What comes to your mind when you hear the term “employee health and wellness?” For me and many employers that I speak with, this term brings to mind the long history of engaging with health and wellness partners who have promised to deliver improved health to an employee population.
I can recall the large number of health and wellness solutions that were founded on good, solid health principles that, in theory, should have achieved measurable results of lower claim costs, more productive employees, and human resources looking like a star for implementing the program. Unfortunately many of us have lived through the excitement of engaging with a new vendor solution just to find that lack of engagement and poor results are what laid at the end of the rainbow.
But does it have to be that way?
I’m a believer in wellness, the healthy employee, and solid health principles. I’m also a believer in data and tracking the right things.
In some cases it may be difficult or even nearly impossible to demonstrate short-term results that would be better derived through longer term cohort analysis, statistical overviews, and years of evaluation. To that point, there is a way. They are called “Guideposts.” Guideposts are the indicators that shine within the data and can tell us whether or not we are on the right path. They are critical and particularly valuable when we’re trying to measure the health of a population.
First the Framework
First things first (as my grandmother used to tell me). We need to have a method to get at that data easily and quickly and define clear profiles of our employees.
1. Dynamic Data Dashboards are Imperative
What are your data sources for employee data? Do they include employee information and health data? I find that some organizations have access to their employee data and use it, others have access and don’t use it, and then there are many who simply do not have great access.
The only way to “get into” your employee data is to have a system that is current, easy to manipulate and accessible.
I’ve found that organizations approach this in one of two ways:
- Have dedicated talent who can incorporate the data using business intelligence software such as Tableau, or
- Engage with one of the data analytic tool vendors that will provide you with de-identified data and supportive dashboards.
Either way, we need to be able to create a system of ease and access.
2. Sub-Profiles of your Employee Populations (plural) is Key
Nearly all organizations have different groups of employees or sub-profiles. These sub-profiles can be described by age group, type of work, geographic location, medical plan enrollment, top diagnoses, etc. Understanding the different types of employee groups or sub-profiles that we have within our populations, provides an overview of “who’s here.” This is found to be a more strategic approach than simply fitting all of our employees into one big bucket instead of recognizing that each sub-profile needs a little something different.
Clear Sight in Execution
The junction of having accessible employee data and detailed sub-profiles on the employee population, makes it tremendously easy to employ a health and wellness strategy and engage the best vendors to support that strategy. In my opinion, it is the cornerstone to a successful health and wellness strategy. We can more accurately determine the problems we wish to tackle and predict the immediate and long-term results that we expect to see. Now on to the guideposts…
Guidepost #1 – Expected Health Data
This reminds me of our dynamic phone maps that tell us we should expect to see a gas station, store or favorite coffee spot, as we travel to our destination. Expected health data is very similar. We can often expect to see certain movement with specific health or employee data elements as we move forward with a new health / wellness vendor solution. What is it that we expect to change in that sub-profile once they engage with this new solution?
An example I’ve seen is a company pay for bariatric surgery to those who have both an obesity and type 2 diabetes diagnosis. The employer may not be able to track an employee’s weight loss however there is the ability to track reductions in diabetic supplies and drugs. The diabetic supplies and drugs are the guideposts. In this instance, you can see that an impact is being made and even begin to quantify that impact in your annual budgeting.
Guidepost #2 – Engagement Upticks
One of the most difficult tasks as an employer is to get employees interested and excited about a new health / wellness solution. We may have a proven communication strategy that we use or perhaps we get lucky because the moon and the stars aligned that day. At any rate, tracking upticks and attempting to define their existence is a good use of our time. I would expect that this data is tracked regularly and especially after planned communication is distributed.
I talked to an employer who had primarily been using email for communication. They switched to their internal Slack channel and engagement in their wellness program increased. Funny thing is that initially they did not even notice that was happening. Regularly reviewing this data keeps us from missing those surprises and allows us to capitalize quickly.
Guidepost #3 – Unexpected Results
Unexpected results may be the most important guidepost. What I find most fun and interesting about the unexpected results that will emerge is that they tell us 3 things:
- They tell us something about the type of employee who is really connecting with the program. Perhaps it’s a different sub-profile than we expected or it’s more sub-profiles than expected.
- They tell us that our solution produced a broader impact than expected. Those who have bariatric surgery not only reduce their usage of diabetes medication. They also reduce their usage of hypertension and hyperlipidemia medications and have fewer sick days.
- They tell us when we’re off track. Perhaps we’re looking at the wrong indicators. Or perhaps we have the wrong vendor solution or process in place. Both concerns are worth thought and discussion.
What gets measured gets improved
Data, Data, Data
An effective program requires that we look towards our guideposts while adjusting and adapting throughout the year. Data is a significant tool that helps us do that. Data gives us the info to disrupt our status quo of anemic strategies and programs and move towards real disruption leading to positive results for our employees and our organizations.
Sylvia is a strategic advisor to emerging health and wellness companies with innovative solutions for employers and their employees. With over 15 years of an unusual array of experience including working in the employer, consulting, and health plan environments, she brings a targeted approach to new solutions achieving remarkable results in the employer ecosystem.
A couple months ago I attended Disability Allyship: Advocation for Abilities, an event sponsored by Breaking.Glass. This one-day conference was focused on disabilities in the workplace and employees with disabilities. Some employees come to the workplace with a disability, others may develop a disability while working. Some have a disability that we can see, others may have a hidden disabilities.
