To date much of the discussion around health reform has been focused on cost containment, IT and the delivery system but little has been mentioned about a key pillar in President Obama’s health reform initiative, the pillar of wellness and prevention. Today, wellness and prevention took front and center stage in the dialog that President Obama continues to have with the public, employers and other stakeholders regarding the national imperative for health reform.

What does President Obama’s announcement mean for preventive health? Like much of the initial dialog around health reform, I think that this is the beginning of reframing the discussion around individual accountability and the health system’s responsibility to lead the effort in educating and motivating critical behavior change. If the goal of the health reform effort is ultimately to bend the cost curve, through efficiency and inclusion of all into a system the root cause of cost escalation needs to be addressed. While I may be oversimplifying this, evidence continues to mount that individual health habits and behaviors are associated with a significant portion of preventable healthcare conditions and now is the time to address a root cause of healthcare costs - change health behaviors.

What I found interesting today is that employers who have successfully managed to contain their healthcare costs such as Pitney Bowes, Safeway and J&J have done so through effectively building an integrated wellness culture. In addition to experimenting with various benefit coverage and designs, these organizations actively talk, treat and reward their employess for personal health accountability. The organizations that President Obama mentioned today have some other fundamental elements that are critical to their success in developing a wellness culture. Their program elements are integrated, tied to a performance culture and include the recognition that incentives, rewards and continuous awareness and dialog with their employees enables the emotional connectivity that ultimately leads to individual engagement. These companies have proven that it is possible to lower costs through a focused effort on health and wellness. These companies have proven that an integrated health and wellness solution that truly engages individuals ultimately leads to increased productivity and a return on investment. Isn’t it time that we all begin to take a page from their playbook?

Several weeks ago my company presented a webinar on Health and Productivity Strategy with an emphasis on the “motivation” factor, truly rewiring the brain to change behavior. Since last week I have had numerous conversations with audience members on our Whole Brain Philosophy and the need to strategically integrate wellness rewards with strong communications, social networks and gaming in order to truly engage individuals in the behavioral change progression. The discussions have centered around Maritz framework of focus-repetition and reinforcement to rewire the brain.

Some very enlightening observations have come out of those conversations such as:
- There are opportunities to better integrate health management services with stronger motivation strategies to fully derive the benefits of your health and productivity investment.
- A critical component seems to be lacking in most health and productivity programs - communication.
- Health incentives are being used but not as strategically as they could in order to reinforce new behavior adoption
- Understanding your population in terms of ensuring appropriate rewards options, health support services and communication support is not happening

The result of this is disjointed health and wellness programs that are not really promoting behavior change. The one issue that continues to stand out to me as a challenge for organizations is in communications. I continue to see programs that front load the communications about health and wellness benefits during open enrollment but there are little to no communications pulsed throughout the year to keep the health and wellness program top of mind. The focus on the program is non-existent. The other ramification of not communicating throughout the year is that employers are missing an opportunity to recognize how their employees are doing with their wellness goals. The repetition and reinforcement are virtually non-existent.

The net-net in all of this is that in thinking about your wellness program, it is very easy to focus on the health services piece and then the incentive strategy but the importance of a robust communication strategy can’t be overlooked as a critical success factor.

I recently read a whitepaper by Hummingbird Health entitled Why Wellness Programs Fail and it got me to thinking about some additional observations I would make on why programs are not optimized as they should be. The whitepaper highlights some key failure points that are consistent with what I see when helping clients assess why their program isn’t delivering the results expected.

- The wellness movement has to start at the top. Executive management needs to embrace wellness as a business imperative not a “nice to have” and they need to live to that mission.
- Know the demographics of the workforce. Demographics are one key data point that help in disseminating the appropriate communications and rewards but I would suggest going a step further in taking the pulse of your population and their readiness for change. Understand what they expect, prefer and what types of tools, communications and rewards may actually engage them in the collective process of adopting healthier behaviors.
- Serving all employees. Understand the health of your workplace. Sounds easy enough but I am continually amazed at how difficult that is for organizations.
- Lack of communication. This is probably the single biggest reason that I would say wellness programs fail. There is not enough budget or emphasis given to the importance of communication either in content or frequency. Effective communication continues to reinforce attention on the wellness movement and it answers five key questions that employees continue to have: 1) what do you want them to do 2) why do you want them to do it 3) how do you want them to do it 4) what’s in it for them and 5) how are they doing.
- Scrimping on costs – spend money to save money on healthcare costs. I couldn’t agree more on this finding. Too often an organization tries to cast too broad a net and spreads investment dollars too thin with the result being a rather disjointed and haphazard program with very little strength to drive change. Make the most of those investment dollars and focus them on a couple of objectives with the idea that you can always phase in more services and interventions after the wellness movement picks up momentum.
- Goals – make them measurable. Begin with the end state in mind. What will be your measure of success in your wellness movement?
- Know the bottom line. Understand the impact of your workforce’s health on corporate productivity, value and profitability. At Maritz we call it the lifetime value of an employee.

Creating a wellness movement in an organization takes time, resources and investment. The last thing that you want is for it to fail. Taking some of these observations to heart may help in mitigating the risk of failure.

Last week my company presented a webinar on Health and Productivity Strategy with an emphasis on the “motivation” factor or what it takes to truly rewire the brain to change behavior. Since then, I have had numerous conversations with audience members on our Whole Brain Philosophy and the need to strategically integrate wellness rewards with strong communications, social networks and gaming in order to truly engage individuals in the behavioral change progression. The discussions have centered around Maritz framework of focus, repetition and reinforcement in order to rewire the brain.

Some very enlightening observations have come out of those conversations such as:
- There are opportunities to better integrate health management services with stronger motivation strategies to fully derive the benefits of your health and productivity investment.
- A critical component seems to be lacking in most health and productivity programs - communication.
- Health incentives are being used but not as strategically as they could in order to reinforce new behavior adoption
- Understanding your population in terms of ensuring appropriate rewards options, health support services and communication support is just not happening

The result of this is disjointed health and wellness programs that are not really promoting behavior change. The one issue that continues to stand out to me as a challenge for organizations is in communications. I continue to see programs that front load the communications about health and wellness benefits during open enrollment but there are little to no communications pulsed throughout the year to keep the health and wellness program top of mind. The focus on the program is non-existent. The other ramification of not communicating throughout the year is that employers are missing an opportunity to recognize how their employees are doing with their wellness goals. The repetition and reinforcement are virtually non-existent.

In thinking about your wellness program, it is very easy to focus on the health services piece and then the incentive strategy but the importance of a robust communication strategy can’t be overlooked as a critical success factor.

Following my last post I have a few more thoughts on segmentation and the impact it has on driving successful health and wellness incentive and communication programs.

In order to be of value, segments must be:

1) Identifiable: distinctly different on measurable variables
2) Substantial: large enough to matter
3) Accessible: reachable through a variety of communication channels
4) Stable: persist over time
5) Responsive: respond to efforts aimed at them
6) Actionable: differences are able to guide communication and reward strategies

In my last post I spoke briefly about the fact that organizations tend to use the health status pyramid or grid (see below) as a starting point for a segmentation strategy.

However, another method of beginning a segmentation strategy could be based on current and potential value of a participant in a specific health and wellness track.

The segmentation strategy sets the framework for whom, how and what the organization wants to communicate and reward. Essentially, segmenting a wellness participant population into more finite segments will enable an organization to better understand 1) how to engage their members, 2) direct the appropriate health management efforts, 3) identify which rewards will have the greatest impact on that population and 4) determine how to make communications more meaningful.