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Heart and Mind Connections:
Integrated Strategies for
Greater HealthClient Summit Sessions
July 17, 18, 20
Teleconference phone:888-809-8974
Agenda
Connection Between Heart Disease and Mental Health: Joe Hullett
Northrop Grumman Newport News Wellness Initiative: Steven Apostoles
Pratt & Whitney Stress Management Seminar Program: Tracy Newmark, Amy Wilson
Discussion
Why Heart Disease?
Human cost: No 1. killer of Americans and a leading cause of disability
Financial costs: Key contributor to rising health care and disability expenditures and a prime cause of decreased productivity
The Costs of Heart Disease and Mental Health
Heart disease is often associated with a mental health diagnosis, which may not be properly diagnosed or may be undertreated.
There is a significant difference in medical health costs for individuals with coronary artery disease (CAD): • In one study, the costs to the employer for the physical health care
of CAD patients without co-morbid behavioral health diagnoses was $883 per member per month.
• These costs rose 54% to $1,358 per member per month for CAD patients with depression or anxiety.1
Individuals with CAD who were treated with selective antidepressants for six months were: • 91% more likely to experience a significant reduction in the cost of
hospital inpatient services • 72% more likely to experience a significant reduction in the cost of
office-based services in the treatment of their disease2
About Heart Disease and Mental Health
Depression, anxiety, hopelessness, pessimism, hostility and anger have all been linked to heart disease.3,4,5
Depression and anxiety disorders may affect heart rhythms, increase blood pressure, alter blood clotting, and lead to elevated insulin and cholesterol levels. These risk factors often predict, and are a response to, heart disease.6
People with heart disease are more likely to suffer from depression than otherwise healthy people; conversely, people with depression are at greater risk for developing heart disease.7
Those who have heart disease and who are depressed have an increased risk of death after a heart attack compared with those who are not depressed.8
Fighting Heart Disease: The Role of Behavioral Health Experts
Emotional, psychological and behavioral intervention and support is essential in helping to prevent or manage heart disease.
Behavioral experts can:• identify and manage behavioral health contributors that
can impact heart health, such as depression, anxiety and chronic stress
• support those who are living with heart disease• promote and help sustain a healthy lifestyle
Initiative Components
Client summit CD toolkit
• Costs of heart disease and mental health diagnoses• Information about the heart and mind connection• Organizational/program considerations• Communication tools
Staff information and training Affiliate information and training Behavioral Health Management article
Service Options Offered by ValueOptions
Standard:• 24/7 assessment and referral• Employee assistance program (EAP) • Stress reduction counseling• Depression screening• Intensive case management• Support for family and support systems• Primary care physician (PCP) behavioral health consultation• Educational programs
Enhanced services:• Lifestyle coaching• Tobacco cessation• Nurse line• Integrated care
Benefits of an Integrated Cardiovascular/Behavioral Health Program
Increased referral rate to the EAP and mental health/substance abuse program
Decreased overall health care and disability costs Enhanced productivity Reduced absenteeism Improved employee/member perception of
organization’s commitment to their health and well-being
Plan
All employees and dependents may participate (on their own time)
Participation is entirely voluntary and results are confidential
Four on-site wellness coordinators located throughout the yard
• Clinic, Buildings 901 & 600, SPF Shop• Focus on early detection, prevention and risk
reduction
Initiatives
Health risk appraisal (HRA) On-site screening/health fairs Flu shots Risk-reduction programs
• Heart health• Cancer/diabetes prevention• Weight management• Nutrition/exercise• Stress management• Work/life balance
Design
Based on the seven benchmarks of the Wellness Councils of America:
1. Capturing Senior Level Support
2. Creating Cohesive Teams
3. Collecting Data
4. Crafting an Operating Plan
5. Choosing Appropriate Interventions
6. Creating Supportive Environments
7. Carefully Evaluating Outcomes
Building Support
Sought senior level leadership commitment, including the Sector President, Senior VP of Programs and VP of Human Resources
Obtained buy-in from senior union officials Tailored approach to address concerns of
the various managers
Creating a Cohesive Team
Chose our team well Sought and received corporate support Chose vendor who is willing to engage Selected steering group committed to
oversight
“A committee is a cul de sac down which great ideas are lured and then quietly strangled.”
Collecting Data to Drive Initiative
Organizational Needs
Demographic information
Health risk appraisals Health screening data Medical claims Disability Absenteeism Ergonomics
Employee Interests
Focus groups Individual
interviews/simple surveys
Meetings
Operations Plan
Vision Goals Objectives Marketing Timeline Itemized budget Evaluation plan
Intervention Choices
Awareness Education Lifestyle modifications support Healthcare providers collaboration Incentives/disincentives Screenings Flu shots Ergonomics Job design/accommodation Return to work Workplace stress reduction
Creating Supportive Environments
Establishing multiple permanent yard sites that provide privacy
Including dependents Scheduling off-shift hours Roving health screens Engaging Food Services to provide healthy choices Aligning organizational, HR and health promotion
policies/practices Benefit plan design Coordinating with provider and community resources Balancing high touch with high tech
Consistently Measure Outcomes
Number of study years Number of subjects Number of separate interventions Percentage change in sick leave Percentage change in absenteeism Percentage change in medical costs Percentage change in workers compensation
costs
Concerns
Developing metrics to support ROI Loss of momentum both at the Sector and
Corporate Engagement by healthcare providers Duplicate programs provided by healthcare
providers (HRA) increase costs Integration with other benefit programs
Pratt & Whitney
Pratt & Whitney is a world leader in the design, manufacture and service of aircraft engines, industrial gas turbines and space propulsion systems.
