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Workplace Wellness
in the Age of Healthcare Reform

Barry Hall, FSA

National Healthcare Reform Conference
Los Angeles
September 21, 2010
Health Care Reform Supports Wellness

                        • Calories to be posted in
                          chain (>20) restaurants                                           • Health status-based
                        • Preventive screening co-                                            incentives may rise
                          pays waived for employer          National report on                from current 20% to
Nursing mother            plans* and for Medicare           effectiveness of                  30%, and later, to 50%*
break time and          • Wellness program grants           wellness programs               • Wellness program
accommodations            to small businesses (<100         (after periodic surveys           demonstration
required                  EEs) for wellness programs        and research)                     project in 10 states



     2010                2011                 2012                2013                 2014
                                             National health promotion plan

                                Childhood obesity demonstration project grants

                                Workplace health promotion effectiveness research
                               (plan sponsor tax of $1 per year per member, rising to $2)


                 The “law of the land” says health is not just about
                  reactive “sick care” – engagement is required.

      * Applies to non-grandfathered plans

 1
4th Annual Global Wellness Survey

    Objective:
    • Assess trends in employer-sponsored
      wellness strategies and practices

    Participants:
    •   1,245 participating employers
    •   47 countries
    •   15 million employees
    •   All industry categories
    Reports:
    • Global survey report
    • Executive summary in 8 languages
    • To be released in October 2010
                                            www.BuckSurveys.com




2
Workplace wellness is:

    • Global

    • Growing rapidly

    • Becoming a business imperative




3
Location of Employees



    Africa/Middle East                                         19%

    Asia                                                                       33 %


    Australia                                               16 %

    Europe                                                                       34 %

    North America                                                                                         62%

    Latin America                                                                35 %




                         Preliminary (pre-publication) results from 2010 Global Health Promotion Survey

4
Global Prevalence of Health Promotion Programs




               Preliminary (pre-publication) results from 2010 Global Health Promotion Survey

5
Globalization of Strategy


                      STRATEGY IS GLOBAL*
                          (MULTINATIONAL EMPLOYERS)




                     No
                    46%                                                   Yes
                                                                          54%




               * Covers majority of employees regardless of geography




                Preliminary (pre-publication) results from 2010 Global Health Promotion Survey

6
Status of Wellness Strategy


    NUMBER OF YEARS WELLNESS STRATEGY HAS BEEN IN PLACE

    0 - 1 year                              13%

    2 - 5 years                                                                               53%

    5 - 10 years                                16%

    More than 10 years                        14%

    Don’t know                  3%




                         Preliminary (pre-publication) results from 2010 Global Health Promotion Survey

7
Employer Objectives Driving Wellness Strategy
                                Africa/                                                                           Latin    United
                               Mid East            Asia          Australia         Canada            Europe      America   States
Productivity/Presenteeism            2                5                4                1                    1     1         2
Morale/Engagement                    1                2                2                3                    2     2         4
Absence                              5                6                3                2                    4     7         3
Workplace safety                     2                4                1                 6                   6     3         6
Work ability                         4                1                5                 4                   5     4         7
Org. values/mission                  5                3                8                 7                   3     5         5
Attract and retain                   8                8                7                 8                   7     8         8
Promote image/brand                  7                7                6                 9               10        10        9
Health care costs                   11               11               10                 5               11        11        1
Social responsibility                9                9                9               10                    9     6        10
Comply with legislation              9               10               11                11                   8     9        11
Supplement gov't care               12               12               12               12                12        12       12

                            Preliminary (pre-publication) results from 2010 Global Health Promotion Survey

  8
Cost Burden of Chronic Disease


                                                                                                         Direct Costs:
                                                                                                             Health Care
                                                                                     20%


                                                          80%
    Indirect Costs:
    Productivity Loss



    Source: DeVol R, Bedroussian A, et al., An Unhealthy America: The Economic Burden of Chronic Disease. The Milken Institute. Oct. 2007.




