What is a Comprehensive Workplace Health Management Program? with George Pfeiffer

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DESIGNING A
COMPHREHENSIVE HEALTH
PROMOTION PROGRAMGEORGE J PFEIFFER, MSE, FAWHP
PRESIDENT, THE WORKCARE GROUP, INC.
georgeworkcare@earthlink.net

+ 1Designing a Comprehensive Worksite Health
Promotion Program
 Understand the value and need of having an integrated,
comprehensive approach to employee health promotion.
 Identify common elements/practices for designing a
comprehensive worksite health promotion program.
 Identify common practices using a national accreditation model.
LEARNING OBJECTIVES

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Designing a Comprehensive Worksite Health
Promotion Program
 Only 24% of large companies (>750) have a comprehensive
program as defined by the 2004 National Worksite Health
Promotion Survey:
• Health education
• Integration
• Linkage with other programs
• Supportive social and physical environment
• Worksite screening
DID YOU KNOW?

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National Worksite Health Promotion Survey: 2004
 Total Companies 6.9%
 50-99 employees 4.6%
 100-249 employees 6.0%
 250-749 employees 11.3%
 >750 employees 24.1%
Source: Linnan L, Bowling M, Childress J, Lindsay G, Blakey C, Pronk S, Wieker S, Royall P. Results of the 2004 national worksite health
promotion survey. American Journal of Public Health. 2008;98(8):1503-1509.9
Companies Implementing All Five Elements

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National Worksite Health Promotion Survey: 2004
 41.3% of all companies linked their health programming to related
programs.
 29.9% offered supportive social and physical environments.
 28.6% integrated their programming into the organizational
structure.
 26.2% provided health education.
 23.5% provided worksite screenings.
Source: Linnan L, Bowling M, Childress J, Lindsay G, Blakey C, Pronk S, Wieker S, Royall P. Results of the 2004 national worksite health
promotion survey. American Journal of Public Health. 2008;98(8):1503-1509.9
Companies Implementing
Specific Elements

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Promotion Program
 An integrated, comprehensive model to employee health
management addresses an organization’s entire population:
• disregards risk status.
• facilitates positive risk migration (e.g., medium/high to low).
• represents a sustainable health management/well-being
strategy.
• encourages and facilitates a cross-functional approach to
program planning and management.
VALUE PROPOSITION

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Designing a Comprehensive Worksite Health Promotion Program
 *$6,000 per employee
Direct Medical Costs
Estimated Total Costs $18,000
PEPY
Sources: Loeppke, et.al., JOEM, 2003; 45:349-359 and Brady, et al, JOEM, 1997; 39:224-231
DIRECT COSTS RELATED TO INDIRECT COSTS
■ Estimated
$12,000 per
Employee
Medically Related
Productivity Costs
Presenteeism
Absenteeism
Short-term Disability
Long-term Disability

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Promotion Program
CHANGE OF COSTS RELATED TO CHANGE IN RISKS

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Promotion Program
Goals
 Keep
employees
healthy
 Avoid
migration
to higher
risk levels
Goals
 Identify risk
factors early
 Target risks with
appropriate
interventions
Goals
 Provide
appropriate
treatment with
the greatest
benefit at the
least risk and
cost
 Improve
treatment
compliance/
adherence
Goals
 Assess
outcomes
 Reassess total
health needs
Goals
 Improve
decision-making
skills regarding
care options
 Improve
provider/patient
communication
Pfeiffer, GJ. Stages of the continuum of care. WorkSET Program. 2008.
Goals
 Keep employees
healthy
 Avoid migration
to higher risk
levels

Promotion Program
 Identifying strengths, weaknesses, and gaps along continuum
• Review existing program components against continuum.
• Identify what needs to be fixed.
• What needs to be added/eliminated?
• “Low hanging fruit”?
FIRST STEP: HOW BALANCED ARE YOUR
OFFERINGS?

Promotion Program
■ What needs to be done before implementing your new plan?
• Do you need more data?
• Do you need to change your goals/objectives?
• Do you need additional resources?
• Do you need to change your staffing/contracts?
FIRST STEP: HOW BALANCED ARE YOUR
OFFERINGS?

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Promotion Program
Goals
 Keep
employees
healthy
 Avoid
migration
to higher
risk levels
Goals
■ Identify risk
factors early
■ Target risks with
appropriate
interventions
Goals
■ Provide
appropriate
treatment with
the greatest
benefit at the
least risk and
cost
■ Improve
treatment
compliance/
adherence
Goals
■ Assess
outcomes
■ Reassess total
health needs
Goals
■ Improve
decision-making
skills regarding
care options
■ Improve
provider/patient
communication
Pfeiffer, GJ. Stages of the continuum of care. WorkSET Program. 2008.
Goals
■ Keep
employees
healthy
■ Avoid migration
to higher risk
levels

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Designing a Comprehensive Worksite Health Promotion Program
Program/Practice Models

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Promotion Program
1. Align features and incentives with the organization’s core mission,
goals, operations, and administrative structures.
2. Operate at multiple levels.
3. Target the most important health care issues.
4. Tailor components to needs of individuals.
5. Achieve high rates of engagement and participation.
6. Achieve successful health outcomes.
7. Evaluate—scorecards and metrics.
Adapted from: Goetzel RZ, Shechter D, Ozminkowski RJ, et al. Promising practices in employer health and
productivity management efforts: findings from a benchmarking study. J Occup Environ Med. 2007;49:111–130.
“PROMISING PRACTICES”

