Organizational Support and Engagement for a Healthier Workforce
CULTURE OF HEALTH
TABLE OF CONTENTS
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| Introduction
| Defining a Culture of Health
| The Business Case for Creating a Culture of Health
| Assess Your Culture
| Examining Regional Health Risk Factors
| Develop a Strategy
| Leadership Roles
| Evaluate Your Organization: 1 or 2 Stars, or 4 Stars?
| Evolving to a 4-Star Organization
| Key Implementation Steps
| Avoid Potential Pitfalls and Barriers to Engagement
| Further Reading
| Contributors
2CULTURE OF HEALTH
INTRODUCTION
Individuals need a supportive culture in order to be successful—at work, at home or in their community.
While 80 percent of individuals tried to make a major lifestyle change last year, only 10 percent to 20 per-
cent were even partially successful.
As a business leader, you have an opportunity to establish health as a key organizational value, and to cre-
ate a culture of health—a workplace culture that promotes good health for everyone, while boosting your
bottom line. Within a culture of health, employees will find it easier to make healthy choices. New health
behaviors will more likely be sustained for a lifetime. Program results will be magnified.
Beacon Health Options can help your company achieve and sustain a culture of health.We will build on your current strengths, helping you develop a shared wellness vision that promotes health
and productivity. We will generate greater participation and lasting behavioral change. We will focus on
keeping healthy people healthy, while supporting those who are working to improve their health. Review
this document to learn more about the value and core components of a culture of health.
• We will build on your current strengths, helping you develop a shared wellness vision that promotes
health and productivity.
• We will build on your current strengths, helping you develop a shared wellness vision that promotes
health and productivity.
3CULTURE OF HEALTH
DEFINING A CULTURE OF HEALTH (COH)
The word “culture” originated from the farming concept of cultivation.
True to its origin, a culture of health refers to the complex web of
social influences that nurture individuals to achieve complete physical,
mental and social well-being. Cultures of health…
• OPERATE AT BOTH CONSCIOUS AND UNCONSCIOUS LEVELS,
from concrete procedures (such as no-smoking policies) to
subtle influences (such as peer group attitudes about exercising
during lunch).
• ARE MULTIDIMENSIONAL. They include a broad array of social
influences, including norms, peer support and shared values, as
well as organizational policies, procedures and programs.
• OFFER RELIABLE, CONSISTENT GUIDANCE that embraces
healthy lifestyles, preventive medicine and effective disease
management. Cultures of health are not heavy handed; they
embrace personal expression and differences.
• NURTURE INDIVIDUAL INITIATIVE by encouraging achievement
and maintenance of personal health goals. Cultures of health
present the healthy choice as the easier choice.
• ADAPT TO THE CHANGING DEMANDS OF THE ENVIRONMENT.
For example, in a healthy work culture, lifestyles do not suffer
as a result of new technology or changing job responsibilities.
Subcultures evolve that reflect the special needs and preferences
of groups, while organizations maintain the capacity to change
those aspects of the culture that do not support health.
• HAVE SOCIAL ATMOSPHERES THAT BRING PEOPLE TOGETHER.
The cultural climate includes a strong sense of community,
shared vision and positive outlook. The cultural climate
engenders mutual respect and stimulates teamwork, creativity,
innovation and enthusiasm.
4CULTURE OF HEALTH
THE BUSINESS CASE FOR CREATING A COH
While a culture of health (COH) offers many and often immeasurable benefits, business executives want to
know its potential impact on the bottom line.
Health promotion programs work; a culture of health magnifies results.The business case for a culture of health rests on the economic value of health behavior. More than 25
years of research has documented that health promotion programs have lowered medical, hospital,
disability, workers’ compensation and drug costs. Health promotion programs have increased productivity,
recruitment, retention and employee morale. Robust programs regularly achieve a substantial return on
investment—often $3 in savings for every $1 spent.
Because of the high costs of medical care and labor, healthy and productive employees provide an
important competitive advantage. The University of Michigan’s Health Research Center has tracked the
cost spread between high lifestyle risk and low lifestyle risk in more than 1 million employees. Although
absolute medical care and productivity costs of poor health increase as an employee ages, the gap
between low- and high-risk employees exceeds $3,000 per year throughout adulthood. (The average cost
of an employee with 0-2 lifestyle risk factors was determined to be $2,199 and employees with 5 or more
risks were found to cost $5,520 on average.)
The vast majority of businesses have invested in employee health promotion: Their executives recognize
that the cost of doing nothing about unhealthy lifestyles puts their business at an unsustainable
competitive disadvantage.
While the economic benefits of traditional health promotion programs are substantial, such benefits dramatically increase within the supportive environment that a culture of health provides.
5CULTURE OF HEALTH
A COH DELIVERS UNIQUE HEALTH AND ECONOMIC VALUE. HERE’S HOW:
INCREASES LIFESTYLE CHANGE SUCCESS. Each year, the majority of employees (more than 80 percent)
attempt to achieve healthier lifestyles. Typical health resolutions include managing chronic disease, losing
weight, being more physically active and managing stress. Unfortunately, without the support of a COH,
few employees (less than 20 percent) succeed in achieving their lifestyle improvement goals. Unsupportive
environments overwhelm health resolutions, undermine self-esteem, lower wellness expectations and add
to employee stress—making lifestyle change unsustainable. Increasing healthy lifestyle success is a primary
mechanism for increasing the ROI of health promotion programming.
REDUCES THE LIKELIHOOD THAT EMPLOYEES WILL ADD RISKS TO THEIR HEALTH PROFILE. It is difficult
to stay fit, eat right and manage stress when the culture supports inactivity, a poor diet and inadequate sleep.
The obesity epidemic is one example of this negative cultural trend. A COH supports positive practices and
makes it easier to acquire and maintain lifestyle strengths. Keeping low-risk employees from entering into
higher-risk profiles provides a unique and powerful influence on ROI, and a strong incentive for adopting the
COH approach.
PROVIDES GREATER REACH WITHIN THE EMPLOYEE POPULATION. Traditional health promotion activities
require the active engagement of individual employees. Unfortunately, many employees do not participate
in such programs. COH is an environmental approach. Like breathing clean air or drinking clean water,
employees benefit by being in the environment, even if they haven’t signed up for a wellness program.
ENHANCES THE POWER OF WELLNESS PROGRAMMING. Traditional health enhancement programs benefit
participants only as long as they are engaged in the program. A supportive culture extends the benefit
beyond this active engagement period. This would be the case, for example, when completing the annual
health risk appraisal and setting health improvement goals based on its results becomes a strong cultural
norm. Individual initiative and skills—the primary focus of traditional programs—are enhanced by COH
environmental support.
MORE THAN ECONOMICS
It is tempting to fixate on the economic value of the COH approach. Unlike many other human resource
endeavors, it is possible to measure the economic return.
However, most business leaders know intuitively that a COH will result in a better business. They know
how hard it is to work while ill. They know from their own experience how difficult it is to achieve a healthy
lifestyle when physical and social environments undermine good intentions.
