acil oct8th

WELLNESS PROGRAM WORKSHOP

OCTOBER 8 , 2012 N E W Y O R K C I T Y, N Y

P R E S E N T E D BY: A RV I D R . “D I C K” T I L L M A R , T I L L M A R C O N N E C T L L C

Not just politically correct, developing a wellness program can save your laboratory real dollars with studies showing that 80 percent of all health care spending is preventable and 50 percent of these potential savings come from wellness, lifestyle and behavioral changes. This presentation will provide a road map to launch a new wellness program or improve an already existing one, so join us to improve your laboratory’s bottom line.

AMERICAN COUNCIL FOR INDEPENDENT LABORATORIES

THE NEED FOR WELLNESS

Prevention Why?

Increase in illnesses

3

The biggest threats facing the American work force today are obesity, tobacco use, and stress.

Together, these lifestyle factors contribute to lost productivity and absenteeism, among other problems, but a wellness program can work to combat all three


Source: National Business Group on Health,

BENEFITS OF WORKSITE WELLNESS PROGRAMS

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Hostess introducesTwinkies, 1953 Ray Kroc franchises the

McDonald Brothers, 1955

And then introduces“supersizing,” 1993

MILESTONES IN CONTEMPORARY AMERICA

Awareness/educationMotivationTools, strategiesPolicy and environment

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INDIVIDUAL BEHAVIOR

Individual

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It’s All About Behavior Change

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Individual Family

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Individual Family Worksite

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Individual Family Worksite Community

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Individual Family Worksite Community Nation/World

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Constraining Medical Costs

Centers for Disease Control & Prevention, 2006 Behavioral Risk Factors Surveillance System

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

No Country Can Fund All the Consequences:• Hypertension• Type 2 Diabetes• Osteoarthritis• Stroke • Coronary Heart• Gallbladder• Sleep Apnea• Respiratory Issues• Some Cancers

Obesity Trends Among U.S. Adults (BMI>30%)

1985198619871988198919901991199219931994199519961997199819992000200120022003200420052006

BEHAVIOR & LIFESTYLE: WEIGHT GAIN 1986-2006

PERCENT OF OBESE (BMI>30) U.S. ADULTS

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No Data <4% 4%-6% 6%-8% 8%-10% >10%

DIABETES TRENDS AMONG ADULTS IN THE U.S.BRFSS 1990

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No Data <4% 4%-6% 6%-8% 8%-10% >10%

DIABETES TRENDS AMONG ADULTS IN THE U.S.BRFSS 1991-1992

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No Data <4% 4%-6% 6%-8% 8%-10% >10%


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No Data <4% 4%-6% 6%-8% 8%-10% >10%


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No Data <4% 4%-6% 6%-8% 8%-10% >10%


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No Data <4% 4%-6% 6%-8% 8%-10% >10%


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No Data <4% 4%-6% 6%-8% 8%-10% >10%


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No Data <4% 4%-6% 6%-8% 8%-10% >10%


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No Data <4% 4%-6% 6%-8% 8%-10% >10%


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Obesity costs U.S. companies $13 billion annually

These workers have 36% higher medical costs than fit employees

A WEIGHTY TOLL ON EMPLOYERS

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THE HIGH COST OF SMOKING

A smoker costs the employer $3856/yr in added healthcare costs and lost productivity

The overall prevalence of tobacco use is about 25% of the population, which can be generalized to any workplace population

Calculating the cost of smoking: Assume a workplace with 100 employees Assume 25 employees use tobacco

Result = $96,400/yr in business borne costs associated with smoking

Because of this high cost, it is estimated more than 6,000 companies now refuse to hire smokers Alaska Airlines requires a nicotine test before hiring people Kalamazoo Valley Community College stopped hiring smokers for full-time

positions Union Pacific won’t hire smokers

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THE COST OF POOR HEALTH

Lost productivity related to absence & presenteeism compared to medical & pharmacy costs

Medical Costs

25%

Absenteeism Lost

Productivity 36%

Presenteeism Lost

Productivity 34%

STD/LTD/WC 5%

IBI Research Insights - Single employer example

Chronic disease has $1 TRILLION impact on U.S. lost productivity each year.