9
Health Issues Driving Wellness Strategy
                              Africa/                                                                          Latin    United
                             Mid East           Asia          Australia          Canada            Europe     America   States
Stress                            1                1                 1                 1                1       2         6
Physical activity/exercise        4                3                 3                 3                2       1         1
Nutrition/healthy eating          4                7                 1                 5                5       3         2
Work/life issues                  4                2                 3                 2                3       12        10
High blood pressure               4               10                10                 8                10       4        5
Chronic disease                   2                9                 9                 7                13       5        3
Workplace safety                  9                4                 6                 6                4        6        11
Depression/anxiety                8               13                 7                 4                7        9        9
High cholesterol                 12               11                11                 9                12       7        7
Tobacco use/smoking              11                5                13                11                8       10        8
Psychosocial work envir.         10                8                14                12                6        8        15
Obesity                          15               14                 8                14                14      11        4
Sleep/fatigue                    16               12                 5                 9                11      14        14
Personal safety                  13                6                12                13                9       13        13
Infectious diseases (HIV)         3               17                16                17                18      16        17
Maternity/newborn health         18               15                18                16                16      15        12
Substance abuse                  14               18                15                15                15      18        16
Public sanitation                17               16                17                18                17      17        18

                             Preliminary (pre-publication) results from 2010 Global Health Promotion Survey

10
Key Challenges:

     • Motivating/engaging employees

     • Measuring impact

     • Fostering a “culture of health”




11
Prevalence of Incentive Rewards (or Penalties)

                                                                             Incentive rewards offered today
                                                                             Not offered today, but have plans to offer
                                                                             No plans to offer


     United States          62 %                                                                        25%               13%

     Asia                   42 %                                                19%                                       39%

     Canada                 41 %                                                     30%                                  28%

     Africa/Mid East        34 %                                          24 %                                            41%

     Australia              29 %                                    24 %                                                  47%

     Europe                 25 %                         11 %                                                             63%

     Latin America          16%                               38%                                                         46%

                        0%                   20%                    40%                   60%                 80%           100 %




                       Preliminary (pre-publication) results from 2010 Global Health Promotion Survey

12
Do Incentives Work?


          EFFECTIVENESS OF INCENTIVE REWARDS AT INFLUENCING
              BEHAVIORAL CHANGES AMONG EMPLOYEES

                                              33%



                                                                     24%                                   20%

                       15%

          4%                                                                                 4%


       Extremely    Significantly         Moderately              Minimally            Not effective     Don’t know
        Effective     Effective            Effective              Effective
           5              4                      3                      2                      1



                        Preliminary (pre-publication) results from 2010 Global Health Promotion Survey

13
Measurement and Outcomes




               Preliminary (pre-publication) results from 2010 Global Health Promotion Survey

14
Measurement and Outcomes



     REASONS OUTCOMES ARE NOT MEASURED

     Insufficient resources to support measurement                                                                    59 %

     Don’t know how to measure                                                                                  36%

     No priority from leadership                                                                               33%

     Don’t believe there is a measurable return                                     13%

     Don’t believe the cost of measurement is justified                        9%




                              Preliminary (pre-publication) results from 2010 Global Health Promotion Survey

15
Healthcare Cost Trend Impact
     REDUCTION IN HEALTH CARE TREND RATE – U.S. EMPLOYERS

                                                    Yes
                                                    18%


      Don't know
         60 %                                          No
                                                       22%




     AVERAGE ANNUAL REDUCTION IN HEALTH CARE TREND RATE – U.S. EMPLOYERS

     More than 10 trend percentage points per year          2%

     6-10 trend percentage points per year                           10 %

     2-5 trend percentage points per year                                                                      61%

     1 or less trend percentage points per year                                         28 %




                              Preliminary (pre-publication) results from 2010 Global Health Promotion Survey

16
Building a “Culture of Health”

            EXTENT TO WHICH THE
        ORGANIZATION CURRENTLY HAS A
             CULTURE OF HEALTH


                      37%
                23%         22%                        EXTENT TO WHICH THE
      10%                            8%
                                                   ORGANIZATION PLANS TO PURSUE A
                                                     CULTURE OF HEALTH FOR THE
                                                             FUTURE
     5 = Very    4     3     2    1 = Not at
     much so                          All       54%