Business leaders recognize that employee health is essential to business success, and that fostering a COH
is among their primary leadership responsibilities.
REFERENCES :
Aldana, SG. (2001) Financial Impact of Health Promotion Programs: A Comprehensive Review of the Literature. American Journal of Health Promotion, 15(5):296-320.
Edington, Dee W. (2001) Emerging Research: A View From One Research Center. American Journal of Health Promotion. 15(5):341-349.
CDC Weight of the Nation Press Briefing (unedited), July 27, 2009, http://www.cdc.gov/media/transcripts/2009/t090727.htm
Pellmar TC, Brandt EN, Baird MA. (2002) Health and Behavior: The Interplay of Biological, Behavioral, and Social Influences: Summary of the Institute of Medicine Report. The American Journal of Health Promotion. 16:206-219.
Allen, J. Building Supportive Cultural Environments. Health Promotion in the Workplace, O’Donnell MP, editor, Third Edition. Delmar Publishers Inc., 2001, pages 202-217.
6CULTURE OF HEALTH
ASSESS YOUR ORGANIZATION’S HEALTH AND WELLNESS CULTURE
Are your employees healthy enough to show up for work and ready to
be productive, and not drive up your health care spending?
Would your employees thrive in a culture of wellness and healthy
lifestyle support if you provided one for them?
Can your corporate culture embrace change to save money on its
health care spending?
This survey will offer insight into the extent to which your current
workplace culture supports healthy lifestyles.
Cultural analysis makes it possible to understand and change the culture. Such analysis reveals both cultural strengths and opportunities for improvement.
You can then reinforce cultural strengths to provide a foundation
for further progress. Where gaps emerge between the existing
and desired culture, you can design strategies that are likely to
take root in the culture.
7CULTURE OF HEALTH
SCORE CULTURE OF HEALTH CHARACTERISTIC
Support for employee health is a top organizational priority.
Senior management has articulated a vision for achieving a culture of health, and
delegated responsibilities for carrying that vision forward.
Middle managers understand and communicate how employee health and
wellness are important to the organization’s success.
Organizational policies and procedures (such as no-smoking policies and work
schedules) support employee health.
Work teams are given aggregate feedback on health promotion participation and
progress toward achieving healthy lifestyles.
Traditions and celebrations reflect a commitment to supporting healthy lifestyles.
Work friendships and teams tend to form around healthy activities.
It is common for co-workers to support and encourage each other in achieving their
health goals.
The physical work environment (such as the presence of healthy foods and bike
racks) makes the healthy choice the easiest choice.
A great social climate at work (a strong sense of community, shared vision and positive
outlook) makes it easy for employees to participate in health improvement efforts together.
Now, determine your average score overall on the 15 questions above.
Our organization supports employees in their efforts to create healthy home
environments. We do this, for example, by allowing family members to participate in
wellness activities.
Because a culture of health does not thrive in a vacuum, our organization supports
and promotes community health promotion resources, such as those provided by
health care organizations, insurance providers, fitness clubs, local parks department,
and other community groups.
Employees are rewarded and recognized for achieving healthy lifestyles.
The use of time, company facilities, money and other resources demonstrates our
organization’s commitment to employee health.
Cultural norms for healthy practices are so firmly established that employees would
be unlikely to take up new health risks, such as overeating and physical inactivity,
without push-back from their peers.
4 agree 2 disagree 1 strongly disagree
0 not applicable or don’t know
3 neither agree nor disagree
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strongly agree
RATE YOUR LEVEL OF AGREEMENT
The following statements describe ways cultures of health support employee health and well-being. Rate
your level of agreement with each statement using the following scale:
8CULTURE OF HEALTH
SCORES OF 4-5
Your high average score indicates that you already have important culture of health strengths.
Congratulations! You are breaking the unhealthy trends in the broader culture. Your company is likely to
benefit from lower illness cost and increased job performance. Your employees are likely to achieve their
health improvement goals.
Beacon Health Options can assist you in conducting an in-depth cultural analysis, tailored to your
organization’s unique work environment and history and using quantitative and qualitative input from a
cross section of employees.
SCORES OF 3 OR BELOW
Unfortunately, your low average score indicates that your organization has yet to establish a culture of
health. You are likely to experience one or more of the following adverse consequences:
• Low-risk employees could easily add to their health risks by becoming physically inactive, stressed
and overweight.
• You are unable to take effective countermeasures to address health crises, such as a flu pandemic or
skyrocketing health care costs.
• Employees try to achieve lifestyle goals, but most can only achieve temporary or partial change.
• Health and wellness initiatives experience low participation
(less than 50 percent).
• Employees must receive incentives (beyond their wages) to complete personal health assessments.
• Some managers show their lack of enthusiasm for efforts to promote employee health.
• You lack wellness champions and many employees question the value and appropriateness of health
promotion.
• The impact of health promotion efforts is so small that only tiny reductions (less than 10 percent) in
employee risk are achieved.
Know that you are not alone in your low score. Many organizations, even those with long-standing wellness
programs, have yet to establish strong cultures of health. If your organization hopes to be successful in
achieving a healthy and productive workforce, it will need to address unsupportive features of its current
cultural environments. This is particularly true because goals for lasting change are rarely achieved without
supportive cultural environments.
At Beacon Health Options, we have seen that it is possible to systematically create a culture of health. We
have developed a systematic approach and culture of health resources that will empower you to create the
health-enhancing cultural environments you want and need.
9CULTURE OF HEALTH
EXAMINING REGIONAL HEALTH RISK FACTORS
CULTURAL NORMS IMPACT YOUR WORKSITES
Health behaviors and risks vary widely by locality. What are the top risks in the areas where your
employees live and work? Key health issues from the nation’s largest population health survey* include:
• average days with not enough sleep or rest
• percentage who currently smoke
• percentage with limited activity due to health issues
• percentage who are overweight or obese
• percentage who don’t usually get emotional support
For example, if you have a work location in:
Pennsylvania: The average working-age person does not get enough sleep or rest on 12.9 days each month.
Texas: Sixty-six percent of the working-age population is overweight or obese.
Washington: Twenty-two percent of the working-age population has limited activity due to health issues.
A close look at these regional health risk factors suggests key areas of focus for worksite health promotion efforts
since this is the larger community within which your employees operate. The cultural norms that are impacting the
larger community are affecting them, so the workplace community can offer a positive counter-balance.
* Unlike other risk factor survey results you may have seen, our map shows results only for insured
populations of working age.
10CULTURE OF HEALTH
AVERAGE DAYS WITH NOT SLEEP OR REST
WASHINGTONTEXAS
Lack of Sleep:
Currently Smoke:
Limited Activity:
Overweight or Obese:
Lack of Emotional Support:
12.7 Days
17%
18%
66%
18%
12 Days
15%
22%
63%
15%
Lack of Sleep:
Currently Smoke:
Limited Activity:
Overweight or Obese:
Lack of Emotional Support:
Low Med High
DEVELOP A STRATEGY
As a business leader, you have an opportunity to establish health as a key organizational value, and to
create a culture of health—a workplace culture that promotes good health for everyone, while boosting
your bottom line.
