wellness program workshop · this presentation will provide a road map to launch a new wellness...

WELLNESS PROGRAM

WORKSHOP

P R E S E N T E D B Y : A RV I D R . “ D I C K ” T I L L M A R , T I L L M A R C O N N E C T L L C

Not just politically correct, developing a wellness program can save you real dollars with studies showing that 80

percent of all health care spending is preventable and 50 percent of these potential savings come from

wellness, lifestyle and behavioral changes. This presentation will provide a road map to launch a new wellness

program or improve an already existing one, so join us to improve your bottom line.

Independent Insurance Agents of Wisconsin

© 2013 Tillmar Connect, LLC

THE NEED FOR WELLNESS

Prevention

Why?

Increase in illnesses


3

The biggest threats facing the American work force

today are obesity, tobacco use, and stress.

Together, these lifestyle factors contribute to lost

productivity and absenteeism, among other

problems, but a wellness program can work to

combat all three



Source: National Business Group on Health,

BENEFITS OF WORKSITE

WELLNESS PROGRAMS


5



Hostess introduces

Twinkies, 1953 Ray Kroc franchises the

McDonald Brothers, 1955

And then introduces

“supersizing,” 1993

MILESTONES IN CONTEMPORARY AMERICA


Awareness/education

Motivation

Tools, strategies

Policy and environment

INDIVIDUAL BEHAVIOR


Individual


10


11


12


13

It’s All About

Behavior Change


14

Individual Family


16

Individual Family Worksite


18

Individual Family Worksite Community


22

Individual Family Worksite Community Nation/

World


23

23

Constraining Medical Costs

Centers for Disease Control & Prevention, 2006 Behavioral Risk Factors Surveillance System

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

No Country Can Fund All the Consequences: • Hypertension • Type 2 Diabetes • Osteoarthritis • Stroke • Coronary Heart • Gallbladder • Sleep Apnea • Respiratory Issues • Some Cancers

Obesity Trends Among U.S. Adults (BMI>30%)

1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

BEHAVIOR & LIFESTYLE: WEIGHT GAIN

1986-2006


PERCENT OF OBESE (BMI>30) U.S. ADULTS


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No Data <4% 4%-6% 6%-8% 8%-10% >10%

DIABETES TRENDS AMONG ADULTS IN THE U.S.

BRFSS 1990


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No Data <4% 4%-6% 6%-8% 8%-10% >10%


BRFSS 1991-1992


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No Data <4% 4%-6% 6%-8% 8%-10% >10%


BRFSS 1999-1994


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No Data <4% 4%-6% 6%-8% 8%-10% >10%


BRFSS 1995-1996


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No Data <4% 4%-6% 6%-8% 8%-10% >10%


BRFSS 1997


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No Data <4% 4%-6% 6%-8% 8%-10% >10%


BRFSS 1998


35

No Data <4% 4%-6% 6%-8% 8%-10% >10%


BRFSS 1999


36

No Data <4% 4%-6% 6%-8% 8%-10% >10%


BRFSS 2000


37

No Data <4% 4%-6% 6%-8% 8%-10% >10%


BRFSS 1995-1996


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Obesity costs U.S.

companies $13 billion

annually

These workers have

36% higher medical

costs than fit

employees

A WEIGHTY TOLL ON EMPLOYERS


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THE HIGH COST OF SMOKING

A smoker costs the employer $3856/yr in added healthcare costs and lost productivity

The overall prevalence of tobacco use is about 25% of the population, which can be generalized to any workplace population

Calculating the cost of smoking: Assume a workplace with 100 employees

Assume 25 employees use tobacco

Result = $96,400/yr in business borne costs associated with smoking

Because of this high cost, it is estimated more than 6,000 companies now refuse to hire smokers

Alaska Airlines requires a nicotine test before hiring people

Kalamazoo Valley Community College stopped hiring smokers for full-time positions

Union Pacific won’t hire smokers


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THE COST OF POOR HEALTH

Lost productivity

related to absence &

presenteeism

compared to

medical & pharmacy

costs

Medical Costs

25%

Absenteeism

Lost Productivity

36%

Presenteeism

Lost

Productivity

34% STD/LTD/WC

5%

IBI Research Insights - Single employer example © 2013 Tillmar Connect, LLC

Chronic disease has $1 TRILLION impact on U.S. lost productivity each year.