                                                          27%
         33%                                                    12%
                                                                      6%      1%

                                                 5=        4     3    2    1 = Not at
                                               Actively                        All
                                               pursue


                                                     81%


17
Thank You!




 Barry Hall, FSA
 +1.617.275.8033
 Barry.Hall@BuckConsultants.com

 www.bucksurveys.com
 www.buckconsultants.com

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Workplace Wellness in the Age of Healthcare Reform

  • 1. Workplace Wellness in the Age of Healthcare Reform Barry Hall, FSA National Healthcare Reform Conference Los Angeles September 21, 2010
  • 2. Health Care Reform Supports Wellness • Calories to be posted in chain (>20) restaurants • Health status-based • Preventive screening co- incentives may rise pays waived for employer National report on from current 20% to Nursing mother plans* and for Medicare effectiveness of 30%, and later, to 50%* break time and • Wellness program grants wellness programs • Wellness program accommodations to small businesses (<100 (after periodic surveys demonstration required EEs) for wellness programs and research) project in 10 states 2010 2011 2012 2013 2014 National health promotion plan Childhood obesity demonstration project grants Workplace health promotion effectiveness research (plan sponsor tax of $1 per year per member, rising to $2) The “law of the land” says health is not just about reactive “sick care” – engagement is required. * Applies to non-grandfathered plans 1
  • 3. 4th Annual Global Wellness Survey Objective: • Assess trends in employer-sponsored wellness strategies and practices Participants: • 1,245 participating employers • 47 countries • 15 million employees • All industry categories Reports: • Global survey report • Executive summary in 8 languages • To be released in October 2010 www.BuckSurveys.com 2
  • 4. Workplace wellness is: • Global • Growing rapidly • Becoming a business imperative 3
  • 5. Location of Employees Africa/Middle East 19% Asia 33 % Australia 16 % Europe 34 % North America 62% Latin America 35 % Preliminary (pre-publication) results from 2010 Global Health Promotion Survey 4
  • 6. Global Prevalence of Health Promotion Programs Preliminary (pre-publication) results from 2010 Global Health Promotion Survey 5
  • 7. Globalization of Strategy STRATEGY IS GLOBAL* (MULTINATIONAL EMPLOYERS) No 46% Yes 54% * Covers majority of employees regardless of geography Preliminary (pre-publication) results from 2010 Global Health Promotion Survey 6
  • 8. Status of Wellness Strategy NUMBER OF YEARS WELLNESS STRATEGY HAS BEEN IN PLACE 0 - 1 year 13% 2 - 5 years 53% 5 - 10 years 16% More than 10 years 14% Don’t know 3% Preliminary (pre-publication) results from 2010 Global Health Promotion Survey 7
  • 9. Employer Objectives Driving Wellness Strategy Africa/ Latin United Mid East Asia Australia Canada Europe America States Productivity/Presenteeism 2 5 4 1 1 1 2 Morale/Engagement 1 2 2 3 2 2 4 Absence 5 6 3 2 4 7 3 Workplace safety 2 4 1 6 6 3 6 Work ability 4 1 5 4 5 4 7 Org. values/mission 5 3 8 7 3 5 5 Attract and retain 8 8 7 8 7 8 8 Promote image/brand 7 7 6 9 10 10 9 Health care costs 11 11 10 5 11 11 1 Social responsibility 9 9 9 10 9 6 10 Comply with legislation 9 10 11 11 8 9 11 Supplement gov't care 12 12 12 12 12 12 12 Preliminary (pre-publication) results from 2010 Global Health Promotion Survey 8
