Health Management Intro

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The business case for how wellness & disease management are merging into a solitary prevention model. Using this concept, Attentive Health helps companies manage risk in their organization through cost-effective & customized employee health programs.

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  • At Attentive Health, we work with employers of all sizes to integrate wellness into the busy lives of their employees and leadership teams.Why? Because it makes good business sense.Not because it’s a nice benefit to help people feel happier & and have a better quality of life – although it is.But more importantly: because it is the best & most controllable way to proactively manage labor costs – from healthcare & absenteeism, to productivity & morale.
  • For us, this is not just business – it’s personal. It’s something that has been lived & learned in the trenches.A few years ago, in the midst of a blossoming career in HR, I was going through a major health crisis – and ended up completely transformed.Not only losing about 30% of my body weight, but overcoming a host of chronic health conditions & going off of a long list of medications. To put it mildly: the experience changed my life.At that time, I had also had enough years experience managing healthcare plans, including self-insured plans, to realize what this could mean for businesses.The math was simple: one year I had cost my firm $26,000 and the next year I cost them $2,000. I also felt dramatically better.At the same time, in my role as an HR Manager, I was asked to scour the marketplace for a wellness program for a group of senior managers at the accounting firm where I worked. What I found was that the programs in the marketplace were either inadequate or overpriced, particularly for small and mid-sized businesses.Somewhere in there, it became a personal goal of mine to get involved in changing that. Eventually, I sought out additional education & certifications, and launched Attentive Health in 2007.Since then, we’ve grown quite a bit. We’ve been able to hire additional staff and partner with other businesses to bring Attentive Health’s programs to a growing number of individuals and companies.And at this point in my life, it’s gratifying both personally and professionally, to be part of the solution now, rather than part of the problem.
  • Let’s take a look at those problems…As you are no doubt aware, America is in a health care crisis. We have the most expensive health care system in the world, and the unhealthiest population.And, we spend a lot of time these days analyzing this problem: how we manage the care, how we pay for the care, who is in charge of the decisions when it comes to getting the care, how much it should cost, who should pay, etc.These are all serious problems, to be sure, but they are all downstream issues. If we follow the trail back upstream to the source of the problem, the fact of the matter is, it’s due to the fact that Americans are not very healthy. So if we want to solve this problem, we have to shift our focus.And we have to do that in more than one way. The good news is, our health care system is the best in the world at treating diseases and acute conditions once they arise. If you think about it, our doctors and hospitals can do amazing things once people are sick! The trouble is, we’re not very good at preventing people from getting there in the first place. There are many reasons for that, too, but things are beginning to change in this area. Everyone from the President to the insurance companies themselves are on board these days about not only helping sick people get well, but making a concerted effort toward preventive medicine.
  • But health care isn’t the only issue that businesses are facing when it comes to their labor costs: in fact, it may only be the tip of the proverbial iceburg.Absenteeism is a significant problem in just about any business – that’s why we have attendance policies… which become the source of many disciplinary actions and headaches for companies in general. Not to mention disability costs.Then there is presenteeism – that’s when people are at work, but they’re not really working. It’s estimated that the cost of presenteeism is 7.5 times the cost of absenteeism! And it’s really no wonder people don’t work while they’re at work, when they don’t feel well and they’re anxiety-ridden about their personal lives, etc.From there, it’s not hard to see how all these things start affecting productivity, and how those negative issues in the work environment start impacting things like recruiting, retention, and morale. Then there is Worker’s Comp, which for some businesses, including some I’ve worked for, is almost as much of a cost nightmare as health care. And as it turns out, this too is impacted by the overall health & wellness of the employee population.
  • However, as I mentioned earlier, there is a solution.When we understand that 70% of chronic illnesses are driven by behavior – not heredity – we start to realize just how controllable these costs really are. But it is not just about diet & exercise – it is also about the underlying psychological factors that make us do what we do.
  • So why should employers get involved?For one thing, we’re paying the bills.But also, when we acknowledge that many people spend more than ½ of their waking hours at work, we realize that the best chance of success in changing those behavior patterns starts in the workplace.The good news is, there is hard data to demonstrate the return-on-investment. And, with the results to prove it, more and more companies have been embracing workplace wellness, not only as a cost-cutting measure, but as simply the right thing to do.
  • But what do those wellness programs look like?For many years, everything from subsidized gym memberships to employee newsletters have been considered under the wide umbrella of “Wellness Programs”. Just how effective some of those measures have is not very clear.We’ve also had Disease Management programs that were focused on helping high-cost claimants improve their health. Those programs have worked very well, but they haven’t addressed the issue of preventive medicine.The goal of a total “Health Management Solution” is to address both sides of the equation – sick care, and well care.Another trend we see in health care is to address the whole individual. As we mentioned earlier, physical, mental & emotional well-being all have to be addressed in order to see sustainable results.It’s also important to find ways to help people integrate new behaviors into their everyday lives so that the changes are long-term – as opposed to a fad diet or other quick-fix that only complicates things down the road.But to achieve all of these things, we not only have to change the way individuals think, we also have to address the culture in the workplace. For example, we can’t put out big plates of donuts and sodas at our meetings while also having a workshop on Sugar Addiction. We have to walk the talk and embrace a culture of wellness throughout the organization.
