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Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

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Page 1: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

Heart and Mind Connections:

Integrated Strategies for

Greater HealthClient Summit Sessions

July 17, 18, 20

Teleconference phone:888-809-8974

Page 2: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Agenda

Connection Between Heart Disease and Mental Health: Joe Hullett

Northrop Grumman Newport News Wellness Initiative: Steven Apostoles

Pratt & Whitney Stress Management Seminar Program: Tracy Newmark, Amy Wilson

Discussion

Page 3: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Why Heart Disease?

Human cost: No 1. killer of Americans and a leading cause of disability

Financial costs: Key contributor to rising health care and disability expenditures and a prime cause of decreased productivity

Page 4: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

The Costs of Heart Disease and Mental Health

Heart disease is often associated with a mental health diagnosis, which may not be properly diagnosed or may be undertreated.

There is a significant difference in medical health costs for individuals with coronary artery disease (CAD): • In one study, the costs to the employer for the physical health care

of CAD patients without co-morbid behavioral health diagnoses was $883 per member per month.

• These costs rose 54% to $1,358 per member per month for CAD patients with depression or anxiety.1

Individuals with CAD who were treated with selective antidepressants for six months were: • 91% more likely to experience a significant reduction in the cost of

hospital inpatient services • 72% more likely to experience a significant reduction in the cost of

office-based services in the treatment of their disease2

Page 5: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

About Heart Disease and Mental Health

Depression, anxiety, hopelessness, pessimism, hostility and anger have all been linked to heart disease.3,4,5

Depression and anxiety disorders may affect heart rhythms, increase blood pressure, alter blood clotting, and lead to elevated insulin and cholesterol levels. These risk factors often predict, and are a response to, heart disease.6

People with heart disease are more likely to suffer from depression than otherwise healthy people; conversely, people with depression are at greater risk for developing heart disease.7

Those who have heart disease and who are depressed have an increased risk of death after a heart attack compared with those who are not depressed.8

Page 6: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Fighting Heart Disease: The Role of Behavioral Health Experts

Emotional, psychological and behavioral intervention and support is essential in helping to prevent or manage heart disease.

Behavioral experts can:• identify and manage behavioral health contributors that

can impact heart health, such as depression, anxiety and chronic stress

• support those who are living with heart disease• promote and help sustain a healthy lifestyle

Page 7: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Initiative Components

Client summit CD toolkit

• Costs of heart disease and mental health diagnoses• Information about the heart and mind connection• Organizational/program considerations• Communication tools

Staff information and training Affiliate information and training Behavioral Health Management article

Page 8: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Service Options Offered by ValueOptions

Standard:• 24/7 assessment and referral• Employee assistance program (EAP) • Stress reduction counseling• Depression screening• Intensive case management• Support for family and support systems• Primary care physician (PCP) behavioral health consultation• Educational programs

Enhanced services:• Lifestyle coaching• Tobacco cessation• Nurse line• Integrated care

Page 9: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Benefits of an Integrated Cardiovascular/Behavioral Health Program

Increased referral rate to the EAP and mental health/substance abuse program

Decreased overall health care and disability costs Enhanced productivity Reduced absenteeism Improved employee/member perception of

organization’s commitment to their health and well-being

Page 10: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Newport News

Wellness Initiative

Page 11: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Plan

All employees and dependents may participate (on their own time)

Participation is entirely voluntary and results are confidential

Four on-site wellness coordinators located throughout the yard

• Clinic, Buildings 901 & 600, SPF Shop• Focus on early detection, prevention and risk

reduction

Page 12: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Initiatives

Health risk appraisal (HRA) On-site screening/health fairs Flu shots Risk-reduction programs

• Heart health• Cancer/diabetes prevention• Weight management• Nutrition/exercise• Stress management• Work/life balance

Page 13: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Design

Based on the seven benchmarks of the Wellness Councils of America:

1. Capturing Senior Level Support

2. Creating Cohesive Teams

3. Collecting Data

4. Crafting an Operating Plan

5. Choosing Appropriate Interventions

6. Creating Supportive Environments

7. Carefully Evaluating Outcomes

Page 14: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Building Support

Sought senior level leadership commitment, including the Sector President, Senior VP of Programs and VP of Human Resources

Obtained buy-in from senior union officials Tailored approach to address concerns of

the various managers

Page 15: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Creating a Cohesive Team

Chose our team well Sought and received corporate support Chose vendor who is willing to engage Selected steering group committed to

oversight

“A committee is a cul de sac down which great ideas are lured and then quietly strangled.”

Page 16: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Collecting Data to Drive Initiative

Organizational Needs

Demographic information

Health risk appraisals Health screening data Medical claims Disability Absenteeism Ergonomics

Employee Interests

Focus groups Individual

interviews/simple surveys

Meetings

Page 17: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Operations Plan

Vision Goals Objectives Marketing Timeline Itemized budget Evaluation plan

Page 18: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Intervention Choices

Awareness Education Lifestyle modifications support Healthcare providers collaboration Incentives/disincentives Screenings Flu shots Ergonomics Job design/accommodation Return to work Workplace stress reduction

Page 19: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Creating Supportive Environments

Establishing multiple permanent yard sites that provide privacy

Including dependents Scheduling off-shift hours Roving health screens Engaging Food Services to provide healthy choices Aligning organizational, HR and health promotion

policies/practices Benefit plan design Coordinating with provider and community resources Balancing high touch with high tech

Page 20: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Consistently Measure Outcomes

Number of study years Number of subjects Number of separate interventions Percentage change in sick leave Percentage change in absenteeism Percentage change in medical costs Percentage change in workers compensation

costs

Page 21: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Concerns

Developing metrics to support ROI Loss of momentum both at the Sector and

Corporate Engagement by healthcare providers Duplicate programs provided by healthcare

providers (HRA) increase costs Integration with other benefit programs

Page 23: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Pratt & Whitney

Pratt & Whitney is a world leader in the design, manufacture and service of aircraft engines, industrial gas turbines and space propulsion systems.