41

Goetzl, R; JOEM 45(1) 5-14 2003

TOP 10 MOST COSTLY HEALTH CONDITIONS


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Health Care System 10%

Environment 20%

Genetics 20%

Lifestyle 50%

EXPENSE DRIVERS


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Tobacco: 8,100 +/- deaths per year in Wisconsin

Poor diet: Physical inactivity: 6,900 +/- deaths per year in Wisconsin

Microbial agents: 1,700 +/- deaths per year in Wisconsin

Alcohol: 1,600 +/- deaths per year in Wisconsin

Toxic agents: 1,000 +/- deaths per year in Wisconsin

Medical errors: 1,300 +/- deaths per year in Wisconsin

Motor Vehicles: 800 +/- deaths per year in Wisconsin

Firearms: 400 +/- deaths per year in Wisconsin

Sexual behavior: 400 +/- deaths per year in Wisconsin

Not insured: 300 +/- deaths per year in Wisconsin

Illicit drug use: 300 +/- deaths per year in Wisconsin

PREVENTABLE CAUSES OF DEATH IN WISCONSIN

TOTAL: 22,800


Six Unhealthy Truths Tell the Story of the Rise of Chronic

Disease and It’s Impact on Health and Health Care 44

Truth #1: Chronic Diseases are the #1 cause of death and disability in the U.S.

Truth #2: Chronic diseases account for 75% of the nation’s health care spending.

Truth #3: About two-thirds of the rise in health care spending is due to the rise in the prevalence of treated chronic disease.

Truth #4: The doubling of obesity between 1987 and today accounts for nearly 30% of the rise in health care spending.

Truth #5: The vast majority of cases of chronic disease could be better prevented or managed.

Truth #6: Many Americans (five in six) are unaware of the extent to which chronic disease harms their health – and their wallets.

www.fightchronicdisease.org © 2013 Tillmar Connect, LLC

IMPACT OF HEALTH RISK FACTORS ON PRODUCTIVITY

45

Risk Factors considered in study include:

Tobacco Use

BMI <18.5 or >24.9

Physical inactivity

Lack of emotional fulfillment,

High stress

High blood pressure

High cholesterol

Alcohol use

Overdue preventive visits

Diabetes

25.9%

6.3%

0.0%

0%

5%

10%

15%

20%

25%

30%

0 risks 1 risk 2 risks 3 risks 4 risks 5 risks 6 risks 7 risks 8 risks

Mea

n L

ost

Pro

du

cti

vit

y

Presenteeism

Absenteeism

Boles M, Pelletier B, Lynch W. The Relationship Between Health Risks and Work Productivity.


AS HEALTH RISKS INCREASE, SO DO EXCESSIVE COSTS

46

$840$1,261

$3,321

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

Low Risk (0-2

Risks)

HRA Non-

Participant

Medium Risk (3-4

Risks)

High Risk (5+ Risks)

Excess Costs

Base Cost

These represent the

maximum savings

opportunity if you

moved people from

High (6+ risks) to

Low (0-2 risks)

$175$292

$757

$0

$500

$1,000

$1,500

Low Risk (0-2

Risks) N=685

HRA Non-

Participant N=4,649

Medium Risk (3-4

Risks) N=520

High Risk (5+ Risks)

N=366

Excess Costs

Base Cost

Chart Sources: Medical Edition: Edington. AJHP. 15(5):341-349, 2001; Disability: Wright, Beard, Edington. JOEM. 44(12): 1126-1134, 2002

Average Annual Medical Cost

Average Annual Disability Cost


AS HEALTH RISKS INCREASE, SO DO EXCESSIVE COSTS

47

Have at least 1 coronary risk factor 75%

Were rated poor for nutrition practices 70%

Have high blood pressure 60%

Smoke 57%

Are 20% over their ideal body weight 40%

Exercise Regularly 20%

-There were 3 complicated pregnancies last year that cost the company $300,000

-The interest survey indicated that the majority of employees would like to participate in programs with their families, would like

aerobics classes during the day and would like a weight control class at work. A few employees indicated they wish to quit

smoking.