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Goetzl, R; JOEM 45(1) 5-14 2003

TOP 10 MOST COSTLY HEALTH CONDITIONS

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Health Care System10% Environment 20% Genetics 20% Lifestyle 50%

EXPENSE DRIVERS

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Tobacco: 8,100 +/- deaths per year in Wisconsin

Poor diet: Physical inactivity: 6,900 +/- deaths per year in Wisconsin

Microbial agents: 1,700 +/- deaths per year in Wisconsin

Alcohol: 1,600 +/- deaths per year in Wisconsin

Toxic agents: 1,000 +/- deaths per year in Wisconsin

Medical errors: 1,300 +/- deaths per year in Wisconsin

Motor Vehicles: 800 +/- deaths per year in Wisconsin

Firearms: 400 +/- deaths per year in Wisconsin

Sexual behavior: 400 +/- deaths per year in Wisconsin

Uninsurance: 300 +/- deaths per year in Wisconsin

Illicit drug use: 300 +/- deaths per year in Wisconsin

PREVENTABLE CAUSES OF DEATH IN WISCONSIN

TOTAL: 22,800

Six Unhealthy Truths Tell the Story of the Rise of Chronic Disease and It’s Impact on Health

and Health Care44

Truth #1: Chronic Diseases are the #1 cause of death and disability in the U.S.

Truth #2: Chronic diseases account for 75% of the nation’s health care spending.

Truth #3: About two-thirds of the rise in health care spending is due to the rise in the prevalence of treated chronic disease.

Truth #4: The doubling of obesity between 1987 and today accounts for nearly 30% of the rise in health care spending.

Truth #5: The vast majority of cases of chronic disease could be better prevented or managed.

Truth #6: Many Americans (five in six) are unaware of the extent to which chronic disease harms their health – and their wallets.

www.fightchronicdisease.org

IMPACT OF HEALTH RISK FACTORS ON PRODUCTIVITY

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Risk Factors considered in study include:

Tobacco Use

BMI <18.5 or >24.9

Physical inactivity

Lack of emotional

fulfillment,

High stress

High blood pressure

High cholesterol

Alcohol use

Overdue preventive visits

Diabetes

25.9%

6.3%

0.0%

0%

5%

10%

15%

20%

25%

30%

0 risks 1 risk 2 risks 3 risks 4 risks 5 risks 6 risks 7 risks 8 risks

Mea

n L

ost

Pro

duct

ivit

y

Presenteeism

Absenteeism

Boles M, Pelletier B, Lynch W. The Relationship Between Health Risks and Work Productivity.

AS HEALTH RISKS INCREASE, SO DO EXCESSIVE COSTS

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$840$1,261

$3,321

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

Low Risk (0-2Risks)

HRA Non-Participant

Medium Risk (3-4Risks)

High Risk (5+ Risks)

Excess Costs

Base Cost

These represent the maximum

savings opportunity if

you moved people

from High (6+ risks)

to Low (0-2 risks)$175

$292

$757

$0

$500

$1,000

$1,500

Low Risk (0-2Risks) N=685

HRA Non-Participant N=4,649

Medium Risk (3-4Risks) N=520

High Risk (5+ Risks)N=366

Excess Costs

Base Cost

Chart Sources: Medical Edition: Edington. AJHP. 15(5):341-349, 2001; Disability: Wright, Beard, Edington. JOEM. 44(12): 1126-1134, 2002

Average Annual Medical Cost

Average Annual Disability Cost

AS HEALTH RISKS INCREASE, SO DO EXCESSIVE COSTS

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Have at least 1 coronary risk factor 75%

Were rated poor for nutrition practices 70%

Have high blood pressure 60%

Smoke 57%

Are 20% over their ideal body weight 40%

Exercise Regularly 20%

-There were 3 complicated pregnancies last year that cost the company $300,000

-The interest survey indicated that the majority of employees would like to participate in programs with their families, would like aerobics classes during the day and would like a weight control class at work. A few employees indicated they wish to quit smoking.

