This document outlines a proposal for improving wellness programs at Dartmouth College. It begins with an overview of Dartmouth College as an employer, noting that 50% of self-insured employees are aged 40 or older and that the largest drivers of healthcare spending are conditions like gastroenterology, endocrinology, behavioral health, cancer, cardiology, and orthopedics. The document then presents an implementation model for a wellness program involving commitment and establishment, design and execution, and tracking and modification. It also provides case studies of successful wellness programs at other large employers and identifies immediate opportunities at Dartmouth College, such as improving online health and wellness resources and reducing costs to access the fitness center. The document concludes by
CDC will provide an overview of their WorkLife Wellness Office services and describe how they used the HealthLead accreditation process to provide a framework to assess the comprehensiveness of their new office and existing programs and processes. Also, how the scoring of framework identified strengths and weaknesses and how the assessment plan of action is used for future strategic planning to drive new connections, data sources, and programmatic gaps as they strive to achieve HealthLead Silver. CDC will share specific examples of what was required and shared as part of the HealthLead audit during the presentation.
How to Administer Wellness Programs in Today's Regulatory Environmentbenefitexpress
Are you struggling to make sense of the recent legislative updates surrounding employer sponsored wellness programs? Perhaps you are trying to decide whether to continue with current wellness plans, modify your plans without guidance from the EEOC, postpone new wellness programs or discontinue them all together.
It’s a complicated landscape ripe with several options for “next steps” for employees and plan sponsors of wellness plans in 2019 — with perhaps the biggest barrier of all being that employers cannot measure the risk of wellness plans at this time.
To help guide you through this maze of options, watch our one-hour webinar on-demand to learn what rules remain after the EEOC’s regulations were found invalid and what rules have to be met in 2019 in order to offer a valid wellness program.
How to administer wellness programs in today's regulatory environment
This webinar covers:
Requirements under HIPAA
Requirements under the Internal Revenue Code
Requirements under ERISA
Requirements under GINA
Requirements under ADA
Requirements under ACA
CDC will provide an overview of their WorkLife Wellness Office services and describe how they used the HealthLead accreditation process to provide a framework to assess the comprehensiveness of their new office and existing programs and processes. Also, how the scoring of framework identified strengths and weaknesses and how the assessment plan of action is used for future strategic planning to drive new connections, data sources, and programmatic gaps as they strive to achieve HealthLead Silver. CDC will share specific examples of what was required and shared as part of the HealthLead audit during the presentation.
How to Administer Wellness Programs in Today's Regulatory Environmentbenefitexpress
Are you struggling to make sense of the recent legislative updates surrounding employer sponsored wellness programs? Perhaps you are trying to decide whether to continue with current wellness plans, modify your plans without guidance from the EEOC, postpone new wellness programs or discontinue them all together.
It’s a complicated landscape ripe with several options for “next steps” for employees and plan sponsors of wellness plans in 2019 — with perhaps the biggest barrier of all being that employers cannot measure the risk of wellness plans at this time.
To help guide you through this maze of options, watch our one-hour webinar on-demand to learn what rules remain after the EEOC’s regulations were found invalid and what rules have to be met in 2019 in order to offer a valid wellness program.
How to administer wellness programs in today's regulatory environment
This webinar covers:
Requirements under HIPAA
Requirements under the Internal Revenue Code
Requirements under ERISA
Requirements under GINA
Requirements under ADA
Requirements under ACA
Keeping Up to Date With Wellness Regulations 2015benefitexpress
Learn about the latest developments in wellness programs. A review of EOCC's legal action against wellness programs will be covered and steps to avoid legal action will be discussed.
Identifying the right leaders to build a cohesive senior team begins with defining and recruiting the right people. Coors works with clients in all facets of this process, and our proven search process combines a consultative approach with personalized service.
