Date post: | 19-Oct-2014 |
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CULTURE MAKES A DIFFERENCECreating a culture of well-being: A long term strategy for cost savings
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Lindsey Mangus – Health Promotion Specialist for the Carolinas of Cigna Health Services
Ben Buchanan – Product Manager, Corporate Health & Wellness of Carolinas Health System
Christie Dean – Wellness Coordinator of Mecklenburg County Government
Cheryl Walker – Health & Benefits Manager of the City of Asheville, NC
panelist
why does better health matter in the workplace?
__ Healthier workforce
__ Lower benefit costs
__ Better employee retention
__ Fewer sick days
__ Higher productivity
3Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna
• Fewer smokers
• Fewer heart attacks
• Employees who reverse their risk for metabolic syndrome
• Employees bringing BMI to a healthy range
• Employees having cardiovascular diseases and bringing their stress under control
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 4
$1,6231
$5,1762
$3,2003
$9521
$3931
Potential savings per individual health improvement
Organizations with highly effective Health and Well-Being programs.
1.Cigna Internal Analysis and Proof Points 2.Cardiovascular Even Average Monthly Cost: Milliman’s review of MedStat MarketScan TM Commercial Data 2004 Trended to 2006, Metabolic Syndrome and Employer Sponsored Benefits, An Actuarial Analysis, Milliman, March 2006. 3. Metabolic Syndrom and Employer Sponsored Benefits, An Actuarial Analysis, Milliman, March, 2006 4.2009/2010 North American Staying @ Work Report: The Health and Productivity Advantage. Towers Watson. Link: http//www.towerswatson.com/research/648
cost savings of healthier individuals
5Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
what is a culture of well-being?
It’s more than just encouraging physical wellness. It supports and fosters happier, healthier, moreproductive employees. Built into your overall businessgoals and a routine part of operations, it’s promotedat all levels of your company through programs,policies, benefits and the physical environment.
It motivates and inspires people to take action
to feel their best and perform their best
leading to lower total benefit costs.
culture influences engagement
6Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
1 2 3 4
Strong Leadership
TargetedSolutions
Proper Incentives
OngoingCommunication
Optimal Engagement
key components for a culture of well-being
7Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Help people “know their numbers” and understand their health status and
potential risks
Easy-to-understand resources to help individuals learn how to be well for life
Helpful programs aimed at preventing illness and disease
Highly engaging behavior-change programs thatencourage your employees to practice healthy habits for a lifetime
Motivational programs and challenges to inspire people to actively participate in their health
Expert guidance and consultation to support organizations and individuals throughout the process
HealthAwareness Education Prevention Lifestyle Activity Coaching
building a solution tailored to your organization
8Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
certain components drive higher engagement
key engagement influencers: 1
leadershipcommitment
2tailored programs
3long-termwellness strategy
4easy to access programs available to all employees
5incentives to motivate
9Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
set the tone walk the talk eye on the ball
make it clear you valueemployee health
Creating a culture of well-being is more than providing programs that promote health. It’s a
commitment to improvinghealth. And a plan to make it a
way of life.
engagement boosting best practices
recruit help communicate
model thebehavior
make healthimprovementa standardagenda item
develop a wellnesscommittee to shareideas, work onpromotions and help execute plans
make goals clear,address obstacles,celebrate success
10Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
bottom line •Identifying participants’ health status, is a key first step in motivating individuals to take the right actions to achieve meaningful and lasting healthy behavior changes.
Behavior Savings
Service manager quits smoking, starts walking and avoids stroke
$5,176/month1
Head of finance avoids chronic high blood pressure through exercise, nutrition and stress management
$1,116/year2
Ten people in sales department lose 25 lbs. each and bring weight into a healthy range
$5,760/year1
identify employee health risk
motivate and influence behavior
improved health lower cost
develop culture of well-being
Maintain strong culture of well-being
1. Cardiovascular Event Average Monthly Cost: Millman's review of MedStat MarketScan(TM) Commercial Data 2004 trended to 2006.
2. "An Unhealthy America: Economic Burden of Chronic Disease" - 2010 Hypertension direct/indirect costs PPPY. www.milkeninstitute.org
11Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
“It’s clear that the cost of
doing nothing is greater than
the cost of doing something.
The natural flow of risks is to high risk.
The natural flow of costs is to high cost.”