A culture of health refers to the complex web of social influences that nurture individuals to achieve
complete physical, mental and social well-being. It combines individual initiative with environmental
support. With a culture of health, you will realize greater program participation and lasting behavioral
change. The culture will help keep healthy people healthy, while supporting those who are working to
improve their health.
Because each organization has its own culture (enterprise wide, regionally, and locally) with custom
programs and individual strengths, each organization’s path to a culture of health will be unique.
Yet, a systematic approach guided by behavioral health experts can guide the process.
It begins with a thorough assessment of current perceptions, efforts and strengths, continues through
envisioning and alignment of cultural touch points, and cycles through to evaluation measures, in order to
refine and renew the program.
Throughout this process, every level of the organization must be engaged, on a sustained basis.
MANAGING A PROGRAM VS. A STRATEGY Are you managing a wellness program or implementing a strategy for developing a healthy corporate
culture? Is it the same thing? No, it’s not the same! “Wellness” is not only about “programs,” but is more
about an all-encompassing strategic approach—through a comprehensive alignment of organizational
processes and protocols—to supporting sustainable behavior change related to health risks for target
segments of a population.
Assess whether you are planning for or managing a program or a strategy:
MANAGING A PROGRAM
Our program is a continuum of benefits provided to employees and their families.
We have a plan to deploy scarce resources in order to achieve specific desired outcomes.
We are NOT measuring current performance on all appropriate metrics. For example, we focus on programmatic ROI rather than dividends to the enterprise.
We are measuring most or all appropriate metrics with focus on total dividends for the enterprise.
We are NOT aware of current performance vs. “world class.”
We benchmark current performance vs. “world class.”
We have NOT set organizational goals for improvement on all appropriate metrics.
We have set organizational goals for improvement (as part of the strategy development process).
We focus on corporate office solutions only. For exam-ple, we have one standard program that is available to all business locations regardless of the population needs.
We have a mix of corporate and local solutions, where the business locations have the opportunity to develop and deploy program modules.
MANAGING A STRATEGY
11CULTURE OF HEALTH
BEACON HEALTH OPTIONS CAN HELP
Building on your current strengths, Beacon Health Options can help you develop a shared vision that
promotes health and productivity across the organization, at each location and for each individual. Beacon
Health Options has expertise in changing behavior, at the individual, supervisory and organizational level.
We are engagement experts. We will continue to work with you until the vision becomes incorporated on a
sustained basis within the organization.
We’ve helped employees create a vision for life, we’ve helped supervisors create a vision for the team, and
we’ve helped organizations envision a culture of health.
Beacon Health Options offers expert consultation to your organization’s leaders on creating, supporting
and implementing a culture of health to accomplish objectives on any of 4 major dimensions:
1. Strategy development
2. Team-building
3. Action-planning and program design
4. Resource mobilization and deployment
While every consultation is unique, key steps in the process might include:
Conduct an initial site visit for conversations and review of available data to determine strategic priorities
and appropriate scope of initial diagnostic work.
Conduct an opportunity assessment to determine status on business metrics and the key drivers of
those business metrics. We would identify the characteristics of the organization and its people that
are influencing current health and productivity status, and identify the opportunities or challenges they
represent for performance improvement.
Define scenarios for your organization’s scope and pace of change in pulling the levers available for health
and productivity performance improvement, and then facilitate making a choice among the scenarios for
your path toward creating a culture of health.
Define Beacon Health Options role in serving your organization on its journey along one or more of the
following dimensions:
• advisors to senior leadership team
• advisors to functional managers
• organization team-builders and skill-builders for health and productivity management
• business partner in developing and implementing a health and productivity strategy
• a source of on-site health counselors and program delivery
We have the comprehensive set of competencies, sensitivities and experience required to work with your
organization to mobilize leadership, organizational resources and volunteer spirit to make improving health
and productivity a part of everyone’s job—building new senses of responsibility, new skills and great pride
from organizational and personal accomplishments throughout the company and the community.
The culture of your organization is critical to your business success. By creating a culture of health, your
organization can have a positive influence on the lives of your employees. In the process, you can influence
the culture of your organization in meaningful ways to support your other business goals and initiatives.
12CULTURE OF HEALTH
LEADERSHIP ROLES
Executives, managers, committee leaders and grassroots leaders play important roles in shaping a culture
of health. Leadership development is an essential culture of health strategy.
CORE LEADERSHIP RESPONSIBILITIES
There are 4 primary responsibilities for all leaders:
1. Sharing the culture of health vision. Leaders explain the initiative, how to participate and why
it is important. Leaders need to be able to tell these basics in a way that inspires participation
and lets employees know that this effort is an organizational priority.
2. Serving as effective role models. Leaders develop strategies for walking the talk. This
includes sharing about personal lifestyle strengths and informing others about personal lifestyle
improvement goals. Leaders participate in core health activities, such as completing personal
health assessments and working with a health coach. Minimally, leaders look for ways to lower the
visibility of unhealthy practices. For example, it is not helpful to brag about working long hours.
3. Aligning cultural touch points. Cultural touch points are formal and informal mechanisms for
establishing and maintaining behavior. Rewards, training, traditions, communication systems and
the commitment of time and space are examples of such touch points. Most organizations have
policies, procedures and programs that influence health behavior. Smoking policies are among
the most obvious examples. Equally powerful are the unwritten and informal activities that
influence behavior. The coffee break is an example of such an informal activity. Leaders work with
employees to align such day-to-day influences so that they support positive health practices.
4. Monitoring and celebrating healthy choices. Leaders keep track of progress and acknowledge
individuals’ efforts. Leaders can see progress as it happens. Their familiarity with employees
makes it possible to choose rewards that are most meaningful. One employee, for example,
might enjoy public acknowledgment while another would prefer a quiet celebration. Healthy
practices generate their own intrinsic rewards associated with health, energy and personal
performance. Leaders call attention to these intrinsic rewards, and also see to it that employees
get all the praise, compensation and other extrinsic rewards available. They may, for example,
see to it that employees also see the savings associated with lower medical costs.
SENIOR MANAGEMENT LEADERSHIP RESPONSIBILITIES
In addition to core culture of health leadership responsibilities, senior management is responsible for
connecting employee health to business priorities. Senior management sets the vision and assigns
responsibility for carrying out the culture of health initiative.
MIDDLE MANAGEMENT LEADERSHIP RESPONSIBILITIES
Managers and supervisors are familiar with day-to-day operations and serve as gatekeepers. They play large
roles in determining, for example, whether employees can participate in health initiatives. Their familiarity
with operations and conditions on the ground are important assets in fostering a culture of health.
13CULTURE OF HEALTH
COMMITTEE AND TASK FORCE LEADERSHIP
RESPONSIBILITIES
A committee or task force is often responsible for the development
and oversight of health initiatives. Such groups make it possible to
get input from a cross-section of organizational members. In larger
organizations, steering committees make it possible for different
human resource specialists to coordinate their efforts.
