Thursday, August 25, 2016

What is the REAL Value of Your Wellness Offering?




Most wellness professionals will be familiar with this vignette:
You worked hard to set up a wellness event for your organization that is empirically based, aligned with your mission, and fun for the participants. You put out flyers and used the company intranet to announce your offering. But your sign-ups are going slow.
It is difficult not to be discouraged. Participants in wellness programs often irrationally fail to make choices to improve their health. It is tempting to conclude that the general public is lazy, or does not really care about their health. I believe the problem lies elsewhere. Making decisions that will enhance our health can be more complex than it seems.

As an example, here is an ad that was discovered by Dan Ariely from Duke University (found in his book, Predictably Irrational, 2008). It was an ad placed by the Economist magazine to purchase a subscription:

Welcome to The Economist Subscription Centre
Pick the type of subscription you want to buy or renew

Economist.com subscription: $59
One-year subscription to Economist.com.
Includes on-line access to all articles from
The Economist since 1997.

Print subscription: $125
One-year subscription to the print edition
of The Economist.

Print & Web subscription: $125
One-year subscription to the print edition
of The Economist and online access to all
articles from The Economist since 1997.

Do you notice anything unusual about this ad? If you look carefully, you will notice that the cost of the print only subscription and the print plus web subscription is the same. Dr. Ariely verified with the magazine that this was not a mistake and also experimented with his students to demonstrate that the Economist was actually making an advertising decision that was effective.

He reprinted the ad for 100 students and asked them to select an option. Option one, the economist.com option was selected by 16 students. The second option, print subscription only had no takers. The overwhelming choice was option three, the print plus web choice, which was selected by 84 students.

Next he took out the print subscription only option and presented the modified ad to another 100 students. By taking out the option that no one in the first group selected, now 68 students chose the economist.com subscription and a mere 32 students took the print plus web option. Why did this occur?

When the Economist placed this ad, most people were still uncertain of the value of an online subscription. They were used to a print subscription, so the cost of $125 did not seem out of line. In comparison, how much is an online subscription worth? Remember, this ad was published in 2007. (The first iPad was not available until 2010, so reading online was still new for most people.) It was difficult for potential subscribers, at that time, to determine how to value an online subscription. They used a comparison of choices as a method to determine the relative value.

This is a similar problem many employees face when they are offered opportunities to participate in a wellness activity. How is the value of that opportunity determined? Activities that are offered before or after the work day will be compared to other commitments with families or friends. (Should I attend the morning Yoga class or stay home with my children until they are on the bus for school?) Activities during the work day are compared to work responsibilities. (If I attend a lunch program, I don’t have time to finish the proposal due this afternoon.)

We often present these wellness initiatives without attempting to establish value because it is so clear to us, as wellness professionals, that what we are offering has value. It is hard to remember that most of our potential participants are far removed from thinking about wellness. Health is something that is considered only when a pain or a problem interrupts the day. It is important to say something about the value explicitly when we are offering a program that will improve a participant’s health.

The second mistake we often make is to talk about the value from a clinical perspective. If we offer a walking program and our statement of value is that it helps the participant meet the minimum requirement that doctors recommend for daily activity, it's value is still not as clear to our participants as it could be.

That is because we establish value by comparing the wellness offering to other things that are also of value to us. How do I judge the value of a walking program in comparison to the time it will take me away from my work responsibilities? The value can be clearer, if instead, it addresses that regular exercise is shown to improve clarity of thought and increase energy, so it may make the participant better at their job. Or perhaps your potential participant will be able to understand the value of a yoga class when she realizes it will help her develop the self-awareness and patience to be a better parent.

These elements do not need to dominate the efforts to engage participants in your wellness programs, but they need to be a part of them so that participants can realize how essential they are to being able to live a full, rich and successful life. This is the ultimate goal of engaging people in wellness.



