Workplace Wellness in FluxMaking Wellness Work

Workplace of the Future ConferenceNashville, Tennessee

October 14, 2015

Nico Pronk, Ph.D.

VP and Chief Science Officer

HealthPartners

Adj. Professor, Social and Behavioral Sciences

Harvard T.H. Chan School of Public Health

Agenda

•Workplace health program design mattersBest Practices Principles of Program Design

•Compliance matters•Perspectives on EEOC guidance for employers

What Works in Workplace Health?• Systematic reviews of the evidence

• Effectiveness reviews• Economic reviews

• Expert reviews and guidance documents• Best practices

• Intentional application of current knowledge• Evidence-based• Evidence-informed

Workplace Wellness Best Practices•What best practices are associated with highly

successful programs?• Review of literature• 44 Best Practices identified, e.g.

• Commitment to healthy culture• Adequate resourcing• Human-centered culture• Participatory practices• Program branding• Analysis and reporting• Wellness champion network

• Categorized into overarching principles of design

1. Leadership: Multi-level

2. Relevance: do choices matter for employees?

3. Partnership: integrate and work together

4. Comprehensiveness: multi-level, multi-component

5. Implementation: execution matters

6. Engagement: experience is key

7. Communications: ongoing and engaging

8. Data Driven: Best data available, CQI, evaluation

9. Compliance: Legal and ethical

9 Program Design Dimensions

• “Say”: 87% is committed to company purpose and values

• “Stay”: 89% intends and would like to stay at TURCK for a year or longer

• “Strive”: 93% gives “best effort” each day

• 69% reduction in behavioral health visits

• Sustained decreased workers’ compensation and FMLA claims since 2003

• Reduction in external medical visits; increase in onsite clinic and pharmacy use

• <1% turnover (compared to 13% industry average)

• LifeWorks@TURCK is associated with 7% to 8% income from operations

• Compared to health plan trend, $4.7 M averted (2008-2013)

Program Design Matters TURCK Case Study

Perspectives on Compliance• Lots of regulations to consider…

• ACA, HIPAA, GINA, ADA, Public Health Service Act, ERISA, OSHA, applicable State Law, Internal Revenue Code,…

• Equal Employment Opportunity Commission (EEOC) proposed guidance for employers who sponsor wellness programs• Guidance related to ADA and GINA• Proposed rule applies to wellness programs that include disability-related

inquiries or medical examinations (not such programs as education or general health information services/practices)

EEOC Proposed Rules• Programs must be voluntary• Incentives cannot exceed 30% of total cost of employee-only coverage• Employer is required to give notice related to medical information

protection and use• Programs must be “reasonably designed” to promote health or prevent

disease• Program must be non-discriminatory

“Reasonably Designed”• A health-contingent program complies if it:

1. Has a reasonable chance of improving the health of, or preventing disease in, participating individuals

2. Is not overly burdensome3. Is not a subterfuge for discrimination based on a health factor4. Is not highly suspect in the method chosen to promote or prevent disease

• Programs are not required to be accredited or based on specific evidence-based guidelines. However, it is encouraged to increase the likelihood for success by considering practices recommended by the CPSTF and USPSTF• Evidence-informed vs. evidence-based; leaving room for innovation

Questions Remain• Employers and employees should be well-informed about these rules

and ensure programs are in compliance• Furthermore, from an ethical perspective, transparency into data

practices, participatory practices, and the overall mission and vision of the program will go a long way in creating a culture of respect and trust• Without trust, a culture of health will be unattainable

“Change moves at the speed of trust”--Gary Gunderson

Wake Forest University Baptist Medical