Is there value in investing in a corporate health and wellness program in a tight economy? Stress related to job security, loss of personal wealth, and overall gloom about the future has caused many employees to be less focused at work, bring higher levels of presenteeism to the workplace and overall, less productive at a time when employers need heightened levels of productivity.

The benefits to investing in a corporate health and wellness program can be many but most notably the investment in human capital can result in:

• Mitigating catastrophic risk
• Decreased healthcare costs
• Reduced absenteeism
• Improved morale and employee productivity

Given the proven benefits, company-sponsored health and wellness programs are conceivably more important now than ever. With obesity rates on the rise and increasingly more stress than usual in the workplace and on the home-front, employee well-being is becoming more and more crucial to a company’s bottom-line.

From Kelly Sonora from MastersinHealth.com, 10 Things You Need to Know About the Healthcare Stimulus:

Barack Obama’s American Recovery and Reinvestment Act of 2009 was signed on February 17, and is already beginning to filter out funds to hopefully stimulate the economy. One of the principal goals of the package is to reform the health care system while creating jobs and insuring more Americans. Through measures to support the unemployed, integrate cutting-edge information technology systems into medical networks, and insuring more children, the act may in some way affect how you receive health care. Find out how.

- Health care industry set to go tech: One of Obama’s umbrella strategies for reforming health
care and stimulating the economy involves pumping money into health care technology
systems. He hopes to create a health information network for hospitals, rural and urban
clinics, and other health care centers by making all medical records electronic; making existing
medical technologies more accurate and effective; and reducing errors in medical care. This
technology boost to the health care system will, Obama hopes, save money, create jobs, and
improve the standards and delivery of health care and medical information. The Dallas
Business Journal reports that the stimulus package will invest $19 billion for health information
technology.
- The unemployed will still receive health care benefits, at least temporarily: Obama plans to
ease the burden of health care costs for the unemployed and reduce the number of uninsured
Americans by extending Medicaid benefits to the unemployed, at least for a time. Individuals
who get unemployment checks would also be able to receive Medicaid, as would their spouses
and children who are under the age of 19, reported the New York Times in January. States
will receive federal aid to help ease Medicaid costs. In late February 2009, TheState.com
reported that Obama “released $15 billion in economic stimulus Medicaid funds for states” to
disperse.
- Children’s Health Insurance Program Reauthorization Act of 2009: The Senate and House
reformed the Children’s Health Insurance Program under this legislation, which extends
insurance to nearly 4 million more children by reworking the Social Security Act. The program
will help families of low-income children who do not qualify for Medicaid pay for their health
insurance, and states will still be able to set their own income eligibility requirements. The
program is funded by a tax increase on cigarettes.
- Governors hold power over releasing funds: While the federal government has designed and
approved the health care stimulus package, governors are in charge of actually releasing
funds, creating eligibility requirements when appropriate, and overseeing the implementation of
the stimulus plan in their states. In late February, governors like Louisiana’s Bobby Jindal (R),
opposed many parts of the economic plan and may reject at least some of the money that is
coming to their state from the federal government. The New Orleans Times-Picayune reports
on Nola.com that Jindal will most likely accept the Medicaid supplements, but according to
Medical News Today, other governors are begrudging about accepting funds that are meant to
be used in a specific way. Instead, governors like New Hampshire Gov. John Lynch (D) are
arguing for more flexibility in how they disperse the federal funds.
- Federal government helps states fund COBRA for unemployed: The Consolidated Omnibus
Budget Reconciliation Act (COBRA) gives individuals who are laid off, retired, switching
between jobs, or have dependents at the time they stop working the option to continue their
group health benefits for a limited time. Some beneficiaries may have to pay for the group rate
insurance, however, but the U.S. Department of Labor holds that “COBRA generally requires
that group health plans sponsored by employers with 20 or more employees in the prior year
offer employees and their families the opportunity for a temporary extension of health
coverage.” Under Obama’s stimulus plan, the federal government will provide states with
subsidies to help offset the costs of COBRA. They will pay for up to 65% of COBRA
premiums “for eligible workers who are involuntarily terminated,” according to the accounting
firm Amper, Politziner and Mattia. Qualifying workers include those who have been involuntarily
terminated on and after September 1, 2008, and qualifying employers include those who are
subject to COBRA legislation, as well as small employers who are subject to State Continuation
legislation.
- Job training funding for those entering health care industry: In another measure to stimulate
the economy while improving health care standards, Obama plans to increase job training
opportunities for those entering the health care industry. The stimulus budget has allotted
$750,000,000 “for a program of competitive grants for worker training and placement in high
growth and emerging industry sectors,” $500,000,000 of which will go to renewable energy
programs. The rest will be distributed by the Secretary of Labor “giv[ing] priority to projects
that prepare workers for careers in the health care sector.”
- Preventive care takes precedent: In his address to Congress in February, Barack Obama
outlined the promised benefits of his economic stimulus benefits, highlighting the fact that the
health care reform boasts “the largest investment ever in preventive care, because that is one
of the best ways to keep our people healthy and our costs under control.” According to a
report by NPR, this move would also create jobs, at least in the short term, even if it did not
result in sustainable medical research projects, as hoped.
- A contract for accountability: In order to promote accountability in health care reform and to
make sure that all of this funding is actually helping the economy and the health care industry,
Obama’s plan includes a contract between the federal government and the Institute of
Medicine. The stimulus package outlines that the $1.5 million contract will require the Institute
to “produce and submit a report to the Congress and the Secretary [of Health and Human
Services] by not later than June 30, 2009, that includes recommendations on the national
priorities for comparative effectiveness research” that will eventually be subjected to public
commentary and review.
- Health IT dominates in all areas of medical industry: The stimulus package lists several ways in
which new health care information systems and technologies will help the facilitation of
medical care and the industry as a whole. These include the exchange of patient medical
records and a subsequent reduction in wait times at hospitals and health care facilities; the
increase of telemedicine technologies for those living in rural areas and who do not have
access to cutting edge medical resources; “technologies that help reduce medical errors;”
and “technologies that meet the needs of diverse populations.”
- Total health care stimulus cost: $150 billion: The total cost of all these (and more) health
care reforms under the American Recovery and Reinvestment Act of 2009 is $150 billion,
according to the Dallas Business Journal, including $17 billion for Medicare and Medicaid
incentive programs, $2 billion for technology grants, and $19 billion for a health information
technology.