-An additional survey showed that almost all managers were supportive of the proposed wellness program. It further indicated that managers would participate and encourage others to as well.

Sample XYZ Company Summary Report - Percentage of employees who:

IMAGINE IF YOU COULD SAVE 25% OFF YOUR RISING HEALTH CARE COSTS

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25% savings off of Rising Health Care Costs

$1,080 $1,151 $1,291 $1,440$1,587 $1,730 $1,845 $1,958

$7,832$7,379$6,918$6,348$5,758$5,162$4,604$4,320

$0

$2,000

$4,000

$6,000

$8,000

$10,000

1999 2000 2001 2002 2003 2004 2005 2006

Year

Ann

ual e

mpl

oyer

he

alth

car

e co

st p

er

empl

oyee

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WELLNESS PROGRAMS

EFFICACY & CASE STUDIES

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A multitude of studies show ROI averages of $3 for every $1 invested

One recent study had the return as high as 10 to 1

Companies must be patient. “Worksites typically don’t realize returns until about three years into the program. If an organization is willing to wait two or three years, it will be capable of achieving this magnitude (3 to 1) of ROI.”

A review of 32 studies found claims costs were reduced by 27.8%, physician visits by 16.5%, hospital admissions by 62.5%, disability costs by 34.4% and incidence of injury by 24.7%

NUMEROUS STUDIES DOCUMENT STRONG ROI

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From a review of 73 published studies of worksite wellness programs Average $3.50-to-$1 savings-to-cost ratio in reduced absenteeism

and health care costsFrom a meta-review of 42 published studies of worksite

wellness programs Average 28% reduction in sick leave absenteeism Average 26% reduction in health care costs Average 30% reduction in workers’ compensation and disability

management claims costs Average $5.93-to-$1 savings-to-cost ratio

A comprehensive health management program at Citibank $4.56-$4.73-to-$1 savings-to-cost ration in reduced total health

care costs

WELLNESS WORKS, ACCORDING TO ROI STUDIES

52BUSINESS CASE &

IMPLEMENTATION

WELLNESS PROGRAMS

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DEFINING HEALTH RISKS & RISK LEVELS

Health Risk Measure High Risk Criteria

Alcohol > 14 drinks per week

Blood Pressure Systolic >139 mmHG/Diastolic >89 mmHG

Body Weight BMI =/>27.5

Cholesterol >239 mg/dl

Existing Medical Problem

Heart, Cancer, Diabetes, Stroke

HDL <335 mg/dl

Illness Days >5 days last yr

Life Satisfaction Partly or not satisfied

Perception of Health Fair or Poor

Physical Activity <1 time per week

Safety Belt Usage Using safety belts <100% of time

Smoking Current smoker

Stress High

Overall Risk Levels

Low Risk 0 to 2 high risks

Medium Risk 3 to 4 high risks

High Risk 5 or more high risks

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GET WELL OR PAY NOT TO

Consumers may be able to improve their health and bottom line by participating in company sponsored wellness programs.

More employers are offering cash, discounts and even lower health insurance premiums to entice workers to participate in a variety of programs.

Starting next year, employees could have further incentives to get healthy as more companies add penalties to insurance premiums for workers who don’t partake.

“It’s an opportunity to get cash for doing what’s right for you.

Despite cutbacks amid the recession, 58% of large U.S. companies now offer lifestyle-improvement programs, up from 43% in 2007, according to a Watson Wyatt Study. And 56% provide health coaches, compared with 44% in 2007. Health-risk appraisals are offered at 80% of companies, up from 72% in 2007.