-An additional survey showed that almost all managers were supportive of the proposed wellness program. It further indicated that

managers would participate and encourage others to as well.

Sample XYZ Company Summary Report - Percentage of employees who:


IMAGINE IF YOU COULD SAVE 25% OFF YOUR RISING

HEALTH CARE COSTS

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25% savings off of Rising Health Care Costs

$1,080 $1,151 $1,291 $1,440$1,587 $1,730 $1,845 $1,958

$7,832$7,379$6,918$6,348$5,758$5,162

$4,604$4,320

$0

$2,000

$4,000

$6,000

$8,000

$10,000

1999 2000 2001 2002 2003 2004 2005 2006

Year

An

nu

al em

plo

yer

healt

h c

are

co

st

per

em

plo

yee


49

WELLNESS PROGRAMS

EFFICACY &

CASE STUDIES


50

A multitude of studies show ROI averages of $3 for every $1

invested

One recent study had the return as high as 10 to 1

Companies must be patient. “Worksites typically don’t realize

returns until about three years into the program. If an

organization is willing to wait two or three years, it will be

capable of achieving this magnitude (3 to 1) of ROI.”

A review of 32 studies found claims costs were reduced by

27.8%, physician visits by 16.5%, hospital admissions by 62.5%,

disability costs by 34.4% and incidence of injury by 24.7%

NUMEROUS STUDIES DOCUMENT STRONG ROI


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From a review of 73 published studies of worksite wellness programs

Average $3.50-to-$1 savings-to-cost ratio in reduced absenteeism and health care costs

From a meta-review of 42 published studies of worksite wellness programs

Average 28% reduction in sick leave absenteeism

Average 26% reduction in health care costs

Average 30% reduction in workers’ compensation and disability management claims costs

Average $5.93-to-$1 savings-to-cost ratio

A comprehensive health management program at Citibank

$4.56-$4.73-to-$1 savings-to-cost ration in reduced total health care costs

WELLNESS WORKS, ACCORDING TO ROI STUDIES


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BUSINESS CASE &

IMPLEMENTATION

WELLNESS PROGRAMS


53

DEFINING HEALTH RISKS & RISK LEVELS

Health Risk Measure High Risk Criteria

Alcohol > 14 drinks per week

Blood Pressure Systolic >139 mmHG/Diastolic >89

mmHG

Body Weight BMI =/>27.5

Cholesterol >239 mg/dl

Existing Medical

Problem

Heart, Cancer, Diabetes, Stroke

HDL <335 mg/dl

Illness Days >5 days last yr

Life Satisfaction Partly or not satisfied

Perception of Health Fair or Poor

Physical Activity <1 time per week

Safety Belt Usage Using safety belts <100% of time

Smoking Current smoker

Stress High

Overall Risk Levels

Low Risk 0 to 2 high risks

Medium Risk 3 to 4 high risks

High Risk 5 or more high risks


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GET WELL OR PAY NOT TO

Consumers may be able to improve their health and bottom line by participating in

company sponsored wellness programs.

More employers are offering cash, discounts and even lower health insurance

premiums to entice workers to participate in a variety of programs.

Starting next year, employees could have further incentives to get healthy as more

companies add penalties to insurance premiums for workers who don’t partake.

“It’s an opportunity to get cash for doing what’s right for you.

Despite cutbacks amid the recession, 58% of large U.S. companies now offer

lifestyle-improvement programs, up from 43% in 2007, according to a Watson Wyatt

Study. And 56% provide health coaches, compared with 44% in 2007. Health-risk

appraisals are offered at 80% of companies, up from 72% in 2007.