GRASSROOTS LEADERSHIP RESPONSIBILITIES
Every employee has a leadership role in nurturing a culture of health.
Grassroots leaders engage in self-leadership. Employees manage
their health through preventive medicine, healthy lifestyles and disease
management. Finding and creating supportive environments for
personal health goals is an essential self-leadership skill.
Grassroots leaders bring health home. A supportive household
environment is essential to employee health. Dependents living at home
have important roles to play in controlling medical costs. Employees
can lead efforts to create cultures of health within their households.
Grassroots leaders support their peers. Helping others to achieve
health goals is a powerful leadership strategy. Such assistance can be
one way or mutual support. Employees can also serve as peer support
leaders by organizing teams and support groups. There are a number
of benefits to those offering support:
• raises their own self-esteem
• deepens one’s understanding of how difficult health goals such
as losing weight are achieved
• increases the number of friends engaged in healthy behavior
Grassroots leaders form effective health partnerships with the
broader community. Employees at all levels can support community
health initiatives,
14CULTURE OF HEALTH
EVALUATE YOUR ORGANIZATION: 1 OR 2 STARS, OR 4 STARS?
You are getting started in developing a healthy culture in your company, and you likely have some ideas
for initial steps to take. Before moving forward, it’s important to understand where the journey should
ultimately lead for your organization to get the most out of its culture of health.
We have illustrated some of the critical steps, as part of an evolutionary path toward fully embedding
health into your corporate culture, starting as a 1- or 2-star organization with minimum investment and
returns to achieving a 3- or 4-star status with maximum investment and returns.
How does your organization compare with the 4-star organization?
ELEMENT OF HEALTH AND PRODUCTIVITY MANAGEMENT
STRATEGY DEVELOPMENT Manage a “program” (a
continuum of benefits
provided to employees and
their families)
Not measuring current
performance on all
appropriate metrics
Not aware of current
performance vs. “world class”
Have not set organizational
goals for improvement on all
appropriate metrics
Focused on corporate-office
solutions only
Manage a “strategy” (a plan
to deploy resources in order
to achieve specific desired
outcomes)
Measuring most or all
appropriate metrics
Benchmarking current
performance vs. “world class”
Have set organizational goals
for improvement (as part
of strategy development
process)
Have mix of corporate and
local solutions
CHARACTERISTICS OF 1-STAR OR 2-STAR ORGANIZATION
CHARACTERISTICS OF 3-STAR OR 4-STAR ORGANIZATION
15CULTURE OF HEALTH
ELEMENT OF HEALTH AND PRODUCTIVITY MANAGEMENT
TEAM BUILDING
ACTION PLANNING
RESOURCE MOBILIZATION
HR “owns” health and
productivity and has
subcontracted some
responsibility to vendors
Conflicting agenda among
silos in organization for
addressing specific issues and
opportunities
Leadership is not engaged
Singular approach
programmatically for all
population segments
Singular approach to program
promotion and distribution
Work site is not a “point
of sale” for health and
productivity
Have not engaged “spark
plugs” within the organization
Have not partnered with
vendors to engage beyond
the level of a standard vendor
relationship offering off-the-
shelf services
Have not mobilized the not-
for-profits and retailers in the
communities
Have not mobilized health
care delivery systems and
physicians to lead consumer
behavior change process
Share ownership across
organization for health and
productivity
Cross-functional teams work with
a single agenda on specific issues
and opportunities
Leadership is engaged and
serving as catalysts and role
models
Segmented approach
programmatically—based on
various demographic factors
and health status of population
(for example, work sites)
Segmented approach to
program promotion and
distribution based on
segments’ needs
Work site is a “point of sale” for
health and productivity
Have engaged “spark plugs”
Have strategically partnered
and collaborated with vendors
to create value-added program
components and interventions
Have mobilized not-for-profits
and retailers
Have mobilized health
care delivery systems and
physicians to lead consumer
behavior change process
CHARACTERISTICS OF 1-STAR OR 2-STAR ORGANIZATION
CHARACTERISTICS OF 3-STAR OR 4-STAR ORGANIZATION
16CULTURE OF HEALTH
EVOLVING TO A 4-STAR ORGANIZATION
Take a look at how your program might evolve as you work toward
becoming a 4-star organization in the following scenarios.
Keep in mind not all of the steps are appropriate for every organization:
1. Expanding available program offerings beyond the basic “wellness”
program. Specific program module evolutions include:
• health coaching: from telephonic coaching to on-site coaching
• healthy food service
2. Leader, manager and supervisor engagement and personal leadership
3. Evolution of measurement and accountability processes
4. Transitioning from managing a program to managing a strategy
5. Aligning consumer incentives with desired behaviors in 3 areas:
• health risk and condition management
• network utilization
• benefits plan utilization
17CULTURE OF HEALTH
4-STAR1-STAR
1. Expanding
available program
offerings
beyond the
basic “wellness”
program
Health coaching
Healthy food
service
Program offerings
for employees:
health risk
assessment
telephonic health
coaching
Web tools
on-site health fairs
off-site vendor
programs (for
example, Weight
Watchers, gym
memberships)
Offer telephonic
and/or Web-based
health coaching
to employees and
dependents
Subsidize several
healthy food
options (salads,
fruit) or offer a “buy
10 healthy meals
and get 1 free”
program
Additional program
offerings:
on-site
lunch-n-learns
on-site preventive
screenings
on-site fitness
activities
healthy cafeteria
choices
Plus, bring health
coaches to
biometric screening
events to build
relationships with
employees
Enhance nutrition
education by
labeling worksite
food choices with
green, yellow and
red labeling based
on nutritional value
Additional program
offerings for
employees and
dependents:
on-site clinical
education and peer
support groups
on-site health
counseling
on-site screening
kiosks and resource
centers
healthy living-
promoting
environments,
including tobacco-
free campuses
on-site care
In addition, health
coaches identify
those who would
benefit from and
are receptive to
working with a
telephonic coach
Re-allocate pricing
of food items so
that healthy items
labeled “green”
are cheaper and
subsidized by
unhealthy items
labeled “red,” such
as french fries
Program
offerings are:
available to
incentivized
employees,
dependents
and retirees
integrated
through data
proactive and timely
interventions
Plus, bring health
coaches on-site to:
support chronic
condition
management
groups
address individual
health needs
put employees on a
path toward health
Eliminate unhealthy
food options from
cafeteria, vending
and meetings
2-STARPROGRAM
COMPONENT3-STAR
18CULTURE OF HEALTH
4-STAR1-STAR
2. Leader, manager
and supervisor
engagement
and personal
leadership
3. Evolution of
accountability
process
Evolution of
measurement
process
4. Transitioning
from managing
a program to
managing a
strategy
Obtain buy-in of
CEO only through
sale of business
case
Sites are asked
by corporate to
communicate
national program
offerings to
employees and offer
a health screening
event at the
worksite
Measure program
participation only
Focus on
corporate-office
solutions only
that are directed
and managed
by vendors with
minimal metrics
Also obtain buy-
in of leadership
team through sale
of business case
during a senior
leadership health
summit
Business locations
are also responsible
for achieving
goals in national
programs (for
example, percent
participation in
screening event)
Plus, measure
changes in health
behaviors, changes
in health status
of population
and employee
satisfaction
Focus on
programmatic
specific ROI rather
than dividends to
the enterprise
Engage managers’
and supervisors’
support by:
identifying “what’s
in it for them”
aligning objectives
with incentives
sponsoring
manager education
workshops on
leading health
transformation
Sites are responsible
for creating and
implementing local
program offerings
for employees and
family members,
such as weight
management
competitions or
chronic condition
support groups,
with specific goals
and incentives
Plus, measure
changes in health
care costs and cost
drivers and absence
and disability data
Leverage a mix of
corporate and local
site programmatic
solutions and
community
resources. Also
benchmark current
performance vs.