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DISCOUNTS AND FREEBIES

Employees may be able to get $200 to $300 for participating in health-risk appraisals, smoking-cessation, weight management and preventive care classes.

Other offerings include heavily discounted weight loss programs and free or discounted gym memberships. At some companies, employees who participate are rewarded with gift cards or lower insurance premiums.

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WELLNESS PROGRAMS

EMPLOYERS’ EXPERIENCES

WITH ROI

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HISTORICAL PERSPECITIVE ON SAVINGS

Johnson & Johnson Started in 1979 Invested $30M, 94% participation rate Cholesterol, activity and smoking Results of $224 per year savings per employee ($8.5M annually)

Pitney Bowes Analysis 1991; Health Care University started in 1993 2.8:1 ROI for participants in HCU Increased productivity, less absenteeism for gym members Ergonomics showed a 5.1 ROI

Union Pacific Winner of C. Everett Koop Award 1994, 1997, 2001 Smoking down from 40% to 28% over 10 years 10% decrease in lifestyle related healthcare costs equating to $53.6M dollar difference in 2001

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... AND TODAY’S EXPERIENCE

2008 PRICEWATERHOUSE COOPER’S HEALTH AND WELLNESS TOUCHSTONE SURVEY RESULTS:

69% of 561 companies have a wellness program

Less than 30% of members participate: the use of incentives increases

participation

52% of respondents don’t believe wellness programs are effective at

mitigating healthcare costs, improving performance/productivity, or

enhancing employee engagement/loyalty.

They do believe they are effective at reinforcing corporate responsibility and

image

Only 37% of respondents integrate occupational health with their

wellness strategy

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ASSOCIATION OF RISK LEVELS WITH SEVERAL CORPORATE COST MEASURES

Research conducted at the University of Michigan has shown that the low risk employees (1-2 risk factors) have lower cost for short term disability, workers’ comp, absence and health care costs whereas high risk employees (5+risk factors) have higher costs.

Source: Wright, Beard, Edington, JOEM 44 (12): 1126-1134

WELLNSS PROGRAM SAVINGS

So, how do you do it?

WELLNSS PROGRAMS

Benchmark #1 - Capturing CEO Support

Benchmark #2 - Creating Cohesive Wellness

Teams

Benchmark #3 - Collecting Data To Drive Health

Efforts

Benchmark #4 - Carefully Crafting An Operating

Plan

Benchmark #5 - Choosing Appropriate

Interventions

Benchmark #6 - Creating A Supportive

Environment

Benchmark #7 - Carefully Evaluating Outcomes

WELCOA’s 7 BENCHMARKS

ONE SIZE DOES NOT FIT ALL!

WHAT DOESN’T WORK

Health Assessments aloneLow budget, low intensity, low participation ratesPrograms that focus on what’s in it for the

organization, not the individual participant“Under the radar” initiativesNIH (not invented here) philosophyHuge incentives that would be better used for

programmingHERO Panel: EHM – What Really Works? HERO Forum for Employee Health Management Solutions

New Orleans, Louisiana -- October 2007 Ron Z. Goetzel, Ph.D.

Cornell University and Thomson Medstat

Employ features and incentives that are consistent with the organization’s core mission, goals, operations, and administrative structures;

Operate at multiple levels, simultaneously addressing individual, environmental, policy, and cultural factors in the organization;

Target the most important health care issues among the employee population;

Engage and tailor diverse components to the unique needs and concerns of individuals;

Achieve high rates of engagement and participation, both in the short and long term;

Achieve successful health outcomes, cost savings, and additional org. objectives;

Are evaluated based upon clear definitions of success, as reflected in scorecards and metrics agreed upon by all relevant constituencies.