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DISCOUNTS AND FREEBIES

Employees may be able to get $200 to $300 for

participating in health-risk appraisals, smoking-cessation,

weight management and preventive care classes.

Other offerings include heavily discounted weight

loss programs and free or discounted gym

memberships. At some companies, employees who

participate are rewarded with gift cards or lower

insurance premiums.


56

WELLNESS PROGRAMS

EMPLOYERS’

EXPERIENCES

WITH ROI


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HISTORICAL PERSPECITIVE ON SAVINGS

Johnson & Johnson Started in 1979

Invested $30M, 94% participation rate

Cholesterol, activity and smoking

Results of $224 per year savings per employee ($8.5M annually)

Pitney Bowes Analysis 1991; Health Care University started in 1993

2.8:1 ROI for participants in HCU

Increased productivity, less absenteeism for gym members

Ergonomics showed a 5.1 ROI

Union Pacific Winner of C. Everett Koop Award 1994, 1997, 2001

Smoking down from 40% to 28% over 10 years

10% decrease in lifestyle related healthcare costs equating to $53.6M dollar difference in 2001


58

... AND TODAY’S EXPERIENCE

2008 PRICEWATERHOUSE COOPER’S HEALTH

AND WELLNESS TOUCHSTONE SURVEY RESULTS:

69% of 561 companies have a wellness program

Less than 30% of members participate: the use of incentives increases

participation

52% of respondents don’t believe wellness programs are effective at mitigating

healthcare costs, improving performance/productivity, or enhancing employee

engagement/loyalty.

They do believe they are effective at reinforcing corporate responsibility and image

Only 37% of respondents integrate occupational health with their wellness

strategy


59

ASSOCIATION OF RISK LEVELS WITH SEVERAL

CORPORATE COST MEASURES

Research conducted at the University of Michigan has shown that the low risk employees (1-2

risk factors) have lower cost for short term disability, workers’ comp, absence and health care

costs whereas high risk employees (5+risk factors) have higher costs.

Source: Wright, Beard, Edington, JOEM 44 (12): 1126-1134 © 2013 Tillmar Connect, LLC

WELLNSS PROGRAM SAVINGS


So, how do

you do it?

WELLNSS PROGRAMS


Benchmark #1 - Capturing CEO Support

Benchmark #2 - Creating Cohesive Wellness Teams

Benchmark #3 - Collecting Data To Drive Health Efforts

Benchmark #4 - Carefully Crafting An Operating Plan

Benchmark #5 - Choosing Appropriate Interventions

Benchmark #6 - Creating A Supportive Environment

Benchmark #7 - Carefully Evaluating Outcomes

WELCOA’s 7 BENCHMARKS


ONE SIZE DOES NOT FIT ALL!

WHAT DOESN’T WORK

Health Assessments alone

Low budget, low intensity, low participation rates

Programs that focus on what’s in it for the organization, not

the individual participant

“Under the radar” initiatives

NIH (not invented here) philosophy

Huge incentives that would be better used for programming

HERO Panel: EHM – What Really Works? HERO Forum for Employee Health Management Solutions

New Orleans, Louisiana -- October 2007 Ron Z. Goetzel, Ph.D.

Cornell University and Thomson Medstat


Employ features and incentives that are consistent with the organization’s core mission, goals, operations, and administrative structures;

Operate at multiple levels, simultaneously addressing individual, environmental, policy, and cultural factors in the organization;

Target the most important health care issues among the employee population;

Engage and tailor diverse components to the unique needs and concerns of individuals;

Achieve high rates of engagement and participation, both in the short and long term;

Achieve successful health outcomes, cost savings, and additional org. objectives;

Are evaluated based upon clear definitions of success, as reflected in scorecards and metrics agreed upon by all relevant constituencies.