Being a person who studies health care and its cost, I’ve paid particular attention to the cost of disability. I think sometimes we expect these costs to show up as a worker’s compensation or disability claim. Of course it does, but what about the disability that we just haven’t seen yet. The type that develops from too much sitting, too much typing, and too much stress. Essentially all the challenges that are often put upon our employees everyday.
Years ago, early in my work career, I began to develop pain in my left elbow. The pain was related to all the typing and computer work that I was doing. My elbow would be sore and swollen and I would keep working. I sought the help of doctors who suggested surgery (which I was not interested in pursuing) or simply reducing the amount of work I did (again I wasn’t interested), or begin to lean on alternative support such as voice dictation. The way I chose to NOT help myself at work was by NOT raising my hand to ask for an accommodation such as voice dictation software or a more comfortable desk set-up. I chose instead, to avoid any hint that I may be on the brink of filing a worker’s compensation claim or too weak to do my job. I’d spend my spare time roaming around the office looking for more comfortable chairs that weren’t being used or making a makeshift sit / stand desk out of books and boxes.
Lucky for me after years of just dealing with this pain I connected with a chiropractor and acupuncturist that fixed my elbow within a relatively short period of time. I was lucky.
Recently I met Michelle who was not quite as lucky. Michelle worked for years and spent many hours on the computer. She was a “go-getter” and loved the work that she was doing. As a result, she worked despite the pain in her arms, wrists, and neck until finally, one day, her arms and fingers completely froze up and she was unable to type another letter! This sent Michelle on a long journey of worker’s compensation, surgeries, disability, and depression.
She eventually was able to work again, with accommodations, which then sent her on a new journey of learning to engage with potential employers when you have a hidden disability. All of this being complicated by her own and other’s opinions and insecurities related to hiring people with disabilities.
So where do the hidden disabilities reside in our populations? Are we seeing them in our healthcare data? Are we noticing them before they become disabilities? What about depression, anxiety, back issues, wrists problems? Do we have policies and the culture in place to make it easy for our employees to ask for help?
- 10% of Americans have a medical condition which could be considered a hidden disability.
- 96% of people with chronic medical conditions live with a condition that is hidden.
- 25% of them have some type of activity limitation, ranging from mild to severe.
The cost to an employer for a disability accommodation averages $500. The cost of a disability is much more!
If you’re looking to build a more supportive organization and more well-rounded health approach, here is list of some wonderful resources on disabilities in the workplace. Please also share your own.
When I received my Open Enrollment booklet that year there was a big change. There were new medical plans, actually high deductible plans. At first I ignored them until I noticed the monthly employee deductions. It was going to cost me triple to stay in my low cost, copay for my services, plan. The high deductible option required a lower monthly pay deduction however, I was going to be on the hook for the first $2,000 of my medical services.
That was years ago when my company moved 75% of its employees out of our comfortable 100% paid HMO plan to a consumer directed health plan option. As an account executive, what a great story I was able to tell to potential corporate clients who were interested in those plans for their own employees. They could save lots of money, still provide coverage to their employees and finally find a way to engage their employees in their own health.
Despite all the studies that indicate improved health outcomes, worse health outcomes, or lower employer costs, there still is no “right” answer when it comes to how employees will react to being “pushed” to a consumer directed (high deductible) health plan. Although our organizations seek to foster a congruent culture, within it we have many types of employees each requiring a path to changing and adopting corporate strategies.
Not providing that path to change leaves us with unhappy and stressed employees and is completely counter to our desire for healthier employees.
The types of employees that I’ve encountered throughout the years include:
Missed the Communication – This employee somehow did not pay enough attention when making their selections and enrolled in a high deductible plan. Later in the plan year, they get an unexpected bill from their doctor and simply can’t understand what happened. They call the Benefits Call Center immediately to complain and broadly share with their co-workers how “crappy” the company benefits plan have become.
Unprepared – This employee understood what they signed up for and made the decision because they needed a small monthly employer deduction. Now that they’ve had medical services, they are in a payment plan with their medical group that will last a year. They are feeling the additional cost of their medical plan and don’t know how to seek lower cost services such as alternative labs and mail-order drugs. Financial stress is an added burden for this employee.
Uninformed – An example here would be Lois. Lois owned 10+ properties and was a wiz at financially managing millions of dollars in the real estate world. When it came to her benefits, she was paralyzed. She would pay a considerably higher monthly deduction just so she could continue paying a $25 copay when she went to the doctor. Lois understood nothing about how deductibles, out-of-pocket maximums or preventive care services work. Lois also would not think highly of her benefits and be angry about the costs.
Engaged – Yes, this employee can predict their health costs, determine the best plan, understand the out-of-pockets and deductibles, identifies the risks and generally makes the best decision for themselves. This employee “has it together” and is not distracted by the plan options. It’s what we all hoped all our employees would understand from the many communication and tools provided.
Obviously the engaged employees are less distracted and stressed and more capable of focusing on personal and corporate initiatives.
Before we finish up our open enrollments and completely wind down for the holidays, consider planning how we can support Missed the Communication, Unprepared, and Uninformed in the new year. Depending on the significance of the changes to your plans this open enrollment, ongoing outreach and attention may be the difference between anyone paying attention to upcoming company initiatives including your wellness programs.