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Level 4 – Special Needs
Disease management, EAP, behavior
health, health concierge, prenatal
education, work hardening, ergonomics
Level 3 – Risk Reduction
Targeted interventions, health coaching,
risk specific online & print applications,
topic specific workshops/support groups
Level 2 – Risk Avoidance/Well-being
Screenings, HRA’s, health coaching,
benefit education, online resources,
benefit education, self-care
Level 1 – Organizational Readiness and
Engagement
Business alignment, total leadership
support, benefit design, policies,
environmental supports, incentives
Pfeiffer, GJ. Worksite Health International. 2011
Special
Needs
Risk
Reduction
Risk Avoidance/
Well-being
Organizational Readiness &
Support

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US Healthiest HealthLead™
Workplace Accreditation Program
15

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Copyright 2012 Alliance to
Make US Healthiest
: Business Sustainability Model? on
Places of Work
Business Sustainability

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Medal Criteria Based on
Comprehensiveness and Impact™
Planned

Promotion Program
■ Organizational Engagement and Alignment
■ Population Health Management and Well-being
■ Outcomes Reporting
© US Healthiest/HealthLead™ 2010. All rights reserved
US HEALTHIEST HEALTHLEAD™ HEALTHIEST
WORKPLACE ACCREDITATION PROGRAM

+ 19Designing a Comprehensive Worksite Health Promotion Program
 Business Alignment
 Leadership Alignment
 Data Alignment
 Policy Alignment
 Employee Benefits Alignment
 Environmental Alignment
 Communications Alignment
 Administrative/Operations Alignment
Organizational Engagement and Alignment

 Business Alignment
 Is your program aligned with your organization’s business goals?
 Specific mission statement and related goals/objectives?
 Leadership Alignment
 “C-Suite”/Senior leadership?
 Middle-management/Supervisory
 Lay-leadership
 Wellness committees?

 Data Management Alignment
 Data sources aligned with defined goals/objectives?
 Standard collection/evaluation processes?
 Dashboard?
 Policy Alignment
 Tobacco-free, vending?
 Policies that reduce access/cost barriers?
 Physical activity
 On/off the clock
 Flex-time

 Employee Benefits Alignment
 Affordable healthcare?
 Value-based benefit design?
 Incentive programs?
 Well-being: personal leave, education, financial health, retirement?
 Environmental Alignment
 Physical activity?
 Nutrition?
 Ergonomics?
 Lactation rooms?

Promotion Program
 Communications Alignment
 Branding?
 Know leverage formal/informal networks
 Health literacy?
 Multiple media/channels?
 Administrative/Operations Alignment
 Dedicated staff?
 Wellness committee?
 Performance standards internal/external?
 Quality control?

Promotion Program
 Primary Prevention and Health Maintenance
 Risk Factor Intervention/Modification
 Decision Support/Medical Management
 Well-being and Information Support Services
 Work Safety
 Community Engagement
Population Health Management/Well-being

Promotion Program
 Primary Prevention and Health Maintenance
 Health risk assessment/biometrics?
 Lifestyle and well-being management?
 Incentives?
 Safety?
 Risk Factor Intervention/Modification
 Risk identification/targeting?
 Personalized programming?
 Incentives?

Promotion Program
 Decision Support/Medical Management
 Health benefit support?
 Health literacy?
 Medical consumerism/self-care?
 Disease management?
 Well-being and Information Support Services
 Resiliency?
 Work/life balance information and support
 EAP
 Continuing education?

Promotion Program
 Work Safety
 Culture of safety—job/personal?
 Compliance with federal/local safety regulations?
 Ongoing education/cross-training wellness?
 Community Engagement
 Leverage community resources?
 Engaged in health-related issues?
 Support employee volunteerism?
 “Leading by Example”—locally, nationally, internationally?

Promotion Program
 Process Outcomes
 Risk Outcomes
 Clinical Outcomes
 Financial Outcomes
Outcomes Reporting

Promotion Program
What percentage of your population:
 Eligible?
 Complete HRA?
 Complete biometric screening?
 Know your program by name/logo?
Outcomes Reporting/Process Outcomes

Promotion Program
 Are considered low-risk?
 Continue to be low-risk after second HRA?
 Are engaged in targeted risk interventions?
Outcomes Reporting/Risk Outcomes

Promotion Program
 Comply with preventive screenings?
 Medication adherence for leading chronic conditions?
 Comply with minimum health measures regarding:
 Activity, BMI, Fruits/Vegetables, Tobacco Free, Alcohol?
Outcomes Reporting/Clinical Outcomes

Promotion Program
What is your organization’s three-year trend:
 Direct medical costs?
 Medical-related sick-days?
 Short-term disability?
 Workers compensation?
Outcomes Reporting/Financial Outcomes

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Promotion Program
 We address our entire population.
 We address all levels of risk.
 We address the “total worker.”
 We have a “total leadership” model.
 We work cross-functionally.
 Our program is aligned with our business:
mission, goals, and objectives.
CHECKLIST

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Promotion Program
 We attempt to integrate our services and
data rather than segmenting our services.
 We align policies, benefits, and
environmental supports.
 We continually communicate.
 We try to identify and reduce barriers to
participation and engagement.
 We provide meaningful data to our key
stakeholders.
CHECKLIST

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Further Information
 www.ushealthiest.org

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What is a Comprehensive Workplace Health Management Program? with George Pfeiffer