– Dee Edington, PhDFormer Director, Health Management Research Center, University of Michigan
Carolinas HealthCare System:“A Culture of Wellness”
Wellness…Historically
CHS LiveWELL – Guiding Principles
• Achieving optimal health and well-being…Through an integrated and customized care experience.– It is our goal to improve the total health and well-being of our
teammates so they can provide the best care to our patients– We are committed to providing a comprehensive and optimal
health experience to our teammates and their families, based on experience, research, analytics and communications
– We will use our integrated System resources to consistently deliver a high-quality health experience throughout our teammates’ life stages
1. To Create a Culture of Wellness you must choose your metrics accordingly.
Communication
2. To Create a Culture of Wellness you must use your data wisely.
• Data sources to leverage:– Health risk assessment data– Biometric data– Claims data
• Use the data to help you choose the most appropriate partners within your community for assistance.
Completing the 360º View
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Person
Personal Health Survey
Clinical BiometricsClaims
Consumer Data
Personal Health Survey captures health and lifestyle risks not readily available elsewhere
Biometric and Clinical Data identify the status of disease not just its presence
Consumer Data provides socio-geographic consumption trends
Claims supply a wealth of medical and cost data at the member level
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3. To Create a Culture of Wellness you must Meet your Employees Where they are.
• A one-size fits all strategy will not work for all three population segments.
• Each group has it’s own unique challenges, and will need its own resources to maintain or improve their health status.
• Focusing on high risk members only, will only return short term success.
High RiskHigh Risk
Rising RiskRising Risk
WellWell
“It is common sense to take a method and try it. If it fails, admit it frankly and try
another. But above all, try something.” -Franklin D. Roosevelt
• Leverage
• Executive Support
• Departmental Support
• Public Recognition
• Activities that are educational and engaging
Although, we don’t yet have the ROI from our newly created enterprise wellness program, we certainly have insight on what needs to happen first!
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2011Wellness Passport
myTotal Awards for Healthy Behavior
Wellness Passport
myTotal Awards for Healthy Behavior
Wellness Passport Activity Log
Wellness Passport Wellness Passport ProgramProgram Reward Based Wellness Program
Tracking Mechanism Activities and Points Address the Risk Behaviors
of Population
Wellness Kickoff◦ Vendor Fair◦ Biometric Screenings
10K Step Walking Program◦ 8 Weeks
Wellness Seminars◦ ICMA Webinar Sessions
Health Risk Assessment
De-stress and Relaxation Techniques
Flu Clinics
Wellness Boot Camp
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331 Total Participants
Blood PressureNormal 38%Pre Hypertension 55%Hypertension 7%
Note: 62% of the participants are at risk or abnormal.
Total CholesterolDesirable 65%Borderline High 26%High 9%
Did You Know?A 2001 University of Michigan study showed that for every employee who reduces their cholesterol levels from 240 to 190, employer’s save an average of $1,200 per year.
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Body Mass IndexBelow Recommended 1%Recommended 25%
Overweight 31%Obese 34%Extreme Obesity 10%
Note: 75% of County employee participants that were measured are in or above the Overweight
category.
331 Total Participants
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Waist CircumferenceDesirable 60%Abnormal 40%
Did You Know? Fat around the waistline is strongly associated with coronary heart disease, diabetes and colon cancer.
Recognized by the American Heart Association as a GOLD LEVEL recipient for fulfilling the following parameters:
Offer employees physical activity support
Provide/increase healthy eating options at the worksite
Promote a wellness culture
Implement at least 9 criteria as outlined by the AHA in the areas of physical activity, nutrition and culture.
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◦ Employees have had for years…
Access to Mecklenburg County’s 11 fitness centers with classes where employees may participate at a discounted price.
Mapped and Marked walking trails in a secure environment.
No Smoking Policy (Implemented in the 1990’s).
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Established -Internal Wellness Program, myTotalHealth, supported by a Wellness Team ; Wellness Ambassadors from different departments and divisions
Offered - Free tobacco cessation classes
Promoted a walking challenge, including pedometers, information on walking distributed through e-mails, County websites, with prize incentives
Showcased - Artwork in the stairwells that encourages employees to take the stairs rather than riding the elevator, with the County Manager leading by example
Sponsored - Numerous Healthy Cooking classes throughout various County locations
Provided - On-Site Biometric screenings as part of our “Know Your Numbers” campaign to educate and help employees with awareness
Support and commitment – From the County Manager, The Executive Team, Dept. Directors, Managers and Front Line Supervisors.