  • A few recent examples of how this has been done for some of Attentive Health’s current clients:At a large dental practice, we implemented with a voluntary group health counseling program. About 25% of the staff enrolled and are affecting change throughout their culture from a grass-roots level. Some of the participants are addressing current health conditions while others enrolled in order to prevent health issues.At a small administrative office, we started the process by instituting a Wellness Committee. The next step was having their employees complete confidential Health Risk Assessments to raise their personal awareness. Following that, we implemented a basic education program which began with an inspirational kickoff meeting and a 6-week wellness challenge for the staff – this inspires camaraderie and gets the behavior change process started. Quarterly workshops and monthly newsletters introduce new information over time.We are also doing work with a division within the US Navy. The admiral of this division realizes the importance of wellness and has integrated our program into a larger organizational culture change initiative to help them become and Employer of Choice. But it all starts with the leadership team. Our first objective is to work with the admiral and his leadership staff to present the business case while also working with them as a team to implement healthy changes of their own… so that they will not only support, but also “walk the talk” as the program rolls out among the staff.
  • Because those projects are still in their first year or so of implementation, we don’t have statistics to demonstrate their specific ROI. However, there is plenty of compelling evidence from work that others have done in this area to demonstrate how a risk management approach to wellness pays off. Here’s one example from the American Journal of Health Promotion in which Health Risk Assessments were used to categorize employees into “Low” “Medium” and “High” risk groups, and the results of changes in those scores were correlated with productivity, absenteeism, and medical cost improvements.In another, similar study, researchers were able to demonstrate a $56 annual reduction in medical claims from a 1 percentage point reduction in an individual’s overall wellness score. That’s huge!It also goes to show why we think Health Risk Assessments and other baseline data collection is a critical part of the process when it comes to implementing a wellness program.
  • So what is our process exactly?We begin by assessing the workplace – both physically and culturally, to determine where and what kinds of change might be needed. We do an initial “Workplace Wellness Evaluation” at no cost. And, if an employer is interested, we can also conduct a baseline “Health Risk Assessment” to give you a clinical view at the same time. (there is a cost associated with the Health Risk Assessment)Also at no cost, we present our findings, along with a customized plan for your organization. Typically this is a phasing-in process; we don’t typically recommend a full wall-to-wall program in the first year. We find that it is better to let momentum, and engagement, build over time. Just as we do with individuals and integrating new behaviors over time, we also want to make sure that we integrate new wellness initiatives into the fabric of the organization over time. We’re not looking for flash-in-the-pan results, but long-term strategies. The next step, of course, is to determine which elements to implement when, and roll them out to the staff. On the next slide I’ll talk a little bit about what some of those items are, but before I do, I want to talk about what, to me as an HR executive, was the most important part of the program: and that is the results.People tend to think of insurance as a commodity, something you have to buy. But the truth is, the health of your employees is another area of risk to be managed, just like your facilities and professional liability. We take our role in this seriously, which is why each year we sit down with our clients and report on the results of the programs in place – to see whether they are effective, and addressing the areas of risk that your particular organization faces. Maybe in your population the issue is smoking, maybe it is obesity and diabetes, or maybe it is workplace stress and heart health. Either way, we consider it our job to help determine those areas of risk, and help you manage them.This is why we don’t just consider ourselves a Wellness Company, but we also we see our role as a Risk Manager. Leveraging professional HR experience as well as personal experience, to address the growing health concerns of your population.
