Oregon Public Employee Benefits BoardHERO Scorecard ResultsAugust 2019
Theresa Cross, MS RDNWellness Manager, OHA, Pubic Employees’ Benefit Board
Kay Zimmerli, CWPMSenior Workforce Health Consultant, Kaiser Permanente
In collaboration with: Steven Noeldner, Ph.D., M.S.Senior Consultant, Total Health Manager, Mercer
AGENDA
PEBB Wellness & HEM program evolution HERO Scorecard – Purpose & Insights What drives health behavior PEBB HERO Survey Results Trendline PEBB HERO Scorecard – Recommendations Culture of Health Priorities & Next Steps
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UnhealthyBehaviors
HealthRisks
ChronicDisease
HealthCare
Costs
PEBB Wellness Programming Evolution PEBB continues to be at the forefront of maximizing health for its 41,000 employees through its patient-centered philosophy. PEBB's health
engagement strategy addresses key medical challenges: weight–management, tobacco use, and chronic conditions/metabolic risk factors. Assessments and engagement. Starting first with employees, the program has expanded and evolved over time. Covered family members
may now access resources and support (e.g., WW, tobacco cessation, diabetes prevention). Analyzing results via a custom employee survey report along with medical records data compiled by Kaiser Permanente, and claims data
prepared by Mercer, the state initially showed improvements in BP, cholesterol and weight loss, compared to baseline and Oregon general population data. Recent trends have seen fluctuating results and adjustments due to changes in testing methods.
Timeline– 2012: Health Engagement Model (HEM) launched. Composed of a health assessment – including measuring waist circumference
and participating in two health actions. Participants were also expected to work with their medical providers to address their individual risk factors. Those who elected not to participate, or did not fulfill the requirements, paid a monthly premium contribution surcharge. 71% HEM participation rate the first year. (Completed baseline HERO Assessment v3)
– 2013: HEM requirements modified; removed reporting requirement for health actions, added a more sophisticated medical plan design and a contribution discount (reward) for participation. (Completed HERO Assessment v3)
– 2014: PEBB added supports to address depression, alcohol and substance abuse, and added an exercise and gym reimbursement to sustain healthy behavior change.
– 2015: Governor’s Executive Order on State Agency Employee Wellness drafted.– 2016: HEM program Spousal/Significant Other participation sunsets due to changes in GINA guidelines. – 2017: Governor’s Executive Order signed, developing a pathway to create supportive workplace structures, policies, and system for
accountability and evaluation. State Wellness Manager appointed. Wellness Coordinating Council formed.– 2018: Agencies complete their first, two-year wellness strategic plans. HEM participation reaches 81%.– 2019: New Employee Wellness Survey launches, an evolution from a phone survey to a census recruitment of all state agency
employees (18,886 respondents, analysis underway). (Completed HERO Assessment v4.1)
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The HERO Health & Well-being Best Practices Scorecard in Collaboration with Mercer©
Health Enhancement Research Organization (HERO): is a national non-profit that conducts high-quality workforce health research, focusing on the impact of workforce health on healthcare costs.
The HERO vision is to promote a culture of health and performance through employer leadership.
The Purpose of the Scorecard is to: checklist of health and well-being best practices
benchmarking against other organizations
evidence-based assessment of health management strategies
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DRIVERS OF HEALTH
What affects employee health
Environmental and social
factors
Medical care
Family history and genetics
Personal behaviors
What drives behavior change
Awareness and education Motivation
Skills and tools
Strategic workplace supportPolicy and environment
20%
30%
10%
40%
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Source: McGinnis et al, Health Affairs, 2002
Comparative Data/Section
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0 5 10 15 20 25 30 35
Measurement & Evaluation
Participation Strategies
Program Integration
Programs
Organizational & Cultural Support
Strategic Planning
National Average Large Employers > 5,000 Government OR PEBB
HERO ASSESSMENT version 4.1
SectionNationalAverage
Large Employers
>5000 EEGovt.