About the Author:

Dr. John Weaver is a licensed psychologist, the Director of the Healthy Thinking Initiative, and chair of the Wisconsin Psychologically Healthy Workplace committee. He has written several articles and is the author of two books: The Prevention of Depression: A Missing Piece in Wellness and The Healthy Thinking Program.

For information about the impact of psychological science on wellness and applied to the workplace, follow him on Facebook and Twitter @bizpsych. 

If you want further insight into understanding the true value of wellness you can see Dr. John Weaver speak at the upcoming WI WELCOA Conference.
View the skill building session agenda here.




Monday, July 25, 2016

An Inside Look: Cleveland Clinic’s Award Winning Wellness Program


Over the past five years Cleveland Clinic has successfully bucked the trend of increasing healthcare costs by decreasing the amount of healthcare services their employees require. AND they accomplished this without resorting to common cost shifting measures like high deductibles.

myInertia’s new wellness partner, David Pauer, Cleveland Clinic’s Employee Health Plan Wellness Director, recently sat down with us to share some insight into the organization’s powerful approach. 

Confirming the outcomes, David shared,“…Our utilization, the amount of prescriptions and any service provided, is actually down five percent in the past five years. It’s really phenomenal [considering that]…in our primary network of providers we don’t have a deductible at all—no amount that the employee or their family members would have to pay before the insurance kicks in. And we also do not charge co-insurance, so there’s no percentage that people have to pay after the insurance kicks in. And there are also very few co-pays…”

So how has Cleveland Clinic achieved the dual goal of lowering healthcare utilization while maintaining low cost access to these services for their employees? They focused their approach around four main elements:

1. Shift to rewarding healthy behaviors. Back in 2010 Cleveland Clinic faced similar challenges that many employers do - rapidly rising premiums (21% increase) and low wellness program participation rates. As David explained, “We were offering the traditional T-shirts and water bottles, just for filling out a health risk assessment, and we got about 20-25 percent participation. And really no outcomes. We didn’t really show that we improved anybody’s health.”

The key was finding a solution that would motivate employees to engage in the program. David highlighted, “The thought was we should reward people who are helping keep the overall costs down.”

2. Tie coordinated care participation to premium incentives. Their initial focus was to offer a premium discount (now the maximum 30% ACA allowance) to all plan members diagnosed with a chronic condition that joined and completed a coordinated care program. When asked how they chose the specific conditions, David Pauer shared, “We targeted six conditions because they are the most common, have a large effect on people’s health and also have a high cost: BMI greater than 27, diabetes or asthma diagnosis, high blood pressure (greater than 140/90), LDL cholesterol greater than 130, and tobacco use.”

3. Keep the healthy, healthy. In order to make the maximum impact CCEHP knew they needed to address their entire employee population. And by doing so they had been able to manage their premium increase down to 11%. by 2013. As David Pauer explained, “It’s part of a philosophy of keeping your healthy population healthy. It’s much easier and cheaper to keep healthy people from getting to the point where they have a chronic condition than it is to wait until they have the chronic condition and then try to treat them.”

Employees not diagnosed with a chronic condition are required to participate in a physical activity program in order to receive their premium discount. The program validates activity levels through the use of wearable trackers, along with fitness center visits.

4. Create an environment for success. In addition to the Employee Health Plan, Cleveland Clinic features an employee wellness department that offers programs for every employee, whether they’re on the health plan or not. This is an important factor in creating an environment that makes it easier to achieve wellness goals. For example, they ensure there are healthy food options in all facilities, encourage walking options on campus, and form wellness committees that help with employee communication.

Since 2010, this wellness program approach has created outstanding outcomes for both Cleveland Clinic and their employees:

  • Cleveland Clinic estimates that they’ve saved about $125 million (in cost avoidance) over the course of the program.
  • For 2016, employee premiums were only increased 2%. David clarified, “We would not have had to raise it at all except that our pharmacy costs continue to go up, even though we’re paying for fewer medications”.
  • 60% of plan members, both employees and spouses are currently participating for a discount.
  • This year Cleveland Clinic estimates that every single employee who has the health plan is saving $700 compared to the expected trend line, regardless of whether they receive an incentive.
  • In addition, those meeting the requirements for the 30% premium discount can save an additional $500-$1,400 per plan.