Chief Allied Health Professions Officer’s Conference 2016
Workshop 5: Population based service re-design – Chair Shelagh Morris
Embedding a health promotion strategy across MSK physiotherapy services in Salford. Gillian Rawlinson, MSK Advanced Practitioner and Senior Lecturer. Salford and UCLAN
Prioritisation in Public Health: Overview of Health Economics ApproachesOlena Nizalova
Overview of Health Economics Approaches Towards Prioritization based on the developments from the NIHR School of Public Health Research project led by Professor David Hunter.
Wellness programs are an effective method to maintain group health plan costs, motivate employees to take control of their health, while assisting employees lead happier, healthier and more productive lives. Employers seek solutions by offering incentives that are tangible, easily accessible and tailored to the employees work/life balance for voluntary participation.
Prior to the passage of the Affordable Care Act, navigating the legal landscape of wellness programs and incentives could be treacherous. However, the Affordable Care Act seemed to be a clear endorsement of standards-based wellness programs by the government. PPACA generated even more opportunities to get creative with these wellness programs, but it is important to understand the risks.
Chief Allied Health Professions Officer’s Conference 2016: Main stage present...NHS England
Chief Allied Health Professions Officer’s Conference 2016
Main stage presentations
AHP Innovation Delivering #FutureNHS. Suzanne Rastrick, Chief Allied Health Professions Officer (CAHPO), NHS England.
Reshaping the workforce. Daniel Mortimer, Chief Executive, NHS Employers.
Putting the 'We' into 'Wellbeing. Roz Davies MBA Managing Director of We Love Life and Recovery Enterprises.
Sharing, learning and connecting sectors through open innovation. Paul Taylor, Innovation Coach, Bromford Lab.
How AHPs will transform care: a mandate for change. Suzanne Rastrick, CAHPO, NHS England. Dr Peter Thomond, Managing Director of Clever Together. Dr Joanne Fillingham, Clinical Fellow to the CAHPO.
Delivering innovation to make clinicians ecstatically happy. Dr Neil Bacon CEO and Founder of iWantGreatCare.
This educational webinar, outlined the key legal requirements that need to be considered when implementing a corporate wellness program. We will discuss successful ways that companies have developed communication with their population, to not only get them engaged, but to get them fully on board.
The rules and regulations required by HIPAA, GINA, the ADEA and the ADA will be addressed, as well as the changes brought about by PPACA. This webinar will provide the knowledge and guidance needed by first time - and long time - managers of corporate wellness programs.
Continuous Workforce Development: The Next Rung on the Medical Assistant Care...nhanow
Communication among providers about a patient can be difficult without a central repository for patient data. Lack of information can lead to errors or omissions in treatment, resulting in readmissions to the hospital or long-term care facility. This presentation describes the types of patient information available through health information exchanges and show how increased access to patients’ clinical information fosters smoother transitions of care, especially in a post acute care setting.
The aim of this study was to investigate if a HWC program conducted by coaching trainees in a university/worksite setting would have a positive impact on participants’ health and well-being. Moreover, we wanted to evaluate the effects of HWC in wellness scores when face-to-face meetings and additional social-embedded support activities are offered to participants. HWC trainees in CtbW used several coaching strategies including coaching role definition, patient centeredness, visioning, participant self-determined goals through self-discovery, promotion of self-mastery and growth mindset, strengths support, accountability and ownership setting, intrinsic motivation, and supporting environmental and social activities.
Keeping Up to Date With Wellness Regulations 2015benefitexpress
Learn about the latest developments in wellness programs. A review of EOCC's legal action against wellness programs will be covered and steps to avoid legal action will be discussed.
Identifying the right leaders to build a cohesive senior team begins with defining and recruiting the right people. Coors works with clients in all facets of this process, and our proven search process combines a consultative approach with personalized service.
Chief Allied Health Professions Officer’s Conference 2016
Workshop 5: Population based service re-design – Chair Shelagh Morris
Embedding a health promotion strategy across MSK physiotherapy services in Salford. Gillian Rawlinson, MSK Advanced Practitioner and Senior Lecturer. Salford and UCLAN
Prioritisation in Public Health: Overview of Health Economics ApproachesOlena Nizalova
Overview of Health Economics Approaches Towards Prioritization based on the developments from the NIHR School of Public Health Research project led by Professor David Hunter.