PEBB(Q2-2019)
1. Strategic Planning 10 12 9 92. Organizational & Cultural Support 23 24 22 203. Programs 21 27 21 294. Program Integration 5 6 5 55. Participation Strategies 22 28 20 336. Measurement & Evaluation 9 11 8 14Total Score 90 108 85 110
Benchmark report averages, Q2-2019 results
Points
Chart1
Measurement & EvaluationMeasurement & EvaluationMeasurement & EvaluationMeasurement & Evaluation
Participation StrategiesParticipation StrategiesParticipation StrategiesParticipation Strategies
Program IntegrationProgram IntegrationProgram IntegrationProgram Integration
ProgramsProgramsProgramsPrograms
Organizational & Cultural SupportOrganizational & Cultural SupportOrganizational & Cultural SupportOrganizational & Cultural Support
Strategic PlanningStrategic PlanningStrategic PlanningStrategic Planning
OR PEBB
Government
Large Employers > 5,000
National Average
14
8
11
9
33
20
28
22
5
5
6
5
29
21
27
21
20
22
24
23
9
9
12
10
Sheet1
HERO ASSESSMENT version 3
SectionPEBB 2013PEBB 2012National 13National 12Max Points% max
1. Strategic Planning751163.6%
2. Leadership Engagement15173345.5%
3. Program Level Mgmt17112277.3%
4. Programs40285671.4%
5. Engagement Methods43286764.2%
6. Measurement & Evaluation851172.7%
Total Score1309420065.0%
HERO ASSESSMENT version 4.1
SectionPEBB 2019National 2019Max Points% max
1. Strategic Planning9102045.0%
2. Organizational & Cultural Support20235040.0%
3. Programs29214072.5%
4. Program Integration551631.3%
5. Participation Strategies33225066.0%
6. Measurement & Evaluation1492458.3%
Total Score1109020055.0%
Version 3 vs Version 4; How it changed: Broadened the “Leadership Support” section (renamed “Organizational Support”). New questions on incentives and intrinsic reward strategies New questions on engagement strategies, mobile apps and devices, challenges, and socialnetworking strategies Updated questions on program design, including more detailed questions on lifestyle coaching New questions on program integration, including disability programs Expanded “Outcomes” section
Sheet2
OR PEBBNational Average
Strategic Planning910
Organizational & Cultural Support2023
Programs2921
Program Integration55
Participation Strategies3322
Measurement & Evaluation149
Measurement & Evaluation149
Participation Strategies3322
Program Integration55
Programs2921
Organizational & Cultural Support2023
Strategic Planning910
Sheet3
National AverageGovernmentLarge Employers > 5,000OR PEBB
Measurement & Evaluation981114
Participation Strategies22202833
Program Integration5565
Programs21212729
Organizational & Cultural Support23222420
Strategic Planning109129
Sheet3
OR PEBB
Government
Large Employers > 5,000
Sheet4
OR PEBB
Government
Large Employers > 5,000
National Average
National Average
Government
Large Employers > 5,000
OR PEBB
Section 1: Strategic Planning0.45
Section 2: Organizational & Cultural Support0.4
Section 3: Programs0.725
Section 4: Program Integration0.3125
Section 5: Participation Strategies0.66
Section 6: Measurement & Evaluation0.58
HERO SCORECARD SURVEY RESULTS & RECOMMENDATIONS
Oregon Public Employee Benefit Board
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Stoplight guides
keep
it up
build
on th
is
need
s atte
ntion
RecommendationsKey Focus Areas
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keep
it up
Programs
Participation Strategies
build
on th
isMeasurement & Evaluation
Strategic Planning
need
s atte
ntion
Organizational & Cultural Support
Program Integration
Legend >60% 45-60%
Keep it Up – 72.5%Programs: assesses specific health management programs offered through a health plan or specialty vendor, or via internal resources.
Continue Doing:– Lifestyle management and behavior change support programs
e.g. weight management, physical activity, social connections, financial, stress, mental and emotional health
– Strengthen awareness and program promotions emphasis on well-being
Consider Developing:– Create Biometric Know Your Numbers (screening awareness) campaign.– Promote social connections
e.g. organized volunteer activities, peer challenges/support
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Keep
it u
p
Keep it Up – 66%Participation Strategies: strategies aimed at encouraging members to participate and to become more engaged in their well-being.