“world class” and
strive to move
toward world class
Obtain buy-in of all
leaders, managers
and supervisors by:
showing them how
the culture of health
will help achieve
their short- and
long-term personal
and professional
goals
aligning incentives
with goals
Business leaders
report to CEO on
what their business
line/function is
doing to develop
a health culture
and have personal
incentives in place
to achieve results
Plus, measure
presenteeism and
productivity and
the impact on unit
costs and operating
margins
Partner with
vendors, but take
ownership over
strategy, planning,
communication
and goal setting.
Measure most or all
appropriate metrics
with focus on total
dividends for the
enterprise
2-STARPROGRAM
COMPONENT3-STAR
19CULTURE OF HEALTH
4-STAR1-STAR
5. Examples of
aligning incen-
tives with desired
behaviors for
various stake-
holders
Health risk
and condition
management
Network
utilization
Benefits plan
design and
utilization
Offer incentive
for enrolling in a
program
Offer standard in-
and out-of-network
health plan benefits
to employees
Waive preventive
office visit co-pays
to remove financial
barriers
Offer incentive
for completing a
program or for
self-reporting
health-behaviors
information (for
example, daily
exercise)
Offer enhanced
medical plan
benefits to
employees
for accessing
medical centers of
excellence
In addition, cover
prescription
nicotine-
replacement
therapy under the
benefit plan
Offer incentive
for verified health
behaviors and
health status (for
example, blood
pressure results,
daily exercise as
reported through
a national fitness
center data feed)
Offer enhanced
medical plan
benefits to
employees for
accessing providers
who meet specific
quality measures
(for example,
Bridges to
Excellence)
In addition, reduce
or eliminate
prescription drug
co-pays for certain
chronic conditions,
such as diabetes
and asthma
Offer financial
incentives for
achieving health
goals (for example,
losing weight,
quitting smoking,
reducing blood
pressure)
Offer enhanced
medical plan
benefits to
employees for
accessing providers
who have been
educated on your
healthy-culture
program and
available resources
and who have
committed to drive
program support
and engagement
with patients
In addition, offer
enhanced medical
plan benefits
to individuals
considering
surgery only after
first discussing
available treatment
alternatives with a
health coach (in an
effort to enhance
consumerism)
2-STARPROGRAM
COMPONENT3-STAR
20CULTURE OF HEALTH
KEY IMPLEMENTATION STEPS
Ready to start but not sure how to begin? Here are some suggestions.
CONDUCT AN ORGANIZATIONAL OPPORTUNITY ASSESSMENT.
One size does not fit all when it comes to the shape and timing of creating a healthy culture. One employer
may have had a success with a best practice case study; however, it may not be the right solution for
you. Motivations and resources vary among companies. Before you get started, conduct an opportunity
assessment of your organization. Address the following questions to find the right approach:
• How does our organization’s performance measure up to “world class” standards?
• What is the economic and social impact of poor health and poor health care of employees and family
members on the organization?
• How important is reducing the total impact to the overall organizational mission and goals?
• How ready is the organizational leadership to embrace and lead a healthy culture as a way of enhanc-
ing sustainability and employee relations?
• How ready are employees and family members to embrace a healthy culture?
• What health behaviors and conditions are most prevalent that we could positively influence for the
most significant results?
• What environmental and other factors are the primary drivers of health status and health care system
utilization?
The results will provide information needed to begin building a roadmap toward becoming a “4-star
organization” and achieving significant financial and productivity results.
DEVELOP YOUR STRATEGY FOR CREATING A HEALTHY CULTURE.
Use the following to build a tailored map for your journey toward creating healthy culture:
• Use the results of the opportunity assessment to demonstrate the potential value of reducing the to-
tal cost of poor health care and poor health—potential to increase operating margins by 50–200 basis
points and shareholder value by 5 percent to 20 percent.
• Create a vision of how managing health becomes part of “how we do things around here”—building
on established norms for other elements of culture and strategy, such as safety, quality, customer ser-
vice, “going green” or Six Sigma.
• Prepare a plan to equip leaders and managers. Make sure to define their roles and provide them the
tools and support to be successful.
• Balance short- and long-term goals. Sometimes you must invest today to earn dividends down the road.
Those expenses can be offset by also investing in program modules that have nearer term dividends.
• Build a healthy culture with an all encompassing strategic approach. Do not simply roll out healthy
culture programs.
21CULTURE OF HEALTH
Potential pitfalls to avoid or barriers to overcome (See section, “Avoid Potential Pitfalls and
Barriers to Engagement”):
“ I don’t want to participate in that program because I don’t like to (fill in the blank) … talk to people on the
phone, go online, participate in small group discussions, etc.”
“I don’t have access to a computer to take the Health Risk Assessment or access to those other tools.”
GAIN LEADERSHIP COMMITMENT AND ENGAGEMENT.
Use the proposal you built in your “strategy development” to present to the senior leadership team (and
other leaders and managers throughout the organization) about establishing health management as
“the right thing to do for our business and our people” and as a core component of business strategy,
budgeting and planning. Remember to tailor your presentation to the WIFM (“what’s in it for me”) of the
group to which you are presenting (the WIFM will be different for each group). Make sure you demonstrate
the audiences’ interests and values. Also, provide tangible evidence of what outcomes can be achieved
organizationally and share stories of the potential life-changing impact to employees.
Potential pitfalls to avoid or barriers to overcome:
“My union leaders told me not to participate in the program.”
“My manager won’t let me leave my workstation to participate in that event.”
BUILD YOUR TEAMS.
It’s time to build your team. Consider who should have a role in the planning, implementing and evolving
healthy culture initiatives.
Assign the:
• Program owner/leader (Who will lead and manage the program, program team regularly?)
• Program champion (Who will help the program owner and team overcome obstacles?)
• Development/planning team
• Corporate implementation team
• Healthy culture committee in each location
• Additional internal and external support
– IT for data interfaces
– Supply chain management for RFP and negotiations support
– Communications
– Legal
– Vendors
– Community resources
– Clinical resources, such as a medical director or vendors’ physician, to opine on clinical appropriate-
ness of proposed strategic initiatives
22CULTURE OF HEALTH
Prior to bringing your team together, determine how to assign roles and what preparatory work needs to
be done to facilitate an organizational culture change, such as:
• Support from key leadership that improving health and productivity is part of everyone’s job.