BEST CRITERIA FOR WELLNESS PROGRAMS

Robert H. Lustig, MD, UCSF Professor of Pediatrics in the Division of Endocrinology, explores the damage caused by sugary foods. He argues that fructose (too much) and fiber (not enough) appear to be cornerstones of the obesity epidemic through their effects on insulin. Series: UCSF Mini Medical School for the Public [7/2009] [Health and Medicine] [Show ID: 16717]

http://www.youtube.com/watch?v=dBnniua6-oM

DR. ROBERT LUSTIG

http://www.youtube.com/watch?v=dBnniua6-oM

Sample Comprehensive Report

Sample Executive Summary

WELL WORKPLACE

(double click on documents to bring up full PDF versions)

http://www.welcoa.org/wwpchecklist/



1. A Vision/Mission Statement for The Wellness Program

2. Specific Goals and Measurable Objectives

3. Timelines For Implementation

4. Roles And Responsibilities 5. Itemized Budget 6. Appropriate Marketing

Strategies 7. Evaluation Procedures

ESSENTIAL ELEMENTS: WELLNESS PROGRAMS

THE EFFECTS OF AN EFFECTIVE WELLNESS PROGRAM

Click image below to read full article

http://www.jsonline.com/news/opinion/wellness-programs-help-make-city-healthier-wellness-programs-help-make-city-healthier-ob63tk3-162655546.html

http://www.jsonline.com/news/opinion/wellness-programs-help-make-city-healthier-wellness-programs-help-make-city-healthier-ob63tk3-162655546.html

Companies are now using incentives to drive participation in health programs

Of nearly 2,000 U.S. surveyed employers, 84% offer employees incentives to participate in a health risk questionnaire (HRQ) and 64% of those offer an incentive for participation screening. 51% provide incentives to employees who participate in health

improvement and wellness programs.

The use of monetary incentives, in particular, has increased dramatically in 2012.

A growing number of employers are beginning to link incentives to a result.

THE USE OF INCENTIVES

The need to have SMART goals & objectives for your Wellness Programs:

SMART GOALS & OBJECTIVES

WHO’S TO BLAME IF YOU’RE FAT?

WHO’S TO BLAME IF YOU’RE FAT?

Click image below to read full article

Emphasis of Preventative Care in the Affordable Care Act

http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html

Well City Milwaukee www.wellcitymilwaukee.org

REFERENCE GUIDES

75

48 Teaspoons Sugar

16 oz32 oz

44 oz 52 oz 64 oz

RETHINK YOUR DRINK

1. 4.2 grams of sugar = 1 teaspoon of sugar

2. Before you order a drink, ask how much sugar is in the beverage – it is listed in grams on the ingredients list

3. After you do the math, simply divide the number of grams of sugar by 4 – and ask yourself if almost 10 or more teaspoons of sugar is really what you want.

Teaspoon of Sugar

Here’s what carbonated soft drink consumption – sugared and diet sodas – looked like in 2010. Average American chugged the equivalent of 48 two-liter bottles and 206 12 – ounce cans of soft drinks in one year.

A YEAR OF SODA: 44.7 GALLONS

QUESTIONS & ANSWERS

Arvid R. “Dick” TillmarHealth Advocate

8820 West Cleveland AveWest Allis, Wisconsin 53227

(414) 690-2232

Web: http://www.tillmarconnect.com/ Email: [email protected]

LinkedIn: www.linkedin.com/in/dicktillmar

THANK YOU!

http://www.tillmarconnect.com/

mailto:[email protected]

https://portal.mxlogic.com/redir/?1jKYOMqekjhOyedFTK-UMMODsS02fB0HW4EsLAEoxaNmszPRtyrLOtXTLuZXTdTdX4P92szPRty2ySAWRVsSyCyCZt4SyOMy-ztN4srjjdyVx8Qg32TSBFVEw3o6pjSsGMdPYfDwedFCQPqtSm6nQS7C3pSem1LblWV0Y

“INTELLECTUALS SOLVE PROBLEMS, GENIUSES

PREVENT THEM.”

ALBERT EINSTEIN

acil oct8th

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