  • These are some of the tools we use to do that.Health Risk Assessments & biometric screenings not only raise employee awareness, but also provide a clinical aspect to our assessment and ongoing risk management processes. Employees learn about their individual results in the strictest confidence, but the employer can see that information on an aggregate basis for the entire population and learn about the risks that are behind the health issues and claims the company is experiencing. Similar to finding out that slips trips and falls are the biggest drivers of your Workers Comp rate, you can find out if smoking, obesity, stress or other factors are impacting your medical and other labor costs.Health/Wellness committees are similar to safety committees and help give employees a leadership role in the initiative and provide grass roots support for changes that are rolled out.A wellness challenge helps get things kicked offWhile newsletters, workshops, and online health resources provide continuous education that employees can access whenever they are readyFor those who are interested in a more committed, long-term approach, we have individual or group health counseling programs. Participants usually engage in these programs for a 6-month period for more intensive support around making behavior change.As you learned earlier, sometimes these initiatives must start at the top, with the executive/leadership teams. It can take the form of individual counseling, or positioned as a leadership training initiative, depending on the culture.There are other things we can do as well, including ongoing fitness initiatives – this is where subsidized gym memberships or onsite classes fit in.Then there are incentive programs – which we try to use sparingly, so that that we rely less on extrinsic motivators, and more in intrinsic motivators. We would much rather have people eating well and taking good care of themselves because they feel good and they want to, than because they’re working toward a piece of merchandise which, once obtained, no longer motivates them.Depending on the organization, there are also other things we can do to enhance our holistic approach in the organization, by integrating our services with other existing benefit programs, such as EAPs, catering vendors, facilities maintenance, etc. so that everyone is on the same page to support a culture of wellness in the organization.And, last but not least, we go the extra mile when it comes to ROI reporting. We collect a lot of baseline data on things like absenteeism, productivity, and claims – and then make comparisons as time goes on to see if we are meeting our goals.
  • Health Management Intro

    1. 1. Health Management SolutionsIntroduction<br />
    2. 2. About Us<br />Our Missionis to provide long-term solutions aimed at transforming the health, vitality and quality of life for people and their corporate cultures.<br />The goal of Health Management is to <br />measurably reduce healthcare and absenteeism costs<br />while increasing morale and productivity, <br />so that the result is not just another employee benefit,<br />but a sensible, proactive <br />cost-containment <br />strategy.<br />
    3. 3. ABOUT US<br />Personal Inspiration<br />+ <br />Professional Experience<br />March 2006<br />
    4. 4. The Issues: Health Care<br />America is in a health care crisis<br />By 2018, $1 out of every $5 in the economy will be spent on health care<br />Upstream vs. downstream issues<br />Sick care vs. preventive medicine<br />
    5. 5. The Issues: Beyond Health Care<br /><ul><li>Absenteeism
    6. 6. Disability
    7. 7. “Presenteeism”
    8. 8. Productivity
    9. 9. Recruiting
    10. 10. Retention
    11. 11. Morale
    12. 12. Worker’s Comp</li></li></ul><li>The Solution: Wellness<br />+<br />+<br />70% of chronic illnesses are driven by behavior<br />Behavior is driven by psychological factors: how I feel, what I think<br />In most cases, even excess body weight is a symptom, not a cause<br />
    13. 13. The Solution: Workplace Wellness<br />Properly designed wellness programs yield an average $3 –to- $1 return in reduced health care costs<br />+<br />The average return-on-investment in lower absenteeism costs is approximately $5-to-$1 <br />
    14. 14. The Solution: Beyond Wellness<br /><ul><li>Health Management Solutions go beyond wellness programs to help organizations manage risk proactively
    15. 15. The goal is not only to help sick people get well, but also to keep people healthy and prevent them from migrating upward in risk as they age
    16. 16. Effective programs address the whole individual – physical, mental, and emotional well-being
    17. 17. Long-term behavior change relies heavily on integration
    18. 18. A shift in thinking is required to achieve results:</li></ul> both individually and as an organization/culture<br />March 2006<br />
    19. 19. Recent examples<br />50-employee dental practice & a group health counseling program<br />30-employee administrative office takes a different route with strategic services & basic education<br />Large government organization implements leadership training & more robust employee education<br />
    20. 20. Measurable results<br />After<br />Before<br />63%<br />Low Risk<br />53%<br />+10%<br />-5%<br />25%<br />Medium Risk<br />30%<br />12%<br />High Risk<br />17%<br />Mills et. al., American Journal of Health Promotion, September 2007; 22:45-53<br />-5%<br />Productivity +3.1%, Absences -2.2 days PEPY, Medical Cost -$229 PEPY<br />1 point improvement in Health Risk Assessment score = $56 PEPY annual reduction in medical claims<br />
    21. 21. Our Process<br />Assessment<br /> We conduct no-cost onsite Workplace Wellness Evaluation<br />Planning<br /> Based on our findings, we customize a plan for your organization<br />ImplementationProgram elements are finalized and rolled out to your employees<br />Report, Refine & Revise<br /> Each year, we monitor your areas of risk, report on results, and make any necessary adjustments to the program<br />
    22. 22. Our process<br />Tools We Use<br /><ul><li>Health Risk Assessments
    23. 23. Onsite biometric screening
    24. 24. Health/Wellness Committees
    25. 25. 6-Week Wellness Challenges
    26. 26. Newsletters
    27. 27. Online health resources
    28. 28. Workshops
    29. 29. Individual counseling
    30. 30. Group counseling programs
    31. 31. Executive/leadership programs
    32. 32. Ongoing fitness initiatives
    33. 33. Incentive programs
    34. 34. Provider/vendor integration
    35. 35. Robust ROI reporting</li>

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