Cleveland Clinic has achieved these dramatic results by using meaningful incentives to engage all employees in appropriate behaviors based on their health status - proving that healthier populations really can make a difference.

If you’d like to gain further insight into Cleveland Clinic’s program you can download the full interview with David Pauer here:




myInertia became wellness partners with Cleveland Clinic in 2015. If you’re interested in learning more about how a myInertia partnership could benefit your organization please feel free to contact one of our wellness representatives here.

Thursday, July 14, 2016

What I Learned at the 41st Annual National Wellness Conference


I recently had the honor of attending and presenting at the 41st annual NWI Conference in St. Paul Minnesota. I thoroughly enjoyed attending this year’s conference. I find when I can minus my outside distractions (home/work/community needs) that I really dive into learning, and want to write down every word / buy every book offered. I walk away with such big aspirations and that is a great thing for all of us to do sometimes!



Let me share some of my favorite takeaways and interactions from this year’s National Wellness Conference:

Thursday, June 16, 2016

6 Ways Wearables are Changing the Wellness Landscape


It was a great experience to attend the Fitbit Captivate 2016 conference this past week and learn more about the powerful impact wearables can have on a wellness program. Much of what was shared aligns exactly with our 8+years of experience in implementing wearables at myInertia. We continue to see high sustained engagement and excitement when wearables are implemented. Why do we see this with wearables more than any other wellness initiative? Here are some of the reasons shared at the Fitbit Captivate conference:

1. Wearables are Consumer focused 
Wearables are built and designed with the end user in mind. In order to capture the interest of potential buyers, device powerhouses like Fitbit are continuously working to provide new ways to make their device experience more fun, engaging and simple to use. Because of this we are starting to see wearables become something that employees engage with and purchase on their own, outside of work. Meaning the hard work has been done for you. Employees already WANT devices, which is in direct contrast to other common workplace wellness initiatives like biometrics, health coaching, or online courses. This “want” can drive adoption and engagement because employees are hearing about wearables, and seeing friends, family and co-workers wearing a device. By offering wearables in your wellness program you offering something employees can identify with and want to be part of.

2. Wearables are on 24/7
Some of the poorest choices for health are made outside the work hours. Wearables are great because they are a reminder that is with a participant 24/7. From evaluating sleep patterns, to giving move reminders throughout the day, and tracking all daily stats, wearables are the wellness initiative that go beyond just the 9-5.

3. Wearables Give Insightful Data 
Activity trackers are offering organizations data that they simply couldn’t have access to previously. Monitoring real-time activity data from wearables can give a company a pulse on the uptake of their wellness program. This data allows for potential adjustments to program design and communication throughout the year, while also offering the ability to recognize and reward employees’ healthy behaviors.

4. Wearables Provide Scalability 
Wellness for the masses is made easier with wearables. Wearing a device is easy for participants and can be less difficult than other wellness initiatives to implement at large, multi-location companies.

5. Wearables Strengthen Social Connections 
When your employees see and know others that are wearing a device it opens up conversations and possible networking through the wearables platform. Challenges can bring together people who haven’t interacted previously driving a noticeable culture shift throughout the organization.

6. Wearables are High Touch 
Too many wellness programs are one and done. Making them insufficient to create behavioral change. A good wearables program will encourage employees to engage throughout the year, providing a constant reminder to make the healthy choice.

If you are looking to build the type of wellness program that employees line up to participate in, consider a strategic wearables program. 

You can download our e-book on developing an engagement strategy that will successfully move the needle on population health.