  • 10. Cost Burden of Chronic Disease Direct Costs: Health Care 20% 80% Indirect Costs: Productivity Loss Source: DeVol R, Bedroussian A, et al., An Unhealthy America: The Economic Burden of Chronic Disease. The Milken Institute. Oct. 2007. 9
  • 11. Health Issues Driving Wellness Strategy Africa/ Latin United Mid East Asia Australia Canada Europe America States Stress 1 1 1 1 1 2 6 Physical activity/exercise 4 3 3 3 2 1 1 Nutrition/healthy eating 4 7 1 5 5 3 2 Work/life issues 4 2 3 2 3 12 10 High blood pressure 4 10 10 8 10 4 5 Chronic disease 2 9 9 7 13 5 3 Workplace safety 9 4 6 6 4 6 11 Depression/anxiety 8 13 7 4 7 9 9 High cholesterol 12 11 11 9 12 7 7 Tobacco use/smoking 11 5 13 11 8 10 8 Psychosocial work envir. 10 8 14 12 6 8 15 Obesity 15 14 8 14 14 11 4 Sleep/fatigue 16 12 5 9 11 14 14 Personal safety 13 6 12 13 9 13 13 Infectious diseases (HIV) 3 17 16 17 18 16 17 Maternity/newborn health 18 15 18 16 16 15 12 Substance abuse 14 18 15 15 15 18 16 Public sanitation 17 16 17 18 17 17 18 Preliminary (pre-publication) results from 2010 Global Health Promotion Survey 10
  • 12. Key Challenges: • Motivating/engaging employees • Measuring impact • Fostering a “culture of health” 11
  • 13. Prevalence of Incentive Rewards (or Penalties) Incentive rewards offered today Not offered today, but have plans to offer No plans to offer United States 62 % 25% 13% Asia 42 % 19% 39% Canada 41 % 30% 28% Africa/Mid East 34 % 24 % 41% Australia 29 % 24 % 47% Europe 25 % 11 % 63% Latin America 16% 38% 46% 0% 20% 40% 60% 80% 100 % Preliminary (pre-publication) results from 2010 Global Health Promotion Survey 12
  • 14. Do Incentives Work? EFFECTIVENESS OF INCENTIVE REWARDS AT INFLUENCING BEHAVIORAL CHANGES AMONG EMPLOYEES 33% 24% 20% 15% 4% 4% Extremely Significantly Moderately Minimally Not effective Don’t know Effective Effective Effective Effective 5 4 3 2 1 Preliminary (pre-publication) results from 2010 Global Health Promotion Survey 13
  • 15. Measurement and Outcomes Preliminary (pre-publication) results from 2010 Global Health Promotion Survey 14
  • 16. Measurement and Outcomes REASONS OUTCOMES ARE NOT MEASURED Insufficient resources to support measurement 59 % Don’t know how to measure 36% No priority from leadership 33% Don’t believe there is a measurable return 13% Don’t believe the cost of measurement is justified 9% Preliminary (pre-publication) results from 2010 Global Health Promotion Survey 15
  • 17. Healthcare Cost Trend Impact REDUCTION IN HEALTH CARE TREND RATE – U.S. EMPLOYERS Yes 18% Don't know 60 % No 22% AVERAGE ANNUAL REDUCTION IN HEALTH CARE TREND RATE – U.S. EMPLOYERS More than 10 trend percentage points per year 2% 6-10 trend percentage points per year 10 % 2-5 trend percentage points per year 61% 1 or less trend percentage points per year 28 % Preliminary (pre-publication) results from 2010 Global Health Promotion Survey 16
  • 18. Building a “Culture of Health” EXTENT TO WHICH THE ORGANIZATION CURRENTLY HAS A CULTURE OF HEALTH 37% 23% 22% EXTENT TO WHICH THE 10% 8% ORGANIZATION PLANS TO PURSUE A CULTURE OF HEALTH FOR THE FUTURE 5 = Very 4 3 2 1 = Not at much so All 54% 27% 33% 12% 6% 1% 5= 4 3 2 1 = Not at Actively All pursue 81% 17
  • 19. Thank You! Barry Hall, FSA +1.617.275.8033 Barry.Hall@BuckConsultants.com www.bucksurveys.com www.buckconsultants.com