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.

This is what I am talking about! The attached article in Progressive Grocer highlights the initiative that Kroger launched earlier this week in offering consumers free, yes, free preventive screening services.

While I realize that Kroger will reap the benefits of driving additional traffic to their store locations with such an initiative, my altruistic side likes to believe that companies like Kroger are realizing that it is going to take a collective effort to start turning our health behaviors around in this country. Now, if they would only stop stocking their shelves with cookies, ice cream, candy…we may be on to something.

Note from Mindy: In another contribution to Rewarding Health, Amy Kramer, Healthcare Sector Strategist at Maritz, addresses the correlation between hospital employee satisfaction and patient satisfaction. At Maritz, Amy provides industry expertise in the areas of healthcare and wellness and works with clients and account teams in addressing business challenges

The rising costs of healthcare our crippling our nation. Our health system is in desperate need of reform in order to help us mitigate these costs. The push for electronic records is one way that Congress is attempting to curb these costs. Technology is very much a part of the US population’s culture. From music downloads to virtual worlds where people can interact, people are adapting their lives to the changing technology that is available to them. Hospitals have also been early adapters to technology and have been some of the first segments within the healthcare industry to adopt electronic records and use this as a cost savings tool within there organizations and are seeing some great benefits. First and foremost it is much more timely and effective to communicate with patients, physicians and other healthcare personal digitally. It provides real time information from patient history, test results, prescribing medications and linking to other healthcare professionals. The use of this technology in hospitals has decreased medical errors, due to illegible handwriting and better accuracy filing prescriptions and diagnosis. It provides physicians and other hospital personnel with all the information they need about the patient they are treating without having to connect the dots. It has also streamlined the billing system and created one central database for payment. This allows hospitals to better track their financials and encourage better follow up on unpaid bills.

Congress has been talking about placing a mandate on e-records for the health industry. I still think we are a ways off from a nation wide push to e-records, but President Obama has recommended this as part of the 2009 stimulus package. Not only will e-records promote better practices in the hospitals, but this will also equate to a better patient experience and better patient care and wellness overall.