Wellness programs are an effective method to maintain group health plan costs, motivate employees to take control of their health, while assisting employees lead happier, healthier and more productive lives. Employers seek solutions by offering incentives that are tangible, easily accessible and tailored to the employees work/life balance for voluntary participation.
Prior to the passage of the Affordable Care Act, navigating the legal landscape of wellness programs and incentives could be treacherous. However, the Affordable Care Act seemed to be a clear endorsement of standards-based wellness programs by the government. PPACA generated even more opportunities to get creative with these wellness programs, but it is important to understand the risks.
Chief Allied Health Professions Officer’s Conference 2016: Main stage present...NHS England
Chief Allied Health Professions Officer’s Conference 2016
Main stage presentations
AHP Innovation Delivering #FutureNHS. Suzanne Rastrick, Chief Allied Health Professions Officer (CAHPO), NHS England.
Reshaping the workforce. Daniel Mortimer, Chief Executive, NHS Employers.
Putting the 'We' into 'Wellbeing. Roz Davies MBA Managing Director of We Love Life and Recovery Enterprises.
Sharing, learning and connecting sectors through open innovation. Paul Taylor, Innovation Coach, Bromford Lab.
How AHPs will transform care: a mandate for change. Suzanne Rastrick, CAHPO, NHS England. Dr Peter Thomond, Managing Director of Clever Together. Dr Joanne Fillingham, Clinical Fellow to the CAHPO.
Delivering innovation to make clinicians ecstatically happy. Dr Neil Bacon CEO and Founder of iWantGreatCare.
This educational webinar, outlined the key legal requirements that need to be considered when implementing a corporate wellness program. We will discuss successful ways that companies have developed communication with their population, to not only get them engaged, but to get them fully on board.
The rules and regulations required by HIPAA, GINA, the ADEA and the ADA will be addressed, as well as the changes brought about by PPACA. This webinar will provide the knowledge and guidance needed by first time - and long time - managers of corporate wellness programs.
Continuous Workforce Development: The Next Rung on the Medical Assistant Care...nhanow
Communication among providers about a patient can be difficult without a central repository for patient data. Lack of information can lead to errors or omissions in treatment, resulting in readmissions to the hospital or long-term care facility. This presentation describes the types of patient information available through health information exchanges and show how increased access to patients’ clinical information fosters smoother transitions of care, especially in a post acute care setting.
The aim of this study was to investigate if a HWC program conducted by coaching trainees in a university/worksite setting would have a positive impact on participants’ health and well-being. Moreover, we wanted to evaluate the effects of HWC in wellness scores when face-to-face meetings and additional social-embedded support activities are offered to participants. HWC trainees in CtbW used several coaching strategies including coaching role definition, patient centeredness, visioning, participant self-determined goals through self-discovery, promotion of self-mastery and growth mindset, strengths support, accountability and ownership setting, intrinsic motivation, and supporting environmental and social activities.
Learn best practices for designing wellness incentives that drive and sustain desired behaviors, benchmarks on the type and amount of incentives provided by employers, legal requirements for compliant incentives under the ACA, GINA, and ADA, and examples of effective incentive designs and evolutions to continue to drive better health and outcomes.
The National Diabetes Prevention Program (National DPP) encourages collaboration among federal agencies, community-based organizations, employers, insurers, health care professionals, academia, and other stakeholders to prevent or delay the onset of type 2 diabetes among people with prediabetes in the United States.
Best Practice: Workplace Wellness that works, Transamerica Center of Health S...Aegon
Nine key steps for a successful workplace wellness program to help employees stay healthy and productive, while simultaneously reducing health care costs.
