Wellness Programs are not Sustainable without a Proper Corporate Culture of Health
Wellness Programs are not Sustainable without a Proper Corporate Culture of Health
Airlines have exercises that passengers can perform in their seat. Restaurants display calories for each item on their menu. Dog food is even sold in the context of wellness. No, population health management is not a new topic. But the notion of wellness and its application has become widespread relatively recently.
Companies and municipalities around the world are promoting some aspect of wellness. But as those companies go down the path of instituting wellness programs, many will eventually find waning participation and a lack of sustainable and meaningful lifestyle change that is measurable.Why?
In The Corporate Athlete Advantage, The Science of Deepening Engagement, contributing author Fred Harburg makes the case that in order to have sustainable health behavior change, wellness initiatives (or, better stated, population health management initiatives) must be intensely personal, deeply meaningful, highly relevant, strongly supported by an embracing culture, and measurable in its effect on behavior.
Gym memberships, walking contests and similar programs will lose their meaning unless there is an emphasis on the cultural aspects of the organization. A company's culture can be defined as "the way we do things around here." A company's culture of health can be defined as "the way we do things around here as it pertains to health."
So what is your corporate culture when it comes to health? Do you promote name-brand weight management programs, but serve donuts and bagels for breakfast on Fridays? Do you have a fancy gym staffed with a personal trainer, but have employees who take the elevator to the second floor?
Dr. Dee Edington, world renowned Population Health Management expert, has spent more than 30 years analyzing data from his health consortium that consisted of 2.1 million members. He discovered that companies must adopt a new way of thinking when it comes to health and that the way to do this is by affecting culture.
In Dr. Edington's approach, everything rises and falls with senior leadership. Unless the CEO of an organization sponsors the population health management initiative, all which is left is a grass-roots campaign or a pet program of human resources.
Senior leadership must help create the vision, connect the vision to business strategy, commit to a healthy culture, provide adequate resources and be visibly engaged. Dan Ustain, Chairmen, President & CEO of Navistar International Corporation, is a good example of this.
He promotes his programs by saying, "Our goal is to help employees perform at the top of their game at work, at home and into retirement." Senior leadership sets the foundation of the new culture when it establishes the business value of a healthy and high-performing organization as a worldwide competitive advantage.
It's the responsibility of operational management to align the workplace and policies with the vision set by senior leadership. This includes integrating policies into health culture, branding health management strategies and engaging everyone. A fitness center is of little use if operational management doesn't encourage employees to take advantage of it.
Onsite walking trails are useless if employees are afraid to leave their desk during working hours. Imagine promoting a smoking cessation program in your organization but allowing employees to have smoking areas with smoke breaks! As Dr. Edington says, "You can't put a changed person back into the same environment and expect the change to hold."
Setting up the right framework is instrumental to the flow of a new culture. Most companies have a sick-care system, not a health-care system. Sick employees are rewarded by being able to take advantage of valuable and costly health insurance benefits. But what about the healthy employees? These are people who start off healthy.
They may or may not exercise, but they don't necessarily need to see the doctor for any health condition. Most of the time, these folks go unnoticed and, unfortunately, unrewarded. What eventually happens to many of these folks is they end up getting worse and adopt unhealthy behaviors.
If companies can find a way of rewarding these healthy employees, the likelihood of them becoming unhealthy becomes significantly lower. Most people view their health plan as a Costco membership when they should be viewing it more like their auto insurance program -- where defensive driving is promoted.
Why don't more companies promote defensive health techniques and reward people for living healthy? Companies often have pizza parties if they go 100 days without an injury. The same practice should be employed when it comes to health (except maybe with celery sticks and 0 fat yogurt). Companies should reinforce the culture of health by aligning recognition to the visions, reward their champions, set incentives for healthy choices and reinforce the right behavior at every cultural touch-point.
A question that wellness managers should constantly ask is: "Is the reward that we are giving sustaining the right behavior?" Keep in mind that rewards don't have to be elaborate or expensive. Sometimes acknowledgement is enough. Sometimes it can be a T-shirt or hat that tells the employee, "Great job staying healthy! Keep up the great work."
Throughout any organization, there are informal leaders that exert a significant amount of influence among the workforce. These are the employees that can make or break an organization by creating a difficult working environment or contributing to a great place to work.
Here is where we create winners by helping employees not get worse, helping the healthy people stay healthy, and providing improvement and maintenance strategies. Dr. Judd Allen, in his book Wellness Leadership: Creating Supportive Environments for Healthier and More Productive Employees, discusses the idea of creating the role of champions.
These champions are ambassadors, role models, influencers and promoters of the new culture of health. Investing in training programs for these champions can streamline the process for any organization trying to implement any type of change. The Cooper Companies, a global medical device company, has instituted a formalized champion program that now boasts more than 250 champions in North America and Europe.
These key informal leaders are from different walks of life, different nationalities and play different roles throughout the organization. Their influence is nonetheless significant as the company pursues its goal of being a Quality of Life Company. In our organization, the analysts have a motto that you can't manage what you don't measure.
A lot of wellness programs that are currently in place will eventually fail this test because it will be hard to measure the results. That's where quality assurance comes in. Quality assurance involves integrating all data points, evaluating program outcomes, uses a conceptual outcomes framework, and provides timely feedback of progress toward vision, culture, self-leadership, actions, and economic outcomes.
In your efforts to measure success, can you link your program to worker's compensation claims, health insurance claims, disability claims, productivity and absenteeism? Are you measuring psychosocial, behavioral, health outcomes, indirect costs to productivity, and financial outcome impact areas?
Demonstrating the proof of concept will not only please the executive team, but will give proper guidance as to the efficacy of your program and provide an indication as to the direction you should be taking. The idea of wellness is a great one. But unless companies move from wellness to population health management, they are going to find their initiatives short-lived and their healthcare costs on an increasing and spiraling trend.
One global manufacturer fully adopted a culture of health five years ago. Prior to the initiative, its average medical trend was in the twenties. Its five-year trend since inception of the program has been 12 percent, its three-year trend measuring the most recent three years is 8 percent, and in 2013, their three major health plans in North America will be renewing with 0 percent.
While they still have a long way to go, their adoption of Dr. Edington's framework has paid off in more ways than just healthcare premiums. Employees love what the company is doing and the CEO is leading the charge. If they can do it, your company can do it too.
About the Author
Alan Wang is the Senior Vice President and Lead Consultant at AFIS Benefits & Insurance Services, which integrates health insurance with population health management to provide companies an effective way to manage healthcare costs by inspiring employees to make smarter lifestyle choices.