Note from Mindy: In another contribution to Rewarding Health, Amy Kramer, Healthcare Sector Strategist at Maritz, addresses the correlation between hospital employee satisfaction and patient satisfaction. At Maritz, Amy provides industry expertise in the areas of healthcare and wellness and works with clients and account teams in addressing business challenges.

Long hours, nights, weekends, holidays, strenuous physical and mental workload…such are the demands of nurses and allied health professionals. And demanding it is. As healthcare utilization continues to increase and focus on service delivery begins to take center stage, the healthcare industry is continuously looking to acquire new talent and retain their current workforce.

At current utilization rates, demand outpaces availability of these skilled professionals. In an environment of high stress and high burn-out health systems are challenged with providing enough benefits to be perceived as a profession and employer of choice. According to the American Association of Colleges of Nursing the United States could face a shortage of up to 500,000 nurses. With an aging population, the need for nurses and allied health professionals becomes even more critical to our health system.

Hospitals are initiating strategies geared at acquiring and retaining their top talent. In the past these new recruits have been tossed into new jobs with little experience and been told “sink or swim.” This has caused many new comers to the professions to leave and seek other careers thus adding to the number of vacancies in nursing and allied health.

Hospitals are now offering residency programs and flex schedules for the nursing staff and allied professionals. They are also offering training programs, mentoring programs, and recognition programs to help build confidence with new employees. These programs are driving a more supportive culture and have been proven to decrease turnover and increase employee satisfaction. They also help ease the stress in this exhaustive industry. These are just a few examples of how some hospitals are implementing retention strategies, but much more needs to be done to ensure that hospitals and healthcare systems have the necessary staff to operate and serve patients. Recognition and appreciation for the effort and skills of nursing and allied help professional is critical in this industry. Since we are amidst an aging population the demand for these professions will continue to increase hospitals need to continue to investigate opportunities to increase their retention of key staff.

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.

There was an interesting article in Health Leaders entitled A New Kind of Growth Strategy and it focused on the three strategies that hospital CEOs are taking to drive revenue growth:

- expanding outpatient services
- focusing on promising business lines
- implementing a strategic marketing campaign

Carrie Vaughan raises an interesting point regarding the fact that hospitals seem caught up in the mentality that they have to continue to be big buildings where people come when they are sick. Given the focus on prevention and wellness, I wonder if this isn’t a question that all healthcare entities should be considering - How do I change to deliver on prevention? How does my revenue growth model change to deliver on value? How do I envision my future services?

The complexity of our health system not withstanding, I try to look at the problems in healthcare more simplistically - what are root cause issues for a system that is essentially backwards. Healthcare providers ultimately develop their strategy based on how to achieve the highest amount of reimbursement. So wouldn’t it behoove us as a healthcare system to figure out a more compelling reimbursement strategy that promotes more strategic initiatives around prevention. Wouldn’t accomplishing this task open up the opportunities for hospitals, physicians, pharmacists and even pharma to begin to focus their strategies on innovative prevention methods and services? I know it won’t be easy, it never is but it is my thought for the day.

Do you know what organizations who are realizing significant success in helping their employees adopt healthier behaviors and reduce healthcare costs will tell you about the secret of their success? Health & Wellness is not a program. Health & Wellness is a movement, a cultural phenomenon, a social responsibility. It is as important to their organization as products and brands because their people are their brands, their intellectual capital is their competitive differentiator and a healthy and productive workforce is the difference between great success and mediocrity.

On a more tactical level, some other similar characteristics that I have noticed about organizations where health and wellness movements are resulting in lowering healthcare costs and healthier, happier employees are:
• The dots are connected: not only are the health management services, communications and incentives integrated but wellness is built into an organization’s performance culture.
• Walk the walk and talk the talk: executive leadership and the rest of management is setting the example and tone in leading the wellness movement with passion and vigor.
• Social networking is not just for Facebook: organizations are using the concept of social networking to engage and provide peer support to employees in order to add the “fun” factor into adopting healthy behaviors.
• Tell them once, twice, three times and then tell them again: frequent, unique and robust communications are used intermittently to refocus attention on the wellness movement

We see these gold standard organizations setting the stage for successful wellness movements. What is your organization doing to move wellness from a corporate program to the cultural movement it needs to be?