march webinar: one million data points: the link between well-being, optimal wellness outcomes,...
DESCRIPTION
John Harris, Chairman of the Health Enhancement Research Organization (HERO), discussed the significant body of information accumulating to demonstrate the link between employee well-being, optimal wellness outcomes, and business performance.TRANSCRIPT
Worksite Wellness Council of Massachusetts March 20, 2012
O N E M I L L I O N D ATA P O I N T S
The Link Between Well-Being, Optimal Wellness Outcomes, & Business Performance
John Harris, ChairmanHERO Health Enhancement Research [email protected] me on Twitter: @johnhharris
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R e s e a r c h & To o l s A d v a n c i n g t h e F i e l d
• HERO Scorecard
• Gallup-Healthways Well-Being Index®
• Healthways Well-Being Assessment
• Other Peer Reviewed Research
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Results from The HERO Employee Health Management Best Practice Score Card 2010 Annual Report
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Results from The HERO Employee Health Management Best Practice Score Card 2010 Annual Report
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Results from The HERO Employee Health Management Best Practice Score Card 2010 Annual Report
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Results from The HERO Employee Health Management Best Practice Score Card 2010 Annual Report
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O t h e r H E R O S c o r e c a r d F i n d i n g s
• Over 600 companies, evenly divided between large, medium, and small companies
• Strong leadership and cultural support results in better EHM program participation
• Larger organizations more likely to collect and use EHM data
• Strongly integrated programs produce greater employee engagement and better outcomes
• % of employers that believe health plan is supportive of EHM– 57% very supportive – 40% somewhat supportive – 3% not at all supportive
• Scorecard users who believe the health benefit design is very supportive are far more likely to report that EHM programs have had a substantial positive impact on medical plan cost trend
• Scorecard users reporting highest levels of consumerism are far more likely to report a substantial positive impact on cost trend
• Just under two-thirds of Scorecard respondents say that medical plan access and design support EHM program objectives:– “Effectively” (55%)– “Very effectively” (9%)
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T h e G a l l u p | H e a l t h w a y s W e l l - B e i n g I n d e x
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• 25-year commitment initiated January 2, 2008• 1,000 telephonic “community” surveys completed
per day, 7 days/week• Approaching 1.5 million completed surveys
• For results based on this sample of respondents, the maximum 95% margin of sampling error is ±0.1 percentage points
• Design support and oversight from leading behavioral economists, psychologists, and experts in psychometric survey design and statistical analysis
• Largest and most comprehensive health survey and database
Six Domains:
1. Life Evaluation
2. Emotional Health
3. Physical Health
4. Healthy Behavior
5. Work Environment
6. Basic Access
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T h e H e a l t h w a y s W e l l - B e i n g A s s e s s m e n t
Life Evaluation
BasicAccess
WorkQuality
EmotionalHealth
Physical Health
HealthyBehavior
Gallup-Healthways Well-Being Index®
Community
Healthways Well-Being Assessment™Individual and Organization
Life Evaluation
BasicAccess
WorkQuality
EmotionalHealth
Physical Health
HealthyBehavior
Productivity
HRA
Biometrics
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Individuals ● Experts ● Social Connections ● Environment ● Policy
Making the Transition from Health to Well-Being
Social
FinancialCommunity
Physical
Emotional
Career
Well-being is biggerthan Physical Health
Proprietary Healthways Construct
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T h e I n t e r c o n n e c t e d n e s s o f A l l D o m a i n s
BMI Risk
Healthy Eating
Exercise
Height WeightEnergy Level
# of Health Risks
Coping with Stress
Negative Affect
Personal Sources of Presenteeism
Days of Best Work
Physical Health
Emotional Health
Recognition at Work
Financial Stress
traditional approach current approach future areas of exploration
Drivers of BMI Risks: Example of New Insight
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Source: Healthways Internal Analysis
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ThrivingAverage 20% Lower Medical Costs
SufferingAverage 50% HigherMedical Cost
4.0
7.0
Struggling
“Please imagine a ladder with steps numbered from zero at the bottom to ten at the top. The top of the ladder represents the best possible life for you and the bottom of the ladder represents the worst possible life for you. On which step of the ladder would you say you personally feel you stand at this time?”