Wednesday, June 1, 2016

What You Need to Know: The EEOC Final Rules Regarding Wellness Programs



The Equal Employment Opportunity Commission (EEOC) recently released final rules clarifying how the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA) apply to workplace wellness programs. The in-depth analysis of these rules can be a lot to digest. So we’ve compiled the answers to the most common questions we’ve heard prior to the release, or since the release of the rules, to help you better understand the new guidelines.

Who do these rules apply to?

The rule applies to all wellness programs (participatory and health-contingent) that include disability-related inquiries and/or medical examinations whether they are offered only to employees enrolled in an employer-sponsored group health plan, all employees regardless whether they are enrolled in such a plan, or offered as a benefit of employment by employers without a group health plan. Don’t have medical examinations or disability-related inquiries in your wellness program? Then there’s no need to read further.

Can I offer an incentive to a spouse to answer questions about their health history?

Prior to the release of the rules it was unclear whether wellness programs could offer an incentive to spouses of employees for the collection of genetic information or current and past health status. The final rule states that an employer may offer a limited reward or disincentive to an employee’s spouse as part of a wellness program that collects information about his or her own current or past health status. The maximum incentive allowed in exchange for the spouse’s participation may not exceed 30 percent of the total cost of self-only coverage.

What does it mean for a wellness program to be voluntary?


Another area that had been unclear prior to the final rules was what it meant for a wellness program to be “voluntary” and meet the ADA guidelines exception for allowing medical inquiries and exams as part of a “voluntary” wellness program. For a program to be considered voluntary, the incentives to participate must be under 30% of the coverage cost and the employer:

  • Does not require employees to participate
  • Does not deny coverage under any of its group health plans or particular benefits packages within a group health plan for non-participation, or limit the extent of benefits for employees that do not participate
  • Does not take adverse employment action or retaliate against, interfere with, coerce, intimidate, or threaten employees that do not participate or reach a health outcome
  • Provides a written notice to employees that clearly explains what medical information is to be collected, how it will be used, who will receive it, how it can be disclosed and methods to prevent improper disclosure of medical information.

Even if an employer has an existing notice in place, it must revise or replace with a new notice that complies with the final rule. The Commission will provide an example of a compliant notice on it’s website by June 17, 2016.

How do I calculate the 30% incentive limit?

One key clarification in the final rules is that the 30% max incentive includes not only financial incentives (cash, premium contributions etc.) but also in-kind incentives such as premium parking spots and paid time off. Employers are given the flexibility to determine the value of the in-kind incentive as long as the method is reasonable. There are four ways of calculating the 30% max incentive:

  • If participation in a wellness program depends upon enrollment in a particular group health plan, the incentive may be up to 30% of the total cost of self-only coverage (including both the employee and employer contributions)
  • If an employer offers a single group health plan but participation in a wellness program does not depend on the employee’s enrollment in that plan, an employer may offer an incentive of up to 30% of the total cost of self-only coverage under that plan.
  • If there are more than one group health plan, but participation in a wellness program does not depend on the employee’s enrollment in any plan, the employer may offer an incentive up to 30% of the total cost of the lowest cost self-only coverage under a major medical group health plan.
  • Where there is no group health plan, the maximum incentive is calculated as 30% of the cost of the second lowest cost Silver Plan available through the state or federal health care Exchange in the location that the employer identifies as its principal place of business.

When do the rules go into effect?

The rules will apply prospectively to employer wellness programs as of the first day of the first plan year that begins on or after January 1, 2017, for the health plan used to determine the level of incentive. For example, if the plan year for the health plan used to calculate the permissible incentive limit begins on January 1, 2017 then the rule would begin to apply at that date. If the plan year for the health plan used to calculate the incentive starts on April 1, 2017 then the rule would begin to apply at that date.

Can I still use up to a 50% incentive for tobacco cessation programs?

