Health, well-being and productivity improvement in the workplace
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Transcript of Health, well-being and productivity improvement in the workplace
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Tracy Brower, Ph.D., MM, MCR
Michael Parkinson, MD, MPH, FACPM
What it really takes: Health, well-being & productivity improvement in the workplace
It’s totally possible.
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Today’s speaker
Dr. Michael Parkinson | Principal | P3 Health
•Key medical advisor for Limeade •Principal of P3 Health, EVP and CMO of Lumenos •Previous President of American College of Preventive Medicine • MD from George Washington University, MPH from John
Hopkins and AB from Cornell University
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Overview
Welcome
Understanding the drivers
Laying out the roadmap
Putting it into action
Where corporate wellness fits
#WhatItReallyTakes
@Limeade
Q&A
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Understand the drivers of health and productivity in the workplace, and how to address them in your own organization.
Goals
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What are we trying to do anyway?
$2.8T on healthcare:
75% behaviors30% waste
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Framework: Workforce well-being & business performance
Well-being status Workplace practices
Individual well-being
Individual performance
Org performance
* Adapted from Sherman BW, Lynch DL. Am J Managed Care 2014: 20(2) 155-120
Work factors
Workplace Culture
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Healthy| Minimal preventable illness and injury
Productive| Contributes to the corporate mission and achieves personal goals
Ready| Responds to changing demands
Resilient| Adjusts to setbacks or unusual challenges
Do you have a healthy workforce?
Adapted from IOM: Integrating Employee Health: A Report for NASA 2007
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Determinants of health
Social environment
Physical environment
Genetic environment
Health Disease Healthcare
Individual response Well-being Prosperity
“Live, learn, work and play”
Evans, R. G., Barer, M. L., & Marmor, T. R. (1994)Why Are Some People Healthy and Others Not?. New York: Aldine De Gruyter
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19-34 35-44 45-54 55-64 65-74 75+$0
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
Medium RiskHigh Risk
Non-ParticipantLow risk
Behaviors drive ALL costs
Edington. Am J Health Promotion 15(5):341-349, 2001
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IOM 2011: The Healthcare Imperative: Lowering Costs and Improving Outcomes
Unnecessary services
Inefficient delivery
Excess admin costs
Excessive prices
Missed prevention
Fraud
Where’s the waste?
30%excess waste
$750Bin waste
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Laying out the roadmap
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Employer health & productivity roadmap™*
IncreaseHealthy
Behaviors
OptimizeEnvironment
OptimizeChronic
Care
Speed Care
Transitions
Minimize Acute Care
ReduceExcessiveSurgeryReduceExcess Surgery
*Parkinson MD. Employer Health and Productivity Roadmap™ Strategy, JOEM 55 (12) Supp Dec 2013.
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Putting it into action
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Optimize the environment2
Culture| Policies, leadership
Programs & health| Wellness program, resources, communications
Roles, responsibilities & rewards| Policy alignment, compensation and benefit alignment
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Optimize the environment2
Alignment of rewards and responsibilities leads to:
| Reduce medical spend by $2,500 PPPY
| Decrease STD up to 50%
| Decrease worker's compensation up to 65%
| Decrease turnover for top performers up to 50%
| Increase revenue up to 35%
|
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Increase healthy behaviors
Incentivized health management program or consumer-directed health plan
2Competency based programs address root cause of disease & costs
|Tobacco cessation |Physical activity |Stress management|Weight management
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Minimize acute care
Healthy people use less acute care| Traditional and alternative care
| Virtual visits
| Costs and on-site care options
| Prevalence of acute visits
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Optimize chronic care
2
2
| Condition prevalence
| ID & referral process
| Disease management coaching
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Coaching
2
2
|Prepare to make changes
|Set goals
|Facilitate problem solving
|Develop self-efficacy & gain support
|Build skills
|Engage in medical decision-making with doctor
|
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Coaching and tools
Lifestyle improvement
NutritionTobacco cessation
Physical activityStress management
Chronic disease
Cardiovascular conditionsDepressionDiabetes Maternity
Shared decision support
Back & knee painBreast cancerHeart disease
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Reduce excess surgery
2
2
25%of all surgeries
are unnecessary (RAND)
O’Connor et al. 2003, Armstrong et al 2012; Lee et al 2013*Whelan et al. 2004; Kennedy et al. 2002; Murray et al. 2001; Deyo et al. 2000;
Morgan et al. 2000; Bernstein et al. 1998; Barry et al. 1997; Street et al. 1995
| Shared decision-making before surgery| Reduce:- # of surgeries- Advanced imaging rate
| Expand to more discretionary surgeries| Utilize decision aids
|
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Informing patients
*Foundation for Informed Medical Decision Making survey, 2009 (n=462)
Managing conditions
Changing behaviors
Taking new Rx's
Surgery
Cancer screenings
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Patients actually informed Important for patients to be Informed?
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“Patient activation” – why it matters
| Better health behaviors| Better clinical care and
clinical outcomes| Overall lower cost
* J Gen Int Med 2012;27:52026 and Health Aff 2013;32:216-222
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Speed care transitions
Incentivized health management program or consumer-directed health plan
2
Goal: Get employees back to work
| Address conditions that drive employees away from work
| Reduce frequency of absences
| Monitor return to function and work by major condition
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Where corporate wellness fits
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Invest in employees’ well-being
| Support & reward behavior change
| Tools & resources
| Biometric screenings
| Interventions & coaching
Workplace wellness programs tie it together
ImproveHealth
Well-BeingPerformance
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| Engaging in wellness is a must
| Employees & families want it their way
| Technology is changing the game| Mobile, devices, self-monitoring,
bio feedback, virtual coaching
How technology is driving the future
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| Cash/gift cards
| Nudge messaging
| Loss aversion
| Default option
| Commitment contract
| Peer support group
| Tech/web support
New vocabulary of behavioral economics
CMS RFI “Beneficiary engagement, incentives and behavioral insights” due Sep 15, 2014
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| Recognize financial stakes
| Emphasis on preventive care
| Less medical service overuse
Consumer directed healthcare
“It’s my health and my money, and I’m going to take better care
of both.”
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Physical activity
Attitude of self, sense of purpose
Whole-food, plant-based diet
What I eat, how I move, what I think
The 3 fundamentals of health
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Whole person approach
• Benefit design/incentive driven
• Clinical engagement program
• Member services• 24/7 nurse line
• Employee assistance program
• Worksite health clinics• Central leave management• Disability
• Coaching• Physical condition
management• Behavior condition
management
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“ “
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Q&A
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About Limeade
Incentivized health management program or consumer-directed health plan
2Limeade is a corporate wellness technology company that measurably improves employee health, well-being and performance, while building cultures that support well-being.