Source: Gallup-Healthways Well-Being Index Community Survey and Wellmark Corporate Survey 2008
Six well-being domains
1. Life Evaluation2. Work Quality3. Basic Access4. Healthy Behavior5. Physical Health6. Emotional Health
Cost Disparity of Life Evaluation & Possible Reasons Why
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R i s k D i s p a r i t y B y L i f e E v a l u a t i o n
0%
20%
40%
60%
80%
Suffering Struggling Thriving
0-1 risks2-3 risks4-5 risks6-9 risks
Risk Category by Life Evaluation
Toward Integration to Enhance Health and Well-Being by Evers, KE, Prochaska, JO, Castle, P. & Prochaska, JM. 2009
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L i f e E v a l u a t i o n & O t h e r Va r i a b l e s
Thriving
Struggling
Suffering
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
33%
61%
80%
% With Significant Stress
Thriving
Struggling
Suffering
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
82%
57%
30%
% Feeling Well Rested
Thriving
Struggling
Suffering
95%
79%
50%
% With Sufficient Energy
Thriving
Struggling
Suffering
0% 10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
91%
74%
50%
% Satisfied with Job
Source: Gallup-Healthways Well-Being Index Community Survey and Healthways Well-Being Assessment
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L i f e E v a l u a t i o n & P r e s e n t e e i s m D r i v e r s
0%20%40%60%80%
24% 21% 11%
54% 49%24%
69% 65%
33%
Thriving Struggling Suffering
During the past four weeks (28 days), how often have you been at work but had trouble concentrating or doing your best because of:
0%20%40%60%
10% 11% 4%
35% 30%7%
60%48%
15%
Thriving Struggling Suffering
Job Overload Co-Worker Issues
Technology Issues
0%
10%
20%
30%
40%
50%
60%
70%
80%
53%
13%
30%
65%
23%
39%
70%
33%45%
Thriving Struggling Suffering
0%10%20%30%40%
9% 11%19%18% 20%
32%32% 30%42%
Thriving Struggling Suffering
Source: Gallup-Healthways Well-Being Index Community Survey and Healthways Well-Being Assessment
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P r o d u c t i v i t y I m p a i r m e n t D i s p a r i t y b y L i f e E v a l u a t i o n
0%
5%
10%
15%
20%
25%
Suffering Struggling Thriving
Activity Impairment
Work Presenteeism
Work Productivity Loss
Source: Toward Integration to Enhance Health and Well-Being by Evers, KE, Prochaska, JO, Castle, P. & Prochaska, JM. 2009
Activity Impairment, Work Presenteeism and Work Productivity Loss by Life Evaluation
Prod
uctiv
ity Im
pairm
ent
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C o m m u t e T i m e & W e l l - B e i n g
17%
15%
14%
14%
13%
0% 2% 4% 6% 8% 10% 12% 14% 16% 18%
Over 60 Minutes
46-60 Minutes
31-45 Minutes
16-30 Minutes
1-15 Minutes
% Reporting Anger
64%
66%
67%
69%
71%
60% 62% 64% 66% 68% 70% 72%
Over 60 Minutes
46-60 Minutes
31-45 Minutes
16-30 Minutes
15 Minutes or Less
% Feeling Well Rested
Over 60 minutes
46-60 minutes
31-45 minutes
16-30 minutes
15 minutes or less
46% 48% 50% 52% 54% 56% 58% 60%
50%
50%
52%
56%
58%
% Exercising
Over 60 minutes
46-60 minutes
31-45 minutes
16-30 minutes
15 minutes or less
61% 62% 63% 64% 65% 66% 67% 68%
63%
63%
65%
67%
67%
% Eating Healthy
Over 60 minutes
46-60 minutes
31-45 minutes
16-30 minutes
15 minutes or less
0% 5% 10% 15% 20% 25% 30% 35% 40%
36%
34%