• Align business leaders and managers to take comprehensive (cross-functional and cross-business
unit) approaches to opportunities.
• Enhance the skills and scopes of staff members in their formal roles or as “sparkplugs.”
Once you bring your team together, be prepared to encounter skepticism, anxiety and resistance. Individuals
may be concerned if the initiative will be a success or if they have the support, time and skills to contribute.
Having already done the work to gain leadership commitment at some level, it will be necessary to have their
involvement in the early team building activities and to serve as the change agents.
Potential pitfalls to avoid or barriers to overcome: “Is this wellness program legal?”
CREATE AN IMPLEMENTATION PLAN AND WORK WITH YOUR TEAM TO BUILD CONSENSUS
AROUND THE FOLLOWING TOPICS:
a. Program components and resources
Build a project plan for each resource/activity/program deployment to ensure required resources are
allocated with a timeline. Start by conducting a three-step process of reviewing all available data,
identifying health behaviors you want to address and proposing the activities/events/resources to offer
nationally. Consider any senior management directives, pre-designated funding parameters and the clinical
appropriateness of strategic initiatives as part of your planning process. In addition, don’t forget to meet
regularly during the planning and implementation period to determine status of deliverables and timeline
and to address issues that arise.
b. Target audiences
Once your team has completed the three-step process, determine how to target the intended program
audience. Be thoughtful of how to communicate with the audience. Individuals typically do NOT want to
feel as if they are specifically being targeted based on a particular health issue or their claims data.
Don’t forget to involve and communicate with employee spouses and family members. Remember to
include employees who don’t have a typical schedule. Keep in mind each group will differ based on their
needs and interests.
Potential pitfalls to avoid or barriers to overcome:
“ My spouse cooks for us at home, and that’s why I can’t lose weight” … and other excuses blaming health
status on family behaviors/decisions.
23CULTURE OF HEALTH
c. Resources and funding
Consider how the program and incentives will be funded. Ask yourself:
Will you receive special funding from the CEO’s office? Will funding
come out of the HR or Benefits budget? Do you have the option to bill
back the business locations for their fair share of the program costs
as an offset to medical costs? Can you consider raising medical plan
contributions to offset the incremental expense?
d. Deployment timeline
Build a detailed comprehensive deployment timeline/project
plan that includes these components:
• Plan proposal and refinement
• Leadership and funding approval
• Contracting with vendors
• Legal issues (leave plenty of time for legal review)
• Communications. Consider the following questions:
– Are advance communications to certain stakeholders required?
– Will it be a targeted or general communication?
– Who will need to approve the communications?
e. Key communication messages
Be sure to include these messages in every communication:
• How will the program work?
• What are the WIFM’s for each target audience?
• What are the incentive components, if any?
• What’s happening with employee and family member data?
Is it confidential?
• Are there perceived inequities to address?
• What are the timelines or deadlines for action?
• Where do you go for more info?
Potential pitfalls to avoid or barriers to overcome:
“Who sees my health data?”
“ It’s not fair that you are rewarding diabetics with incentives and
I don’t get anything and have been healthy all my life.”
24CULTURE OF HEALTH
f. Key metrics. Determine how to measure success and to identify needs for
mid-course corrections to the plan.
How will you measure success? Consider developing a mix of metrics from the following categories:
• Workplace environment
• Resource commitments
• Program participation
• Behavior change
• Health status
• Outcomes:
– financial
– absence
– productivity
– presenteeism
– satisfaction
Be sure to set goals and publicize the results to keep all stakeholders accountable. Consider building
health management metrics and benchmarks into a corporate balanced scorecard and/or HR performance
management system. Goal setting can be handled through the annual operating plan process, and results
can be shared and reported out on a quarterly basis with key stakeholders. This is a great way to keep the
organization focused on achieving healthy culture goals and to improve the performance of the programs.
Potential pitfalls to avoid or barriers to overcome:
“ What’s in it for me? Why should I bother to get involved with this program and/or
change my health behaviors?”
g. Data integration
The program offerings that support your culture of health should be selected and evolve based on
data and fact-based decisions. Data is significantly more valuable when you integrate everything that
is available to you—that includes health plan, prescription drug, vision, dental, disability, health risk
assessment, biometric screening and absence data. Often, it can take much more time to integrate data
than you initially anticipated, but it’s definitely a worthwhile investment. After all, how can you determine if
the strategy and programs are effective if you don’t have the data to assess the outcomes?
h. Vendor integration
You likely have multiple vendors offering a variety of programs to employees and their family members. It’s
important that the vendors work together in sharing data and in planning for and coordinating the timing
of their interactions with individuals to minimize confusion. Put yourself in your employee’s shoes. How
would you feel if you received a call from a health plan case manager, a disease management health coach
and the pharmacy benefit manager in the same week? You would likely feel overwhelmed and quickly
opine the health plans just can’t seem to coordinate their efforts. Beyond employee satisfaction, vendor
coordination makes for a more effective and efficient program.
25CULTURE OF HEALTH
MOBILIZE AND DEPLOY RESOURCES.
Don’t forget to think beyond the resources of your organization as
you plan for deployment. Be sure to:
• Build coalitions of multiple stakeholder groups within your
organization and in your community.
• Engage and mobilize providers to practice shared decision–
making and serve as the role of educator with their patients (who
are your employees or their family members).
• Educate retailers that healthiness can be profitable for businesses.
Potential pitfalls to avoid or barriers to overcome:
“My doctor says that I should just listen to his/her advice.”
MEASURE AND EVALUATE.
Post-event evaluation (postmortem debriefs) can provide great value
in learning from the past and applying knowledge to enhance the
program in the future. Here are key questions you’ll want to discuss
with your team:
• What were the outcomes?
– Did we achieve our goals?
– Were there impacts we had not anticipated?
• What lessons did we learn and which lessons are transferable?
• How will we improve our processes?
• How will the data be integrated for future fact-based
decision making?
• Who should we share the results with? After all, what is measured
is managed.
PLAN FOR THE EVOLUTION OF INITIATIVES AND PROGRAMS.
Keep the program fresh to sustain employee engagement over a long
period of time. Ensure you continually look to enhance and augment
the program offerings.
26CULTURE OF HEALTH
AVOID POTENTIAL PITFALLS AND BARRIERS TO ENGAGEMENT
Perhaps you have developed your implementation plan and are prepared to move forward in creating
or enhancing a healthy culture in your organization. Before you do so, you may want to learn from the
mistakes of other employers and anticipate challenging questions and negative comments your employees
may pose.
THE EMPLOYEES QUESTION OR COMMENT
“ WHO SEES MY HEALTH DATA?”
“ ‘THE DOG ATE MY HOME-
WORK’ …AND OTHER EXCUS-
ES WHY I AM NOT GOING TO
PARTICIPATE OR CONFORM TO
YOUR HEALTHY CULTURE.”