2. The MCC Team
• Chase Eldredge, D’11
• Boyd Lever, D’10
• Tom Perry, TDI’11
• Anuradha Ramanath, TDI’11
• Jeff Wang, T’11
2
3. Project Overview
• Dartmouth College aims to improve the
health of its employees, retirees, and
dependents
• The college is interested in exploring
innovative health and wellness programs,
and how comparable institutions
effectively implement these programs
• Improved health and wellness among
beneficiaries may result in reduced
healthcare expenditures
3
4. Agenda
• A profile of Dartmouth College
• An implementation model for wellness at
Dartmouth College
• Case Studies: Wellness at other larger
employers
• Immediate opportunities at Dartmouth
• A path forward
4
5. Dartmouth College is a large employer, with 50%
of self-insured employees 40 years of age or older
5
Self-Insured Employees
At a Glance
No. of
Subscribers
3,892
No. of
Members
8,251
Avg.
Contract
Size
2.1
Male 48%
Female 52%
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
65+60-6450-5940-4930-3918-297-170-6
DistributionofMembersbyAgeGroup
40-49
705
40-49
845
50-59
776
50-59
914
60-64
321
60-64
339
65+
131
65+
82
0 500 1,000 1,500 2,000 2,500
Male
Female
MemberComposition,ByGender,>=40YearsOld
Source: Anthem 2009 Report, p. 5
6. The largest drivers of healthcare spending at Dartmouth
are the usual suspects troubling many employers
• Spending on Gastroenterology, Endocrinology, Behavioral Health, Cancer,
Cardiology, and Orthopedics account for 50% of total healthcare claims
paid in 2009
6
Inpatient Outpatient Professional Rx Total
Gastroenterolog
y
$ 291,515 $ 1,078,451 $ 554,219 $ 242,236 $2,166,421
Endocrinology
252,624
471,800 529,469 934,839 2,188,732
Behavioral
181,577
463,607 1,298,740 871,295 2,815,219
Cancer
119,572
2,133,295 614,837 92,409 2,960,113
Cardiology
1,470,075
1,193,760 658,028 282,074 3,603,937
Orthopedics
735,832
2,841,003 2,104,620 315,168 5,996,623
Sub-Total $19,731,045
Total Claims
Paid
$39,464,188
% of Total 50.0%
Source: Anthem 2009 Report, p. 7-8
7. There has been a high concentration of spending on
a small cohort of employees
• In 2009, claims paid on 83 employees accounted for $8.9 million,
more than 20% of total claims paid
• The top three conditions presented by these employees are:
7
Source: Anthem 2009 Report, p. 29
Condition Number of
Claimants
Expenditure Expenditure /
Claimant
Cancer 16 $1,997,787 $124,862
Cardiology 15 $1,889,802 $126,987
Orthopedics 18 $1,289,266 $71,626
• Not all of these high-cost employees may be susceptible to
intervention by a wellness program; 8 of these 83 employees were
terminated by year-end
• But if each of these conditions can be reduced by one claimant, the
potential cost saving could exceed $300,000
8. For each of the major cost drivers, we know many of
the contributing factors and what to do in response
8
Common Ailments Contributing Factors Potential Mitigation
Gastroenterology
(5.5% of total claims)
IBD, ulcers, heartburn
Poor diet, smoking,
alcohol
Improved diet,
tobacco and alcohol
cessation
Endocrinology
(5.5% of total claims)
Diabetes,
hyperlipidemia, thyroid
disorder
Obesity, sedentary
lifestyle, poor diet,
smoking
Exercise, improved
diet, tobacco cessation
Behavioral
(7.1% of total claims)
Depression, bipolar
disorder, anxiety,
substance abuse
Job stress, family
stress, inactive
lifestyle, trauma
Stress management,
exercise, counseling
Cancer
(7.5% of total claims)
Breast, lung, colon-
rectal, prostate, etc.