32%
29%
28%
% Obese
Source: Gallup-Healthways Well-Being Index Community Survey
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W o r k E n v i r o n m e n t I m p a c t o n E m p l o y e e s W i t h C h r o n i c C o n d i t i o n s
13.5
52.7
20.1
68.9
0
10
20
30
40
50
60
70
80
1-3 Conditions 4+ Conditions
Neutral or Positive Work Negative Work
6.6 Days/Year
16.2 Days/Year
Days Unable to Carry Out Usual Activities Per Year
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Source: Gallup-Healthways Well-Being Index Community Survey and Healthways Well-Being Assessment
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O t h e r R e s e a r c h
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Gallup Research – Only 28% of American workers are engaged in their work
Price Waters Cooper, 2010 – 1 in 4 high-potential employees intend to leave their employers in the next 12 months
AON Hewitt – Global engagement scores are on the decline with recent drops being the largest in 15 years
Research by Ratey in a book published in 2008 – People learn vocabulary words 20% faster after exercise than before
Confidential and Proprietary 20
W E L L - B E I N G , C O S T & P E R F O R M A N C E
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W e l l - B e i n g R e l a t i o n s h i p t o To t a l M e d i c a l C o s t s
0-50 (n=109) >50-60 (n=151)
>80-90 (n=683)
>70-80 (n=582)
>60-70 (n=347)
>90-100 (n=363)
Annual Costs(Indexed)
ANNUAL MEDICAL AND RX CLAIMS COST | Low:High Well-Being = ~3.5x more cost
Source: Wellmark Data, Healthways Center for Health Research Analysis (n=2,235)
4.0
1.0
2.0
3.0
Well-Being Score (Composite)Low High
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W e l l - B e i n g & P r o d u c t i v i t y
HIGHER IS ASSOCIATED WITH HIGHER OVERALL WELL-BEING PERFORMANCE & PRODUCTIVITY
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Well-Being and Performance Well-Being and Absenteeism
Source: Healthways Well-Being Assessment and , Healthways Center for Health Research Analysis
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HIGHER IS ASSOCIATED WITH HIGHER OVERALL WELL-BEING ENGAGEMENT AND RETENTION
W e l l - B e i n g a n d W o r k W i t h d r a w a l
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Well-Being and Engagement Well-Being and Retention
Source: Healthways Well-Being Assessment and , Healthways Center for Health Research Analysis
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W e l l - B e i n g & Te a m E f f e c t i v e n e s s , L e a d e r s h i p a n d P r o d u c t i v i t y
74767880828486
64 to 66 67 to 69 70 to 72 73+Well-Being Score
Lead
ersh
ip S
core
40
45
50
55
60
65
70
75
80
1 2 3 4 5 6 7 8 9 10
11 32 88 564 2,133 4,980 4,267 1,582337
Overall ProductivitySelf-reported on a scale of 1-10
N=
Wel
l-B
eing
Sco
re
747678808284
64 to 66 67 to 69 70 to 72 73+
Team
Effe
ctive
ness
Sco
re
Well-Being and Team Effectiveness
Well-Being Score
Well-Being and Leadership
Implementation of Survey: March, 2010 ************* NO INCENTIVES *************
Eligible WBA Population: 27,090 employees WBA Completion Rate: 52.7%
Completed Surveys: 14,276 employees
Well-Being and Productivity
Source: Healthways Well-Being Assessment and , Healthways Center for Health Research Analysis