Continue Doing:– Evaluating/evolving HEM program– Maintain reward/surcharge strategies
Consider Developing:– Branding wellness-related communications– Targeted communications & action plans
board, union leaders, agency business managers, wellness champions talking points for mid level managers and front line staff
– Increase frequency of employee communications templated communications for agencies
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Keep
it u
p
Build on This – 58.3%Measurement & Evaluation: methods for assessing PEBB’s health and well-being programs.
Continue Doing:– Monitoring physical health risk data– Monitoring healthcare utilization & cost data– Tracking program participation data
Consider Developing:– Share results. Include performance data, goals, and progress
i.e. PEBB board, PMAC, PEBB covered entities, business reps or stewards– Develop reporting dashboard
Increase reporting frequency Expand access to reports (e.g. Wellness Council, Entities, Employees)
– Evaluate opportunities to include spouses
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Build
on
this
Build on This – 45%Strategic Planning: process of defining strategy or direction, and making decisions on allocating resources.
Continue Doing:– Using HERO Scorecard results for strategic planning.– Using medical & pharmacy data (disability data when available).
Consider Developing:– Create formal PEBB strategic plan for your health and well-being program.
Involve key stakeholders (planning and execution) Include measurable objectives (short and long term) Develop tactical roadmap
– Leverage PEBB annual survey/feedback– Connect agency-level organizational goals – Integrate employee retention & absentee data (DAS dashboard?).
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Build
on
this
Needs Attention – 40%Organizational & Cultural Support: create a culture of health, including leadership support. “Culture” = key values, assumptions, understandings, and norms.
Continue Doing:– Expand employee wellness champions and ambassadors access to resources– Acknowledge & share best practices
Consider Developing :– Strengthen leadership support and participation
training opportunities Institute policies and practices
– Strengthen built environment resources & processes Stress and emotional health Built environment Worksite food options Integrate physical activity breaks
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Need
s at
tent
ion
Needs Attention – 31.3%
Program Integration: the degree to which PEBB’s health and well-being programs are integrated with each other.
Continue Doing:– Including safety & injury-prevention elements – Evaluating carrier and vendor hand off policies
(e.g. Diabetes Sustainable Relationships for Community Health/SRCH project initiated).
Consider Developing :– Explore health outcomes and chronic conditions processes (apply SRCH model?)– Referral process flows and tracking – Integrate safety and disability data to better align & integrate programs – Aspirational:
Create a consolidated wellness portal/platform
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Need
s at
tent
ion
“Daring leaders work to make sure people can be themselves and feel a sense of belonging.”
Brené Brown, PhD MSWAuthor of Dare to Lead and Daring Greatly
Creating a Culture of HealthPriority Action Steps for PEBB
Wellness: what’s on the horizon?
– Diabetes Prevention (SRCH project)
– Takeaways from HERO Assessment
– 2020 HEM renewal– Employee Wellness Survey– PMAC well-being
explorations
Oregon Public Employee Benefits Board�HERO Scorecard Results�August 2019AGENDAPEBB Wellness Programming EvolutionThe HERO Health & Well-being Best Practices Scorecard in Collaboration with Mercer©Slide Number 5Comparative Data/SectionHERO SCORECARD SURVEY �RESULTS & recommendationsRecommendations�Key Focus AreasKeep it Up – 72.5%�Programs: assesses specific health management programs offered through a health plan or specialty vendor, or via internal resources.�Keep it Up – 66%�Participation Strategies: strategies aimed at encouraging members to participate and to become more engaged in their well-being.�Build on This – 58.3%�Measurement & Evaluation: methods for assessing PEBB’s health and well-being programs.�Build on This – 45%�Strategic Planning: process of defining strategy or direction, and making decisions on allocating resources.Needs Attention – 40%�Organizational & Cultural Support: create a culture of health, including leadership support. “Culture” = key values, assumptions, understandings, and norms.�Needs Attention – 31.3%��Program Integration: the degree to which PEBB’s health and well-being programs are integrated with each other.Creating a Culture of Health�Priority Action Steps for PEBB