Many, including genetic
Screening, disease
management
Cardiology
(9.1% of total claims)
Heart disease,
hypertension,
circulatory, irregular
Obesity, smoking, poor
diet, inactive
lifestyle, stress
Exercise, tobacco
cessation, improved
diet, stress
Orthopedics
(15.2% of total claims)
Arthritis, back pain,
joint injury, fractures
Obesity, inactive
lifestyle, worker safety
Improved diet,
exercise, safety training
Source: Anthem 2009 Report, p. 23-28
9. What is necessary today is a strategy for
implementing a wellness program at Dartmouth
• A wellness program at Dartmouth College will
likely need to include the following:
– Exercise
– Tobacco cessation
– Improved diet
– Stress management
• In order to successfully implement a wellness
program, Dartmouth will need to have a clear way
forward that involves all constituents of the
College
• Our team has focused on creating an
implementation framework, as well as developing
action items that can be executed on immediately
9
10. Agenda
• A profile of Dartmouth College
• An implementation model for wellness at
Dartmouth College
• Case Studies: Wellness at other larger
employers
• Immediate opportunities at Dartmouth
• A path forward
10
11. EMPLOYEES
WELLNESS
LEADERSHIP
Commitment &
Establishment
• What do I need to
do to create
institutional buy-
in?
• What do I need to
succeed in
establishing a
wellness
program?
• How do I prepare
myself for
engaging with a
wellness
program?
Design &
Execution
• What role do I
play in
administering a
wellness program
across my
institution?
• How do I execute
an effective
wellness
program?
• How do I best
participate in my
wellness
benefits?
Tracking &
Modification
• How do I
continuously
manage a
wellness
program?
• How do I improve
the wellness
program over
time?
• How do I
continue to
improve my
health over time?
DARTMOUTH
COLLEGE
ADMINISTRATION
Implementing a wellness program must involve all
constituencies of the Dartmouth College community over time
12. EMPLOYEES
WELLNESS
LEADERSHIP
Commitment & Establishment
• - Understand the financial and cultural value of
employee health
• - Commit capital to employee wellness
• - Establish a culture of wellness as part of my
institutional’s identity
• - Wellness needs to be a significant portion of the scope
of my work
• - Assess the available wellness resources
• - Have access to decision-makers
• - Increase my self-awareness of my health and wellness
• - Tie wellness to what’s important to me (e.g., wealth,
life satisfaction)
• - Prioritize health and wellness more highly in making
lifestyle decisions
DARTMOUTH
COLLEGE
ADMINISTRATION
The Commitment and Establishment phase creates the
conditions that make a wellness program successful
13. EMPLOYEES
WELLNESS
LEADERSHIP
Design and Execution
• - Establish reporting structures for wellness
• - Set expenditure budgets for wellness
• - Adopt incentive structures for wellness
• - Create systems of accountability for wellness
• - Analyze wellness opportunities and challenges within the
population
• - Establish robust channels of communication with
constituents
• - Proactively engage employees and their health status
• - Promote participation in wellness using approved
incentive structures
• - Explore my benefits and wellness opportunities
• - Make rational health decisions based on incentives and
opportunities
• - Develop “health-based” relationships with colleagues
• - Bring healthy-living back home to my family members
DARTMOUTH
COLLEGE
ADMINISTRATION
The Design and Execution phase involves the day-to-day
activities and choices that result in improved wellness
14. EMPLOYEES
WELLNESS
LEADERSHIP
Tracking and Modification
• - Integrate employee health status as part of financial
reporting
• - Assess benefits provisions based on wellness outcomes
• - Include wellness results as part of employee development
• - Reinvest savings to further wellness promotion
• - Make periodic health assessments
• - Respond to employee feedback
• - Continue to innovate based on employee needs and
responses
• - Raise the bar to the next level
• - Provide feedback to wellness leadership and
administration
• - Self-assess my successes and failures
• - Enjoy my better health, and have more fun
• - Set new goals
DARTMOUTH
COLLEGE
ADMINISTRATION
The Tracking and Modification phase provides mechanisms
to continuously assess and improve the wellness program
15. Agenda
• A profile of Dartmouth College
