Business of Well-being

Forget ROI: Aetna CEO's Perspective on Wellness & Functionality

Mark Bertolini was no ordinary patient. After breaking  his neck in five places during a ski accident in 2004, the chairman, chief executive officer and president at Aetna turned his back on conventional painkillers for combating his partial paralysis. He turned instead to naturopathic medicine, acupuncture, meditation, and yoga, which still helps him take the edge off his chronic pain. His desire to get back to work became his purpose for wanting to get better.

In addition to introducing mindfulness-based wellness programs to Aetna employees, Aetna also collaborated with Goldie Hawn and The Hawn Foundation, which is focused on providing evidence-based mindfulness programs for educators and children. Like Mark, I was no run-of-the-mill patient, either.

In November 2009, I was hit by a 5,700-pound Ford Expedition, in Taos, New Mexico. Consequently, I was admitted to the intensive care unit at Holy Cross Hospital, where I was diagnosed with a clinical traumatic brain injury. Once I was given a one-year, post-traumatic stress disorder treatment plan, I realized rather quickly that mindfulness, resilience, vitality and sustainability trumps return-on-investment rhetoric each time.

Forget ROI

A broader value proposition to achieve better health and functionality has emerged in the corporate wellness space. Instead of discussing ROI in the context of healthcare costs,  CEOs are putting their people - and their functional well-being - at the core of a mission to expand the rigorous, more relevant value-on-investment (VOI) analysis to include organization health business impact.

"A majority of companies still feel they have to speak to medical-cost trend, but I think there are a growing number of companies that feel focusing principally on the cost trend are missing the point," said LuAnn Heinen, vice president of the Washington, D.C.-based National Business Group on Health.

"A few companies -- the brave and profitable -- are saying they're no longer going to be looking at cost-trend at all." Mindfulness at Work -- a breakthrough program developed by eMindful, piloted in the United States by Aetna and recognized by the National Business Group on Health for successful stress management -- has been offered by dozens of employers. Thousands of employees around the world participate.

Participants claim the program is enormously helpful in managing stress, improving creativity, enhancing focus and concentration, and building energy. My positive health and optimal functional well-being playbook entailed a commitment to personal responsibility, self-reliance and accountability toward better living.

My life-long passion to make healing as important as curing continues as I focus on helping people evolve, achieve and thrive by means of actionable behavior change:

1) Mindful Intent -- a conscious determination to cultivate healthy engagement of self and others in meaningful work;

2) Total Well-Being -- the experience of "surround sound" well-being that occurs when the mind, body, spirit, emotional, social, and intellectual health linkages are congruent and harmonious;

3) Healthy Relationships -- social and professional interactions that foster a sense of belonging, coherence and well-being;

4) Health Promotion -- the art and science of helping people discover the synergies between their core passions and optimal health, enhancing their motivation to strive for optimal health, and supporting them in changing their lifestyle to move toward a state of optimal health.

A CEO's Perspective on Functionality

I asked Mark Bertolini, chairman, chief executive officer and president at Aetna, about his mindfulness-at-work approach to optimizing health, healing and functional well-being; specifically, on mindfulness, yoga and medications following the broken neck he suffered in a skiing accident.

How did your recent health issue impact your own functionality at work?

Mark Bertolini - I injured my spinal cord and was in constant pain from neuropathy. I did not want to be on controlled-substances for pain, so I tried a number of alternative medicines including cranialsacral therapy, acupuncture, mindfulness and yoga. This combination, which I call my cocktail, has worked to the point where I don't take any pain medication and can be fully present in the moment.

Did your experience provoke more interest in Aetna's health and wellness programs?

Mark Bertolini - My personal wellness journey has certainly influenced Aetna's organizational wellness. Based on my personal experience, I fully supported the development of yoga and mindfulness-based programs at Aetna. However, the reason we have continued to expand these programs among our employees is because they have been extremely popular and produced results - reducing stress and improving productivity.

Employees participating in our initial mind-body stress reduction pilot programs (mindfulness and Viniyoga) significantly reduced perceived stress with 36 and 33 percent decreases in stress levels respectively. With the success of the pilot, the program was expanded to all Aetna employees. More than 13,000 employees have participated in one of these programs in the past three years. Participants are regaining 62 minutes per week of productivity with an approximate dollar return, in terms of productivity alone, of more than $3,000.