Yes, an employer can offer incentives as high as 50% of the cost of self-only coverage when a program asks employees whether or not they use tobacco or whether they ceased using tobacco upon completion of the cessation program. However, if an employer tests for the presence of nicotine or tobacco, that is now a medical examination and under ADA the 30% limit would now apply to such a screening.


These are some of the main highlights of the EEOC’s final rules and regulations as they apply to workplace wellness programs. Follow the link below to see the rules in full and for an example of a compliant notice coming late June. https://www.eeoc.gov/laws/regulations/qanda-ada-wellness-final-rule.cfm



Friday, May 20, 2016

10 Recommended Health & Wellness Books





Looking for something to add to your summer reading list? myInertia recently attended the 2016 National WELCOA Summit / Arts & Science Promotion Conference and got a lot of great suggestions. Out of the many suggested we listed the 10 we’re most excited to add to our bookshelves. Did we miss any? Feel free to add to our list by commenting below!

Thursday, May 12, 2016

4 Key Takeaways from the 2016 WELCOA National Summit and Art & Science Health Promotion Conferences


photo credit: Health Promotion Conference photo gallery

myInertia attended and exhibited at the 2016 WELCOA National Summit and Art and Science Health Promotion conferences in Orlando. With 5 full days of thought-provoking sessions and wanted to share the key takeaways with our readers.

1. Health Questionnaires are old news
It’s a year later and the verdict is the same - health questionnaires are old school and should be replaced with more meaningful wellness. There was even a round of applause for this. The message remains strong that employees aren’t motivated to participate in these, they don't give the participant any insight in their health that they don’t already know, and the self-reported data doesn't provide good valuable feedback. Yet, the message is not sticking. Many companies are still looking for health questionnaires from vendors. Often, it is seen as the only way to aggregate biometric data, but platforms like myInertia can provide the aggregate data back without the need of a questionnaire. We hope the continued message empowers organization to look beyond health questionnaires. If you want to find out specific information from your employees about their readiness to change, or evaluate health trends year after year, this can be accomplished with simple, no cost, less invasive surveys.

2. Wellness is more than physical health 

The evidence for finding purpose in one’s life as a health booster is strong. Vic Strecher from the University of Michigan shared studies that showed those with purpose had decreased mortality, less incidence of Alzheimer’s and cognitive impairment, better use of preventive health services, and less sleep disturbances. There is no doubt that purpose can have positive impacts on individual health but there were many discussions on the difficulty of implementing these initiatives on a population level. They seem like great concepts to add to a coaching model but the ability help 5000 employees across 25 locations find their purpose can be daunting. Though the message was strong at the conference that “wellness is more than physical health,” it makes us wonder, does moving so far down the continuum away from physical health to finding one’s purpose go too far? The majority of time it still comes back to changes in physical health that the stakeholders in wellness programs want and expect to see, therefore finding a happy medium in the continuum is key.

3. Biometrics alone do not make-up a wellness program
This one-time per year initiatives does not create enough awareness for continuous behavior change throughout the year .A speaker quoted Stephen Covey as saying "To know and not to do is really not to know." This is so true of biometrics as the number of participants that make health changes on their own after “knowing their numbers” is very minimal. That is why there is such a need to create meaningful programs that help participants focus on habit changes and healthy choices year round.


4. Physical activity is key
It was evident that one of those meaningful programs is a good physical activity program. One of the first slides that was shared at the conference was: “Physical inactivity has been identified as the fourth leading risk factor for global mortality causing an estimated 3.2 million deaths globally.” The risks associated with physical inactivity cannot be ignored. Fortunately, as a wellness initiative, physical activity program can be rolled out to mass populations, made easy with the latest fitness trackers, has wide spread benefits, and can bridge the gap between physical wellness and the sought after well-being.

This was just a few of the many great concepts and ideas that were shared at the conference. If anyone would like to contribute feel free to comment.


Author:
Sarah Troup
Director of Wellness Strategy
stroup@myinertia.com | 920-593-8867