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W e l l - B e i n g & Te a m F i n a n c i a l P e r f o r m a n c e
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TOP QUINTILE 2ND QUINTILE 3rd QUINTILE 4TH QUINTILE 5TH QUINTILE
Source: Healthways Well-Being Assessment and , Healthways Center for Health Research Analysis
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W e l l - B e i n g & Te a m F i n a n c i a l P e r f o r m a n c e
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OverallLife
EvaluationEmotional
HealthPhysical Health
Healthy Behavior
Work Environment Basic Access
% at Optimal Income
Caterpillar 68.4 60.9 76.4 78.1 62.6 46.9 85.5 41.7%BU #16 68.6 61.6 75.5 76.8 65.2 46.4 86.2 51.8%BU #17 68.6 59.6 76.3 80.3 66.4 44.4 84.8 41.6%BU #18 68.1 59.9 77.9 78.9 61.5 45.3 85.0 40.8%BU #19 67.8 58.0 75.7 78.1 63.9 43.4 87.7 57.2%BU #20 66.3 58.3 74.7 76.4 59.2 46.0 83.3 31.7%BU #21 66.2 52.4 75.0 76.9 61.1 45.4 86.5 37.9%BU #22 65.8 59.1 76.4 75.8 53.4 45.6 84.2 28.4%BU #23 65.7 57.3 73.9 76.8 61.7 40.1 84.2 36.6%BU #24 65.5 56.8 76.3 76.7 56.8 43.2 83.4 28.3%BU #25 64.5 52.5 73.0 75.3 60.2 42.4 83.8 26.8%
Well-Being Assessment Results by Business Unit
TOP QUINTILE 2ND QUINTILE 3rd QUINTILE 4TH QUINTILE 5TH QUINTILE
High Well-Being BUsvs.
Low Well-Being BUs+ 84% Better Performance
Source: Healthways Well-Being Assessment and , Healthways Center for Health Research Analysis
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E x p a n d e d V a l u e P r o p o s i t i o n
ImproveWell-Being
Adopt or maintainhealthy behaviors
Reduce health-related risks
Optimize care for health conditions and disease
IncreasePerformance
• Productivity
• Engagement
• Absence
• Work Impairment
Reduce Total Medical Cost
• Hospitalizations
• Event Rates
• Disease Rates
• Lifestyle Risks
Increase Total Economic Value
• States
• Communities
• Sponsors
• Individuals
Prevent or delay next new case of disease or conditionPrevent or reduce impact of the next new episode of careEnhance one’s ability to actively manage their well-being
Economic Drivers
Proprietary Healthways Construct
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L i n c o l n I n d u s t r i e sA C u l t u r e o f W e l l - B e i n g f o r t h e W h o l e P e r s o n
• Vertically integrated manufacturer of metal finishing-intensive parts
• 600 employees• 15% revenue growth rate per year
sustained for 15 years• “50 Best Small and Medium Companies
to Work For” for five years in a row• Culture of caring for people and
innovative wellness program
4 “levels” of participation Each level is based on seven criteria:
• Tobacco use, quarterly checks (blood pressure, flexibility, body fat), participation in wellness events, health information update, health risk appraisal, blood profile, behavior based safety participation and work behavior
Highest level are eligible for a company-paid trip to climb a 14,000 foot mountain
• Last year 77 made the climb
Four dedicated wellness resourcesFocus on “Wellness for the Whole Person” based on six domains (shown left)Numerous program components including free pedometers, tobacco free campus, onsite tobacco cessation, health education seminars, gym reimbursements, annual “poker walk”, “brain ‘n pain challenge”, etc.