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“YOU can do a lot with healthy life style changes”
City of AshevilleCity of AshevilleEmployee Health & WellnessEmployee Health & Wellness
Cheryl Walker, SPHR
December 2013
Employee Health & Wellness
• The Asheville Project®City of Asheville, North Carolina• Overview
• On-site Medical Clinic• Overview• Coordination
• Wellness Program• Design & Implementation• Coordination• Next Steps
Asheville’s Workforce
1,100 Full Time Employees & 200 Retirees
Self-Insured Health Program 2,300 Covered Lives
The Asheville Project Disease Management Program®®
The Foundation Principles
• We want you to feel better;
• We care about your health;
• We will remove barriers to get you the treatment you need
(1997 Inception)(1997 Inception)
The Asheville Project®
Diabetes: 1997 106 participants
Asthma: 1998 51 participants
CV Health: 1999 229 participants
Depression: 2006 55 participants
Incentives
Removing the barriers to patient compliance:
Patient Education Ongoing counseling with Pharmacist Care Managers Disease-specific Lab tests Disease-specific medication and supplies
ALL ARE PAID AT 100%
The Asheville Project: 2013
Total participants: 340 15% of the covered lives on the city’s plan
Patients enrolled in 1
Program
Patients enrolled in 2+ (Co-morbidities)
Total Enrollment
Diabetes 17 93 110
Asthma 28 32 60
Cardiovascular 135 131 266
Depression 24 50 74
Use of Incentives• Modification of prescription drug formulary
• Remove brand-name medications with generic equivalents from copay waiver program
• Removal of copay waiver for participants if City not primary insurance (dependents or retirees with Medicare)
• Meeting with patients in on-site medical clinic to enroll in disease management program and help in maintaining compliance
• Tying participation & compliance to Asheville Balanced Choices
Wellness & On-site Medical Clinic
Wellness & On-site Medical Clinic
• Occupational Services: work-related injuries, vaccinations, drug testing, MRO, Hearing testing
• Personal minor illness, flu vaccinations, allergy shots, etc.
• Increase personal visits for employees• Increasing access
• Staff – PA, nurses and non-medical staff• Dependents may utilize clinic services
Asheville Balanced Choices Wellness
Phase 1: Designing our Wellness Program
Determining our goals – What you want to achieve determines the behavior you reward
• Design Wellness programs to reward healthy members (the other 85%) and achieve financial goals
• Coordination with On-site Health Clinic • Utilize all available data (medical claims, On-site Medical Clinic and
Health Risk Assessments) to:• identify members without annual wellness screenings• provide early warning diagnosis’
• Encourage compliance through financial incentives• $600 per year per adult drives behavior
• Continue to develop, track, and expand disease management
Asheville Balanced Choices Wellness Program
Phase 2: ImplementationPhase 2: Implementation• All or nothing approach 89% participation• To participate you must agree to:
• Complete Annual Health Risk Assessment (employee & spouse)• Annual health screenings• Be tobacco free or agree to participate in Tobacco Cessation
program• Participate in 4 additional Wellness Activities (web-based,
employer sponsored activities and preventive care) each year• Tobacco Cessation Program
• Combined group classes with medical supervised nicotine replacement aids and/or prescription drugs at $5.00 copay
• Accountability for 90 days following graduation and semi-annual updates
Asheville Balanced Choices Wellness Program Asheville Balanced Choices Wellness Program • Use Health Risk Assessments and Health Screenings to measure
current health of all adult participants.• Include verifiable biometric data • Use all future data to determine impact/effectiveness of Wellness
program offerings.• Gradually change mindset of Wellness program before
implementation of Outcomes-based program.
• Use Employee Clinic to follow-up on biometric screening concerns and identify participants for enrollment in disease management programs.
• Tobacco Cessation Programs -140 graduates• Current quit rate for members still actively employed 12 months
post graduation
58%
Next StepsThe Asheville Project®, On-site medical clinic, & Wellness Program
• Expanding Provider Collaboration using electronic medical record systems
• Weight Management Program
• Integration of The Asheville Project® & Wellness programs to ensure compliance
• Care Manager Report Cards
• Identification of participants not receiving recommended ‘wellness’ screenings or procedures (eye exams, flu shots, annual physicals, etc.) and offering services through on-site health clinic
• Determine high frequency services to add to employee health clinic that accomplishes cost savings for City and employees
• Designing Phase 3 of Wellness program to include outcomes-based requirements
• Partnerships with community to consider new or unique approaches to Wellness to accomplish Wellness objectives
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Lindsey Mangus – Health Promotion Specialist for the Carolinas of Cigna Health Services
Ben Buchanan – Product Manager, Corporate Health & Wellness of Carolinas Health System
Christie Dean – Wellness Coordinator of Mecklenburg County Government
Cheryl Walker – Health & Benefits Manager of the City of Asheville, NC