40,000 employees worldwide, 20,000 domestic HealthTimeSM, the Employee Wellness Network is

managed by the Global Medical Department.• Contracts with Health Fitness Corporation (HFC)• HFC is a leader in corporate-based health improvement and has

successfully implemented employee health management strategies in numerous Fortune 100 corporations.

Page 24: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Vision, Strategy, Focus

To protect and enhance the health of Pratt & Whitney employees.• Identify and reduce preventable health risks through on-site

programs• Help employees understand and obtain quality health care• Promote a healthy culture

Focus:• Cardiovascular disease• Cancer• Mental health (promotion and increased utilization of available

EAP services)• Influenza (flu shot program)

Page 25: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

ValueOptions EAP Synergy

P&W researched available resources to meet established wellness goals.• EAP contract hours

– On-site and off-site counseling services

– Seminars on various subjects

Requested a stress management seminar.• Participants would learn new ways to deal with

everyday stress, manage time and balance work/ family issues

• Communication tool for promoting EAP services

Page 26: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

“Managing Stress for Life”• 18 seminars at domestic P&W facilities• September 2005 through January 2006• Accommodated time constraints and shift workers• One session videotaped

– DVD produced– Webcast uploaded to HealthTimeSM Web page on company

intranet

• Satisfaction surveys given to participants– 134 surveys returned (14 events)

– Data analysis completed

Stress Management Seminar

Page 27: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

• 95% of participants ranked their satisfaction at a 5 or above (on a scale of 1-7)

Overall Satisfaction With the Stress Management Seminar

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Participant Survey

Page 28: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

• 93% of participants ranked the usefulness of the information at a 5 or above (on a scale of 1-7)

Usefulness of Information

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Usefulness of Information

Page 29: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

• 88% of participants ranked the handouts and materials at a 5 or above (on a scale of 1-7)

Handouts and Materials

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Handouts and Other Materials

Page 30: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

• 91% of participants reported that they increased their knowledge or improved their skills

Did the event/lecture increase your knowledge or improve your skills?

91%

9%

Yes

No

• 84% of participants reported that they will be making a behavior change

Learning, Knowledge, Behaviors

Page 31: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Stress Seminars at Pratt & Whitney

Health Risk Category

PotentialHealth Care

Cost Savings Per Employee Who

Reduces Their High Risk Status

Stress $1,179

High Blood Glucose$22,650

HFC Results Calculator

Potential Program Savings: Stress Seminars at Pratt & Whitney

Page 32: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

“Well done, kept everyone’s interest and spurred many conversations after.”

“This seminar was highly informative and will certainly help with dealing with stressful situations in the future.”

“I feel that these resources should be communicated more often. Not just me, but many people don't know about this or are hesitant about utilizing (the) EAP.”

“Good introduction to stress, but I think more specific details on the very best ways of dealing with stress would be even more beneficial. Possibly real examples and back up ideas.”

Participant Comments

Page 33: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Communication tool for ValueOptions EAP services

EAP utilization increased 38% from 1Q 2005 to 4Q 2005

Used data analysis to determine need for continuation of annual seminars

UTC EH&S Health Promotion Outreach Award

Summary

Page 34: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Discussion

Page 35: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Resources

American Heart Association: http://heart.org National Business Group on Health’s business

case for cardiovascular health: http://www.wbgh.org/pdfs/issuebrief_cphscardio.pdf

ValueOptions’ cardiovascular health initiative: http://valueoptions.com/spotlight_heart/html/pages/index.htm

Page 36: Heart and Mind Connections: Integrated Strategies for Greater Health Client Summit Sessions July 17, 18, 20 Teleconference phone: 888-809-8974

[email protected]

Sources

1 ValueOptions/IHCIS Comorbidity Study, 20032 Group Health Incorporated, www.ghi.com3 Williams R.B. Neurobiology, cellular and molecular biology, and

psychosomatic medicine. Psychosom Med, 1994; 56:308-315. 4 Denollet J., Brutsaert D.L. Personality, disease severity, and the risk of

long-term cardiac events in patients with a decreased ejection fraction after myocardial infarction. Circulation. 1998; 97:167-173.

5 L.D. Kuzansky, K.W. Davidson, and A. Rozanski. The Clinical Impact of Negative Psychological States: Expanding the Spectrum of Risk for Coronary Artery Disease. Psychosom Med, May 1, 2005; 67(Supplement_1):S10-S14.

6 National Heart, Lung and Blood Institute 7 Nemeroff CB, Musselman DL, Evans DL. Depression and cardiac disease.

Depression and Anxiety, 1998; 8(Suppl 1): 71-9.8 Frasure-Smith N, Lesperance F, Talajic M. Depression and 18-month

prognosis after myocardial infarction. Circulation, 1995; 91(4): 999-1005.