Many employees will have a
real concern about not only
who will see personal health
data, but whether third parties
having that data will affect the
employee’s health insurance,
secure job status or eligibility for
promotions.
Prepare to hear the following
excuses from your employees
as to why they don’t want to
participate in health initiatives.
Sometimes they are legitimate
and other times they are mislead-
ing and inappropriate forms of
resistance and fear of change.
I don’t believe my information will
be kept confidential.
I don’t have time.
I have a relationship with my doctor.
I don’t want people calling or
sending me things.
Confidentiality and data privacy
are legitimate employee con-
cerns, but they are not insur-
mountable. Proactively address
the confidentiality at the launch
of your program, explaining and
perhaps demonstrating specifi-
cally what health data is available
and is shared with other vendors
and other employees. Explain
who is permitted to see it and
under what circumstances and
why all of this data sharing is im-
portant to the program’s success.
Concerns about confidentiality
are a major obstacle to facili-
tating behavior change within
a population. Consider ways to
arrange site visits to data-man-
agement vendors by employee
representatives, which might
include union leadership.
Expect to receive a litany of ex-
cuses as to why individuals don’t
want to participate. Despite their
concerns, offer positive points of
view as to why they could benefit
from aspects of the program.
WHY IT’S A VALID CONCERNPROACTIVELY ADDRESSING
THE ISSUE
27CULTURE OF HEALTH
THE EMPLOYEES QUESTION OR COMMENT
“ I DON’T WANT TO PARTICIPATE
IN THAT PROGRAM BECAUSE
I DON’T LIKE TO (FILL IN THE
BLANK) … TALK TO PEOPLE
ON THE PHONE, GO ONLINE,
PARTICIPATE IN SMALL GROUP
DISCUSSIONS, ETC.”
“ I DON’T HAVE ACCESS
TO A COMPUTER TO TAKE
THE HEALTH RISK
ASSESSMENT OR TO
ACCESS THOSE OTHER
TOOLS.”
“ MY SPOUSE COOKS FOR US
AT HOME, AND THAT’S WHY I
CAN’T LOSE WEIGHT”… AND
OTHER EXCUSES BLAMING
HEALTH STATUS ON FAMILY
BEHAVIORS/DECISIONS.
People have different preferred
learning and communication
styles that you need to consider
accommodating if you want to
minimize frustration and maximize
engagement and success.
While it feels as though everyone
is using computers these
days, there are still many U.S.
households without computers
and/or individuals with minimal to
no computer skills.
One size does not fit all when
it comes to learning styles
or preferred methods of
communication. Some people are
visual or auditory learners. Some
prefer communication on the
computer or are better in small
group settings. Some employees
and many of the spouses/
dependents will not be able to
access program resources at the
worksite. Be sure to consider
how they will engage with the
programs and what additional
resources will be necessary.
Ensure that your facility provides
adequate resources (for example,
computer kiosks) at the worksite.
It is easier to justify the cost as
part of an overall strategy for
benefits self-service and em-
ployee communications. Beyond
providing access to computers,
be prepared to offer technical
support for those who do not
have computer skills.
The first step is to make family
members eligible for your healthy
culture programs. Once eligible,
identify ways to involve spouses
and dependents in the program
from the start. Consider leverag-
ing existing company programs
to engage the family members.
For example, if your company has
an annual picnic with employees
and their families, offer health
screenings and an orientation
to the healthy culture program,
resources and incentives.
If you want to make an impact on
an individual’s health behaviors,
you will be much more successful
when you engage the family unit,
so that they can work together
toward a common goal.
WHY IT’S A VALID CONCERNPROACTIVELY ADDRESSING
THE ISSUE
28CULTURE OF HEALTH
THE EMPLOYEES QUESTION OR COMMENT
“ MY DOCTOR SAYS THAT I
SHOULD JUST LISTEN TO HIS/
HER ADVICE.”
There are significant challenges
to motivating individuals to be-
come consumers of health—just
as they are consumers of other
products and services. Innova-
tive employers have recognized
the need to address this issue
from both the “demand” and
the “supply” sides. From the
“demand” side, you may want to
start by explaining to employees
that physicians typically can only
spend between 7 and 11 minutes
on average with each patient;
this means that their physician
is likely not able to address all
of their health needs on a daily
basis. As such, they could benefit
from engaging in the program
and perhaps sharing some of the
literature with their physician to
obtain their buy-in. Also, it is im-
portant to explain that medicine
is not “one-approach-fits-all.” The
right treatment choice is often a
function of the patient’s values
and preferences. It is important
for the patient and the physician
to work as partners in deciding a
course of action for the patient.
Educating the entire medical
community may not be feasible,
but it is possible to focus on spe-
cific physicians that have a sig-
nificant amount of a company’s
employees and family members
as patients. Be sure to educate
the physicians on the healthy
culture tools and resources and
ask for their support.
Physicians can be incredibly
powerful program champions
and drive successful engagement
with their patients. You may even
consider sending a mailer that
describes the program resources
to the physician’s office that can
be placed in the patient’s file as a
gentle reminder.
The patient may or may not have
discussed the program resources
with the physician. But regard-
less, it is difficult for a physician
to recommend that an individual
participate in his or her employ-
er’s healthy culture program
without knowing the specifics
of the program and if it’s based
on sound clinical guidance and
evidence-based medicine.
WHY IT’S A VALID CONCERNPROACTIVELY ADDRESSING
THE ISSUE
29CULTURE OF HEALTH
THE EMPLOYEES QUESTION OR COMMENT
“ IS THIS WELLNESS PROGRAM
LEGAL?”
“ IT’S NOT FAIR THAT YOU ARE
REWARDING DIABETICS WITH
INCENTIVES AND I DON’T GET
ANYTHING AND HAVE BEEN
HEALTHY ALL MY LIFE.”
“ MY MANAGER WON’T LET ME
LEAVE MY WORKSTATION TO
PARTICIPATE IN THAT EVENT.”
As you are planning your
programs, engage your attorney
to review your use of health data
and incentive structures, to insure
that you are legally compliant.
You will need to be prepared to
address these perceived ineq-
uities. Certainly the healthy em-
ployee may feel that he has paid
more than his fair share through
subsidizing the high health care
costs of the unhealthy employ-
ees; however, an employer’s
incentivizing individuals with
chronic conditions will benefit
everyone in the long run through
reduced aggregate health care
costs in the future. Also, be sure
to offer incentives to each indi-
vidual regardless of her health
status. This may mean admin-
istering different incentives for
different individuals, but working
to keep the healthy individuals
healthy is just as important, if
not more important, than helping
individuals with chronic condi-
tions to improve their condition
management skills.
As you work to engage lead-
ers, managers, supervisors and
employees, focus on establish-
ing commitment throughout the
organization in the belief that
participation in program activities
is deemed not only acceptable,
but also valuable to organization
sustainability. In those situations
where workers can’t simply walk
away from their workstation when-
ever they choose (for example,
customer service or manufacturing
line), invest time in supporting
managers to develop plans to
enable their employees to partici-
pate. Managers will be much more
supportive when you collaborate
with them in this process vs. dic-
tating what they will do.