• An implementation model for wellness at
Dartmouth College
• Case Studies: Wellness at other larger
employers
• Immediately opportunities at Dartmouth
• A path forward
15
16. Success Stories with Fitness
• MetLife:
– Challenge: Improving cardiovascular health
– Expended $550,000 per year on fitness center for employee access
– Saved $1.38 million per year by improving cardiovascular risk
profiles of 2,100 members in its fitness centers
• Aetna:
– Aetna measures ROI for its wellness programs using medical claims
data and productivity studies
– 2004 study of fitness center usage under the Healthy Lifestyles
program indicated:
• Lower combined medical and pharmacy costs for fitness-
center users
• Annualized savings of $340 per member per year for fitness
center users
• Comparison of participating members to non-participants
indicated an ROI of 3.4:1
16
Source: Business Roundtable. Doing Well through Wellness: 2006-2007 , p. 47-48
17. • General Motors
- Challenge: Educating a diverse employee
population on health and wellness
- Utilizes lifestyle-based wellness
education
- Example: Deer Hunting Module
- Proper deer lifting routines
- Nutritious venison recipes
- Each program provides:
- Topic information
- Skill building and group support
- Tracking of individual behaviors
and outcomes
• FedEx Express
- Challenge: Diabetes management
- Provides simple $50 cash-reward for
diabetes patients that comply to
regular screening (e.g., retinopathy
screening)
- Participation increased from 55% to
100%
- Diabetes-related ER visits dropped
13%
- Cost-per-episode for diabetes
patients dropped 75%
Source: Business Roundtable. Doing Well through Wellness: 2006-2007 , p. 13-16
Other Success Stories
18. Agenda
• A profile of Dartmouth College
• An implementation model for wellness at
Dartmouth College
• Case Studies: Wellness at other larger
employers
• Immediately opportunities at Dartmouth
• A path forward
18
19. What Dartmouth has today
19
Dartmouth Brown Cornell Yale Harvard Columbia Princeton U. Penn.
EAP ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦
Fitness ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦
Nutrition ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦
Stress Mgt ♦ ♦ ♦ ♦ ♦ ♦ ♦
Smoking
Cessation
♦ ♦ ♦ ♦ ♦ ♦ ♦
HRA ♦ ♦ ♦ ♦ ♦
Gym Cost $297-480 Free $175 $300 $184 $295 $212 $460
Source: Analysis performed by Carl Pratt
• A first glance, Dartmouth College seems to be competitive with the
other Ivy League institutions in providing wellness benefits to its
employees
• However, further study indicates that there are many opportunities
to improve Dartmouth’s wellness offerings
20. Improving Dartmouth’s Web Content
On Health and Wellness
• Example 1: Finding employee health information on website
– Click, scroll, click from Dartmouth.edu
• Example 2: Faculty/Employee Assistance Program
– Does not communicate well to employees seeking assistance
with stress management and other mental health needs
• Improving the website would prioritize
– Easy access to wellness content (1-click)
– Motivating employee participation
– Keeping employees informed on their wellness benefits
– Receiving employee feedback regarding their wellness needs
21. Improving Employee Access to Dartmouth’s
Fitness Center
Disadvantages to current offerings
• Gym membership cost is still second-highest
compared to other Ivy-League schools
- Cost at Dartmouth - $433
- Average of other Ivies - $232
- Brown’s fitness center is free for employees
• Employees have to pay a higher price than
students to access exercise and stress
management programs
• No programs designed specifically for employees
What employees can access today
• On-site fitness center available
• $349 membership discount from street prices
• For fee, 19 exercise programs and 6 stress
management programs are available
• Members who exercise 12 out of 20 weeks receive
$200 discount off of health premiums
22. Agenda
• A profile of Dartmouth College
• An implementation model for wellness at
Dartmouth College
• Case Studies: Wellness at other larger
employers
• Immediately opportunities at Dartmouth
• Next steps
22
23. Next Steps
• Start on the immediate-run items:
– Website
– Gym access
• Begin the implementation process:
– Commitment and Establishment:
• Dartmouth Administration
• Create a wellness leadership team
• Begin to engage employees on their health status
23