BEST CRITERIA FOR WELLNESS PROGRAMS


Robert H. Lustig, MD, UCSF Professor of Pediatrics in the Division of Endocrinology, explores the damage caused by sugary foods. He argues that fructose (too much) and fiber (not enough) appear to be cornerstones of the obesity epidemic through their effects on insulin. Series: UCSF Mini Medical School for the Public [7/2009] [Health and Medicine] [Show ID: 16717]

http://www.youtube.com/watch?v=dBnniua6-oM

DR. ROBERT LUSTIG





Sample Comprehensive Report

Sample Executive Summary

WELL WORKPLACE


(double click on documents to bring up full PDF versions)

http://www.welcoa.org/wwpchecklist/


http://www.welcoa.org/wwpchecklist/

1. A Vision/Mission Statement for

The Wellness Program

2. Specific Goals and Measurable

Objectives

3. Timelines For Implementation

4. Roles And Responsibilities

5. Itemized Budget

6. Appropriate Marketing Strategies

7. Evaluation Procedures

ESSENTIAL ELEMENTS: WELLNESS PROGRAMS


THE EFFECTS OF AN EFFECTIVE WELLNESS PROGRAM

Click image below to read full article


http://www.jsonline.com/news/opinion/wellness-programs-help-make-city-healthier-wellness-programs-help-make-city-healthier-ob63tk3-162655546.html

Companies are now using incentives to drive participation in health

programs

Of nearly 2,000 U.S. surveyed employers, 84% offer employees incentives

to participate in a health risk questionnaire (HRQ) and 64% of those

offer an incentive for participation screening.

51% provide incentives to employees who participate in health improvement

and wellness programs.

The use of monetary incentives, in particular, has increased dramatically

in 2012.

A growing number of employers are beginning to link incentives to a

result.

THE USE OF INCENTIVES


The need to have SMART goals & objectives for your Wellness Programs:

SMART GOALS & OBJECTIVES


WHO’S TO BLAME IF YOU’RE FAT?


WHO’S TO BLAME IF YOU’RE FAT?

Click image below to read full article


Emphasis of Preventative Care in the

Affordable Care Act

http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html

Well City Milwaukee

www.wellcitymilwaukee.org

REFERENCE GUIDES


75

48 Teaspoons Sugar

16 oz 32 oz

44 oz 52 oz 64 oz

RETHINK YOUR DRINK


1. 4.2 grams of sugar = 1 teaspoon of

sugar

2. Before you order a drink, ask how

much sugar is in the beverage – it is

listed in grams on the ingredients list

3. After you do the math, simply divide

the number of grams of sugar by 4 –

and ask yourself if almost 10 or more

teaspoons of sugar is really what you

want.

Teaspoon of Sugar

Here’s what carbonated soft drink

consumption – sugared and diet sodas –

looked like in 2010. Average American

chugged the equivalent of 48 two-liter bottles

and 206 12 – ounce cans of soft drinks in one

year.

A YEAR OF SODA: 44.7 GALLONS


Preventative Services

Recommended Preventative Services

Women’s Preventative Services

Health Outcomes in Wisconsin

Update on Affordable Health Care Act Preventative Benefits


QUESTIONS & ANSWERS


Arvid R. “Dick” Tillmar

Health Advocate

8820 West Cleveland Ave

West Allis, Wisconsin 53227

(414) 690-2232

Web: http://www.tillmarconnect.com/

Email: [email protected]

LinkedIn: www.linkedin.com/in/dicktillmar

THANK YOU!


http://www.tillmarconnect.com/

mailto:[email protected]

https://portal.mxlogic.com/redir/?1jKYOMqekjhOyedFTK-UMMODsS02fB0HW4EsLAEoxaNmszPRtyrLOtXTLuZXTdTdX4P92szPRty2ySAWRVsSyCyCZt4SyOMy-ztN4srjjdyVx8Qg32TSBFVEw3o6pjSsGMdPYfDwedFCQPqtSm6nQS7C3pSem1LblWV0Y

“INTELLECTUALS SOLVE

PROBLEMS, GENIUSES

PREVENT THEM.”

ALBERT EINSTEIN


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