Is your HR department on board?

Mark Bertolini - Our HR department has always strived to create programs that truly help our employees. In the past few years, I think we have developed a more holistic view on how we are helping our employees. This goes beyond traditional wellness programs and into areas like financial literacy. While  people may not connect health or wellness with finances, your financial situation can play a daily role in stress and have an impact on health.

Should CEOs be involved in ideas presented to HR?

Mark Bertolini - Yes, because those types of ideas can have an impact on the entire organization. First, helping our employees improve their health is the right thing to do. Good employees are committed to the health of our organization, and we want to return the favor. From a business perspective, helping employees improve their health can help improve the bottom line through reduced healthcare costs, improved productivity and making better organizational decisions. Any CEO would agree that he or she should be involved with ideas or programs that can affect their organizations on that level.

Which metrics do you use to define program success?

Mark Bertolini - We look at participation broadly across our wellness programs. The first step is getting employees engaged. It doesn't matter how great or unique the program design is if employees aren't joining. Beyond participation, we try to create metrics that are specific to each wellness program. For example, our stress-reduction programs are measured by how we are helping people manage their stress better, and the resulting improvements in productivity.

Programs we have related to metabolic syndrome are measured by how they reduce the risk factors associated with that condition (high blood pressure, high triglycerides, low HDL ("good") cholesterol, high blood sugar, and large waist size). One of our more widely available wellness programs is called Aetna Healthy Lifestyle Coaching, which uses a variety of methods to  help our  members  improve their health.

Our research of 80 employers who used the HLC program found that these employers had a 150 percent return on investment from reduced medical and pharmacy costs, decreased absenteeism and improved productivity. This research also found that employees who participated in the program had health improvements in a number of different areas:

  • 55 percent of program participants exercised more
  • 54 percent of program participants lost weight
  • 51 percent of program participants reduced stress

If you were building a new wellness program, what would you do differently? What advice would you offer?

Mark Bertolini - There are a number of strategies for developing wellness programs, and a wide range of them have proven to be successful, but they all share the same underlying qualities. Successful wellness programs are:

  • Simple
  • Engaging
  • Based on people's personal values
  • Goal-oriented
  • Fit into people's daily lives

I think any employer developing a wellness program needs to include specific needs of the employees, but also has to incorporate these core characteristics.

You've stated that the current healthcare system is broken,how would you fix it?

Mark Bertolini - It's interesting that you use the word "current." Our healthcare system was developed more than 60 years ago, so it's no surprise that is not meeting our 21st century needs. We need to move to an integrated healthcare system focused on patient-centered care during the course of a lifetime. We can accomplish this transformation through technology solutions that seamlessly connect our healthcare system and reduce inefficiencies, redundancies, and administrative costs.

These technologies will also empower people, giving them the ability to act more like true consumers with their healthcare and further disrupting the existing healthcare system. If we can make this transformation, the impact goes beyond just the healthcare system. According to the Institute of Medicine, the U.S. healthcare system wastes approximately $800 billion each year - about 30 percent of our healthcare spending.

If we eliminated this waste, in 10 years we could reduce nearly 50 percent of our national debt. This problem is so significant that it affects our economy and the lives of every American.

How did Aetna become involved with the Hawn Foundation/Mindful Works? And what do you hope to gain from this relationship?

Mark Bertolini - that we shared a mutual interest in building an evidence-base showing that mindfulness-based programs can help people achieve better overall health and wellness. We look forward to promoting mindfulness as a tool to help people become more resilient and able to deal more effectively with the challenges we will all face as a 21st century workforce.

What advice would you give to your CEO colleagues regarding their employee wellness programs?

Mark Bertolini - For many organizations, healthcare costs are one of their biggest financial issues. This means that innovative wellness programs aren't just "nice to have" - they are essential to the success of the organization. And wellness programs don't just reduce healthcare costs - they also can improve productivity.

We firmly believe that the best work happens when you are helping others lead healthier and more productive lives. Wellness programs that truly help people stay well should be a core element of any company's strategy in the future.

About the Author

Mark T. Bertolini Chairman, Chief Executive Officer and President of Aetna- Aetna, a Fortune 100 diversified healthcare benefits company with more than $47.2 billion in 2013 revenue, serves an estimated 44 million people with information and resources to help them make better informed decisions about their healthcare and has operations in North America, Asia, Europe and the Middle East.

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