Program Elements
Intellectual
Physical
Spiritual
Social
Occupational
Emotional
Wellness for the Whole Person:
Company “Wellness Wheel”
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W e l l - B e i n g C u l t u r e I m p a c tE x c e p t i o n a l P e r f o r m a n c e o n A l l D i m e n s i o n s
• Since 2000, tobacco use has gone from 77% to 23%• The industry average of health care costs per person is almost $10,000; for
Lincoln Industries, it is just over $3,500 per person• In 2003, workers compensation costs were over $500,000; in 2006, these
costs were less than $50,000
69.1
66.4
72.2
62 64 66 68 70 72 74
Nation
Local City
Company
Well-Being Assessment: Gallup-Healthways Well-Being Index
58.8
48.6
65.1
Nation
Local City
Company
60.5
58.2
60.9
Nation
Local City
Company
80.6
78.5
82.4
Nation
Local City
Company
48.7
49.6
57.2
Nation
Local City
Company
81.6
78.3
82.5
Nation
Local City
Company
84.1
84.8
85.4
Nation
Local City
Company
Life Evaluation Healthy Behavior
Emotional Health Work Environment
Physical Health Basic Access
Participation rate = 87%
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T h e L i n c o l n I n d u s t r i e s S t o r y
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Note: Shaded estimates reflect significant difference at the 0.05 level.*Means were simultaneously estimated for each of the variables shown in the table.
Lincoln Industries Employee
Number % Physical Health
Mental & Environmental
HealthHealth
BehaviorBasic
Access
Mean* Mean* Mean* Mean*
Yes 422 25 79.4 80.8 61.7 84.4
No 1,276 75 76.5 77.2 56.0 83.4
Four well-being domains according to company and selected demographic variables, 100 point scale, 2009
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H O W W I L L P R O G R A M M I N G C H A N G E B A S E D O N T H E K N O W L E D G E G A I N E D ?
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W e C a n ’ t R e l y o n t h e S t a t u s Q u o
• Worksite health programs have been in existence for about 40 years• There is evidence that these programs can generate an ROI• However, penetration and sustained engagement have been lacking
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Insanity: doing the same thing over and over again and expecting different results - Albert Einstein
The Result?• 67% of American adults overweight or obese• 60% do not exercise• 83% report high to moderate levels of stress• 21% still smoke• 56% have at least one chronic illness
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The Best Science Behavioral Change
Social Networks• A social structure of “nodes” which are connected by
one or more specific types of interdependency, such as friendship, kinship, common interest, knowledge, etc.
Decision Making
Behavioral Economics
Mindfulness
Social Connectivity
Prochaska’s Transtheoretical Model • Rational decision-making through stages of change• Leveraging of learning style, decisional balance, and other techniques
Neuro-plasticity and other approaches• Paying attention in a particular way: on purpose, in the
present moment, and non-judgmentally• The changing of neurons via new experiences• Archetyping
Predictably irrational decision making in humans• Dynamic intermittent reinforcement• Hyperbolic discounting• Stimulating pleasure centers of the brain
Gamification
Gaming Theory• Fun vs. fulfillment• Appealing to all…Explorer, achiever, socializer, competitor• Small actions
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T h e T h e o r y o f S m a l l A c t i o n s
Source: BJ Fogg, Stanford University
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Small Daily Actions | Conversations | Assessment | Social Engagement
3. Assess & track well-being1. Complete Daily Challenges
2. Share, discuss, celebrate4. Social support & comparison
T h e D a i l y C h a l l e n g e – B y M e Yo u H e a l t h
www.dailychallenge.com MeYou Health is a wholly owned subsidiary of Healthways
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M a k e i t F u l f i l l i n g – “ G a m i f i c a t i o n ”
Adapted from Dr. Richard Bartle
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M a k e i t S o c i a l• Social graph
analysis provides breakthrough insights
• Dense social ties drive sustained health behavior change
• Facebook integration creates immediate & social context and diffusion
“Dynamics of Smoking Cessation,” - Christakis & Fowler
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M a k e i t G r o w
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Daily Challenge members invite their friends to form therapeutic communities
Friend connections
drive adherence
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M a k e i t R e a l i s t i c
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The likely impact of one person reducing their soft drink consumption over time?• They lose weight • Their overweight friends may lose
weight• Their normal weight friends will be less
likely to gain weight
Now, imagine if 100,000 people do it?
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M a k e i t A c c e s s i b l e A n y w h e r e
Smart Phones and Mobile Devices
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F I N A L T H O U G H T S