40,000 employees worldwide, 20,000 domestic HealthTimeSM, the Employee Wellness Network is
managed by the Global Medical Department.• Contracts with Health Fitness Corporation (HFC)• HFC is a leader in corporate-based health improvement and has
successfully implemented employee health management strategies in numerous Fortune 100 corporations.
Vision, Strategy, Focus
To protect and enhance the health of Pratt & Whitney employees.• Identify and reduce preventable health risks through on-site
programs• Help employees understand and obtain quality health care• Promote a healthy culture
Focus:• Cardiovascular disease• Cancer• Mental health (promotion and increased utilization of available
EAP services)• Influenza (flu shot program)
ValueOptions EAP Synergy
P&W researched available resources to meet established wellness goals.• EAP contract hours
– On-site and off-site counseling services
– Seminars on various subjects
Requested a stress management seminar.• Participants would learn new ways to deal with
everyday stress, manage time and balance work/ family issues
• Communication tool for promoting EAP services
“Managing Stress for Life”• 18 seminars at domestic P&W facilities• September 2005 through January 2006• Accommodated time constraints and shift workers• One session videotaped
– DVD produced– Webcast uploaded to HealthTimeSM Web page on company
intranet
• Satisfaction surveys given to participants– 134 surveys returned (14 events)
– Data analysis completed
Stress Management Seminar
• 95% of participants ranked their satisfaction at a 5 or above (on a scale of 1-7)
Overall Satisfaction With the Stress Management Seminar
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1 2 3 4 5 6 7
Response (rated 1-7)
# of
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Participant Survey
• 93% of participants ranked the usefulness of the information at a 5 or above (on a scale of 1-7)
Usefulness of Information
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10
20
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70
1 2 3 4 5 6 7
Response (rated 1-7)
# of
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Usefulness of Information
• 88% of participants ranked the handouts and materials at a 5 or above (on a scale of 1-7)
Handouts and Materials
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5
10
15
20
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1 2 3 4 5 6 7
Response (rated 1-7)
# of
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Handouts and Other Materials
• 91% of participants reported that they increased their knowledge or improved their skills
Did the event/lecture increase your knowledge or improve your skills?
91%
9%
Yes
No
• 84% of participants reported that they will be making a behavior change
Learning, Knowledge, Behaviors
Stress Seminars at Pratt & Whitney
Health Risk Category
PotentialHealth Care
Cost Savings Per Employee Who
Reduces Their High Risk Status
Stress $1,179
High Blood Glucose$22,650
HFC Results Calculator
Potential Program Savings: Stress Seminars at Pratt & Whitney
“Well done, kept everyone’s interest and spurred many conversations after.”
“This seminar was highly informative and will certainly help with dealing with stressful situations in the future.”
“I feel that these resources should be communicated more often. Not just me, but many people don't know about this or are hesitant about utilizing (the) EAP.”
“Good introduction to stress, but I think more specific details on the very best ways of dealing with stress would be even more beneficial. Possibly real examples and back up ideas.”
Participant Comments
Communication tool for ValueOptions EAP services
EAP utilization increased 38% from 1Q 2005 to 4Q 2005
Used data analysis to determine need for continuation of annual seminars
UTC EH&S Health Promotion Outreach Award
Summary
Resources
American Heart Association: http://heart.org National Business Group on Health’s business
case for cardiovascular health: http://www.wbgh.org/pdfs/issuebrief_cphscardio.pdf
ValueOptions’ cardiovascular health initiative: http://valueoptions.com/spotlight_heart/html/pages/index.htm
Sources
1 ValueOptions/IHCIS Comorbidity Study, 20032 Group Health Incorporated, www.ghi.com3 Williams R.B. Neurobiology, cellular and molecular biology, and
psychosomatic medicine. Psychosom Med, 1994; 56:308-315. 4 Denollet J., Brutsaert D.L. Personality, disease severity, and the risk of
long-term cardiac events in patients with a decreased ejection fraction after myocardial infarction. Circulation. 1998; 97:167-173.
5 L.D. Kuzansky, K.W. Davidson, and A. Rozanski. The Clinical Impact of Negative Psychological States: Expanding the Spectrum of Risk for Coronary Artery Disease. Psychosom Med, May 1, 2005; 67(Supplement_1):S10-S14.
6 National Heart, Lung and Blood Institute 7 Nemeroff CB, Musselman DL, Evans DL. Depression and cardiac disease.
Depression and Anxiety, 1998; 8(Suppl 1): 71-9.8 Frasure-Smith N, Lesperance F, Talajic M. Depression and 18-month
prognosis after myocardial infarction. Circulation, 1995; 91(4): 999-1005.