Legislation focused on “wellness
programs” continues to evolve,
and what was legal last year sim-
ply may not be legal now.
Employees want to be treated
fairly, and many “healthy” em-
ployees feel cheated when their
peers are earning incentives for
participating in programs when
they have maintained life-long
poor health behaviors and racked
up historically higher health care
costs, which the healthy employ-
ee has subsidized.
Failure to effectively engage
leaders and stakeholders (not
identifying and promoting
appropriate “WIFM”) will create
perceived participation barriers
for all employees.
WHY IT’S A VALID CONCERNPROACTIVELY ADDRESSING
THE ISSUE
30CULTURE OF HEALTH
THE EMPLOYEES QUESTION OR COMMENT
“ MY UNION LEADERS TOLD ME
NOT TO PARTICIPATE IN THE
PROGRAM.“
“ WHAT’S IN IT FOR ME?
WHY SHOULD I BOTHER TO
GET INVOLVED WITH THIS
PROGRAM AND/OR CHANGE
MY HEALTH BEHAVIORS?”
“ WHAT’S IN IT FOR ME?
WHY SHOULD I BOTHER TO
GET INVOLVED WITH THIS
PROGRAM AND/OR CHANGE
MY HEALTH BEHAVIORS?”
Start by sitting down with the union leaders and talking about the importance of building a healthy culture and how it benefits the business, their livelihood and them personally. Find the “WIFM” for those union leaders and make a commitment to help them achieve their WIFM. Ask them to participate in the planning ses-sions so that they feel ownership over the process and outcomes. Consider arranging site visits for the union leaders to the facilities of the vendors for key programs. Their first-hand experiences will likely yield powerful marketing messages for many years to come.
Consider what incentive structures are needed to motivate behaviors for all of the key stakeholders, including your team, wellness committee volunteers, businesses working toward wellness goals, business leaders, managers/super-visors, occupational health nurses, safety leaders, union leadership and members, employees and spouses. They don’t all need to be financial in nature—many individ-uals will feel incentivized by small giveaways (T-shirts) or public ac-knowledgement. Regardless of the structure, plan incentive structures up front and modify as necessary to maintain or build engagement.
Take time to review your benefit plan design, confirming that it aligns with desired behaviors and consumer-driven decisions. For example, you likely don’t want expensive and often unnecessary MRIs to have a low co-pay, but you might want to eliminate co-pays for all preventive office visits. If you are going to incentivize employees to undergo basic biometric screenings (for example, blood glucose and cholesterol), but cannot make them available at the workplace, you may want to waive any lab fees associ-ated with the screenings.
Collectively bargained employ-
ees look to their union leadership
to determine if engaging in your
healthy-culture initiatives is the
right thing to do, and you need to
insure that the union leadership
team is on board with your mission.
Incentives and publicly shared
metrics will engage individuals
to work toward a common goal.
How will you incentivize stake-
holders to engage?
Incentives and publicly shared
metrics will engage individuals
to work toward a common goal.
How will you incentivize stake-
holders to engage?
WHY IT’S A VALID CONCERNPROACTIVELY ADDRESSING
THE ISSUE
31CULTURE OF HEALTH
FURTHER READING
Aldana, SG. (2001) Financial Impact of Health Promotion Programs:
A Comprehensive Review of the Literature. American Journal of
Health Promotion, 15(5):296-320.
Baicker, K, Cutler, D, Song, Z. (2010) Workplace Wellness Programs
Can Generate Savings. Health Affairs, 29(2):304-311.
Burton, W, Schultz, A, Chen, C, Edington, D. (2008) The Association
of Worker Productivity and Mental Health: A Review of the
Literature. International Journal of Workplace Health Management,
1(2):78-94.
Burton, W, Chen, C, Conti, D, Schultz, A, Pransky, G, Edington,
D. (2005) The Association of Health Risks With On-the-Job
Productivity. Journal of Occupational and Environmental Medicine,
47(8):769-77.
Edington, D, Schultz, A. (2008) The Total Value of Health: A
Review of the Literature. International Journal of Workplace Health
Management, 1(1)8-19.
Edington, D. (2001) Emerging Research: A View From One Research
Center. American Journal of Health Promotion, 15(5):341-349.
Yen, L, Schultz, A, Schnueringer, E, Edington, D. (2006) Financial
Costs Due to Excess Health Risks Among Active Employees of
a Utility Company. Journal of Occupational and Environmental
Medicine, 48:896-905.
Wellness Leadership: Creating Supportive Environments for
Healthier and More Productive Employees by Judd Allen, PhD.
Human Resources Institute, 2008.
Zero Trends: Health as a Serious Economic Strategy by Dee W.
Edington, PhD. Health Management Research Center, University of
Michigan, 2009.
32CULTURE OF HEALTH
CONTRIBUTORS
Beacon Health Options gratefully acknowledges the following individuals for their inspiration, insights,
contributions and review of the content contained within this document.
Judd Allen, PhD
President
Human Resources Institute, LLC
Eric Anderson
Graphic Designer
Beacon Health Options
Jill Meece Barnette, MSW, LCSW
Counselor/Senior Coach
Health & Performance Solutions
Beacon Health Options
Amy Daugherty
Editor
Health & Performance Solutions
Beacon Health Options
Anthony Davis
Vice President
Marketing & Communications
Beacon Health Options
Christopher Dennis, MD, MBA
Chief Medical Officer
Commercial Division
Beacon Health Options
Dee W. Edington, PhD
Director
Health Management Research
Center
University of Michigan
Sue Giordano
Vice President, Health
Improvement
Beacon Health Options
Kathy Greco, LMSW, CEAP
Commercial Sales Director
Beacon Health Options
Matt Grenier
Vice President, Project
Management
Beacon Health Options
Eric Hamilton, MS
Vice President
Clinical Informatics
Beacon Health Options
HealthSTAR Advisors
Ed Jones, PhD
Executive Vice President
Commercial Division
Beacon Health Options
Marla LaMontagna, LCSW-R,
CEAP, CCM
Vice President
Account Services
Beacon Health Options
Harold A. Levine, DO
Chief Medical Officer
Beacon Health Options
Bob Mitchell, LPC, NCC, CEAP
Creative Solutions Counseling
Rich Paul, MSW, CEAP
Vice President
Health & Performance Solutions
Beacon Health Options
Maggie Ramsay
Editor
Health & Performance Solutions
Beacon Health Options
Andrea Rizzo
Editor
Health & Performance Solutions
Beacon Health Options
Ginny Sedberry
Regional Director
Account Services
Beacon Health Options
Beverly Shepard
Director of Marketing
Beacon Health Options
Carrie Sioberg, LCSW
Training and Development
Specialist
Health & Performance Solutions
Beacon Health Options
Elizabeth Thorpe, MA, CEAP
Vice President
Health & Performance Solutions
Operations
Beacon Health Options
Sandy Werner
Director, Communications
Health & Performance Solutions
Beacon Health Options
33CULTURE OF HEALTH