Connectivity
    • Prochaska’s Transtheoretical Model
        • Rational decision-making through stages of change
        • Pro-Change Embedded in Healthways Core Products
    • Mindfulness and Neuro-plasticity
        • Paying attention in a particular way: on purpose, in the present moment, and non-judgmentally
        • The changing of neurons via new experiences
      • Dynamic Intermittent Reinforcement
        • Predictably irrational decision making in humans
        • Already in use for medication adherence
    HEALTHHONORS ® LifeMatters ® Gamification
    • Gaming theory
        • Fun vs. fulfillment
        • Explorer, achiever, socializer, competitor
  • Putting Science into Practice (II) Modeling Behavior-Condition Relationships A complex relationship between behavior – condition drives development and severity of health conditions To understand what will happen to a population, a Monte Carlo Simulation Model is employed Once a population is profiled, repeated random interactions weighted to epidemiologic probabilities are used to “age” a population five years Effects of behavior change initiatives can be assessed by adding in probabilities that a program will have an effect along with the probability of recidivism
  • Putting Science into Practice (III) Vitality Simulation App
    • Simplified version of the Simulation Model available for you today
    • Demonstrates application of the model to create awareness and facilitate action by business leaders
    • Allows high-level overview of the process
    Data inputs
    • Input basic demographics
    • Assess current health and risk status of population
    Project future cost trend
    • View projected 5-year medical and productivity cost trends
    • View the most costly contributing conditions
    Investigate interventions
    • Use as a planning tool by selecting various intervention configurations
    • View the potential impact on your cost trends
    1 2 3 Intellectual Property +
    • Implications and action steps you can take
  • Blue Zones Principles – Applying to an Employer Community Move Naturally Right Outlook - Purpose Now - Downshift Eat Wisely - 80% Rule - Plant Slant - Wine@5 Belong - Right Tribe - Community - Loved Ones First THE POWER 9
  • What Does it Mean to be a Healthways Blue Zone?
    • An employer community with high well-being . . . .
      • Has high engagement, energy and vigor where it all seems to work because leadership and employees share a bond of great purpose and
      • A work environment that promotes innovation and collaboration and
      • Becomes a “best place to work” which in turns generates deep seeded pride and drives overall economic and social progress and
      • Has measurably improved business performance and
      • Has gained national recognition and positive media because of its game changing commitment to the vitality of its people
  • Healthier People Cost Less and Perform Better Improve Well-Being Adopt or maintain healthy behaviors Mitigate health-related risks Optimize care for health conditions
    • Performance Increases
    • Productivity
    • Engagement
    • Absence
    • Work Impairment
    • Total Medical Cost Decreases
    • Hospitalizations
    • Event Rates
    • Disease Rates
    • Lifestyle Risks
    • Total Economic Value Increases
      • States
      • Communities
      • Employers
      • Individuals
    Eliminate / delay next new case of disease / condition Eliminate / reduce impact of the next new episode Enhanced well-being Economic Drivers
  • How Do You Make it Real in 12 — 24 Months? Improve Well-Being EXECUTION Improved Business Performance RESULTS Adopt Well-Being Principles, Power 9 CULTURE Leadership Policy Communi-cations Participation (Social Network) AUDIT & BLUEPRINT Environment
  • Recommended Approach Certification Implement Track Progress Outcomes Well-Being Productivity Business Performance Well-Being Assessment Vitality Coach and Compass Vitality Simulation Model Environmental Assessment Assessments Communications Leadership Environment and Policy Participation Blueprint
  • What’s in the Healthways Blue Zone Toolkit Well-Being Assessment: baseline & annual, individual & organization
    • Detailed blueprint focusing on communications, leadership, policies, physical site and participation
    • Creation of multi-year strategy to improve Well-Being
    • Identification of available resources, both Healthways provided and third party
    • Customized communication packages
    Blueprint Design
    • Implementation and ongoing support onsite
    • Well-being leadership and people manager training & tools
    • Progress tracking
    Implementation Support Certification
    • “ Healthways Blue Zone Under Construction” designation
    • Outcomes validation:
      • Well-Being
      • Productivity
      • Business performance
    • “ Healthways Blue Zone” certification and annual renewal
    • Healthways Blue Zone CEO round tables
    • Marketing Support
    Assessments and tools e.g., Vitality Simulation App to size opportunity and engage your leaders e.g., Vitality Compass and Coach Environmental Assessment: community & organization
  • What “You Can Do Right Now” Seven Steps to Improved Company Well-Being Assemble Back of the Envelope Data # Employees Gender % Male Female Age % 65+ 55-64 45-54 35-44 18-34 Employees’ Current State of Health Average Well Poor Employees Lifestyle Behaviors Average High Risk Low Risk Average Medical Costs Per Employee (estimate all-in for current year including Rx, Copays etc.) $ X 0.3 = Employee share Costs of Absenteeism Costs of Presenteeism $ Company cost $ Total costs PEPY Multiply total medical costs by 0.3 $ $ Multiply absenteeism costs by 7.7 X 7.7 = Assess your readiness to change 1 2 Pick 3 behaviors to target beyond current programs Physical Activity Diet Non-smoking Desirable alcohol use Standard of care compliance Stress management Sufficient sleep Health screenings 4 Write down the opportunity as sized by the simulation 5 $ $ Healthcare savings by 2015 $ Productivity savings by 2015 Total savings by 2015 Let off some steam with a game of Community Clash 6 http://www.meyouhealth.com/clash/ Improved performance through improved employee well-being is or will be a top five CEO agenda item for next fiscal year I personally plan to devote at least 15% of my time to this opportunity I am dissatisfied with my current set of initiatives and plans around health Improving the vitality of the communities in which my employees, customers and business partners work is aligned with my stated company goals , as well as being just the right thing to do I recognize the community levers we can pull in the 30 mile home radius around each of my locations http://wellness.weforum.org/ Simulate the cost of doing nothing 3 I can personally mobilize visible and committed leadership to this effort Investigate becoming a certified Healthways Blue Zone 7 http://healthwaysbluezones.com and share the results with a friend Source: Healthways Blue Zone Toolkit 2010; all rights reserved
  • Activating Your Community for Well-Being Ben Leedle, Chief Executive Officer, Healthways Inc.