Category Archives: healthcare

Eliminating Silos in Health and Safety

Few of us need to be sold on the merits of greater collaboration. But if there were any doubts about what it’s able to bring to the areas of health and safety, Dr. Casey Chosewood put them to rest yesterday morning during his opening keynote speech at the National Workers’ Compensation and Disability Conference® in Las Vegas.

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Dr. Casey Chosewood, speaking at the National Workers’ Compensation and Disability Conference on Wednesday.

“Too many organizations today still have silos [that] are unconnected,” said Chosewood, chief medical officer and director of the Office for Total Worker Health Coordination and Research at the National Institute for Occupational Safety and Health (part of the Centers for Disease Control). “But that has to change. We have to put everything under one umbrella and take a more integrated approach.”

Remarkable things can happen when each of the components talk to one another, align their goals, understand the financial challenges of others and work on finding solutions, Chosewood told the packed room of attendees.

Of course, in the world of business, the elimination of silos, as a concept, comes up a lot. But it seems to be an especially powerful idea when it’s applied to safety and health.

Early in his talk, Chosewood took a few minutes to touch on the Ebola outbreak, which is also the subject of Carol Harnett’s Benefits Column posted earlier this week.

“I’m frequently asked if the CDC has a handle on the problem,” Chosewood said, “and that’s a fair question.”

As of today, he explained, there have been eight cases of Ebola in the United States, compared to 14,000 known cases in West Africa (a figure he believes is probably closer to between 20,000 and 28,000).

Chosewood said the CDC believes the risk of Ebola here in the United States remains very low, though he added that doesn’t negate the seriousness of the disease and the need to put “more resources on the ground in West Africa” to address it.

Returning to the focus of his talk, Chosewood said people would be mistaken were they to think they could separate work and home as far as health and well-being are concerned. “You can’t leave what happens at home on the kitchen table [just as] you can’t leave what happens at work on your desk. You shuttle them back and forth.”

Chosewood cited the example of a person who works in a factory who is exposed to lead and then brings it home to an unsuspecting child on the surface of his or her clothing. “Risks don’t just stay in one place,” he said.

During his talk, Chosewood also touched on the importance of changing the culture of the organization. Quoting Sir Michael Marmot (a professor at the University College London), he said it’s “unreasonable to expect people to change their behavior when the social, cultural and physical environments around them fully conspire against them.”

Chosewood shared a close-to-home illustration of the kinds of steps that can be taken.

When the CDC ran out of places to park and needed to build a new parking garage, Chosewood (then in charge of safety and health there) said he intentionally proposed picking a site that required workers to walk 15 minutes. While the move initially made him quite unpopular and existing employees complained about the distance, he said, new hires haven’t complained at all.

In addressing health and safety issues, he said, employers need to be willing to take “short-term heat” for “long-term gain.”

Chosewood said next on the Center’s to-do list will be to slow down the elevators so impatient workers will take the stairs. (I wasn’t sure if he was serious or kidding.)

According to Chosewood, there are three kinds of companies: bad, good and the best. Bad companies, he said, don’t do anything to keep their workers healthy and safe; good companies keep them protected from injury and illness; and the best do what’s needed to ensure their workers go home more healthy at the end of the day.

Employers that fall in this “best” category, he said, will enjoy more engagement, greater productivity and lower injury risk.

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The Pitfalls of Consumerism

Do you put as much thought into selecting your cellphone plan as you do for selecting which doctors and specialists to see for your medical plans?

This question was posed at the National Business Coalition on Health’s annual conference in Washington by Shawn Leavitt, senior vice president of global benefits at Comcast Corp., during his keynote address.

“More than half of all consumers say they’re dissatisfied with the cellphone plan they chose,” he said. “So, if people are having a hard time selecting a cellphone plan that’s right for them, then how do we expect them to make the right decisions with respect to their health plan and health providers?”

The subject of Leavitt’s presentation was that healthcare consumerism — high-deductible plans that put more of the onus for financing and managing healthcare on employees — will not work unless employees receive more expert direction and guidance to help them.

At Comcast, said Leavitt, HR has enlisted so-called “expert shoppers” to help employees with these crucial decisions. It’s coupled that with outreach to certain locations within its vast empire to focus on subsectors — such as call centers — where employees were making heavy use of emergency rooms (and driving up costs) to educate employees on alternatives such as urgent care centers.

“We understand that it’s hard to expect employees who are juggling multiple responsibilities to make the sort of far-sighted decisions we’d like them to make when they’re faced with something as immediate as a sick child,” said Leavitt.

Comcast is using its own marketing wizardry to help educate employees on making wiser healthcare choices, he said. “We have become very good at getting consumers to pay to watch bad movies and reality television shows,” said Leavitt. “We’re focused on bringing that same level of expertise to help our employees make good decisions on healthcare.”

The risks of consumerism were also highlighted by Dr. Mark Fendrick during a panel discussion on pharmacy drug benefits. One of the main questions the panel grappled with was whether it was right for plan sponsors to exclude certain medications from plan coverage.

“If you’re doing that just to save money, I don’t think it’s a good idea,” said Fendrick, director of the University of Michigan’s Center for Value-Based Insurance Design. “I think it’s OK if the drug has been proved to be ineffective or counterproductive or if cheaper generics of equivalent effectiveness are available. But do it for the right reasons.”

The trend of pushing more costs onto employees can end up doing more harm than good if it isn’t managed carefully, he said. “Raising deductibles and pushing more of the cost onto employees without giving them support necessary for needed treatment and medications will simply cause more of them to forgo what they need,” he said. “I’ve had patients tell me that until they exhaust their deductible, they’re not going to do many of the things I’ve told them they need to do to maintain their health. And that goes against what this whole idea of consumerism is supposed to be about.”

 

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The Wellness Journey Continues …

Earlier this month, the Economist Intelligence Unit released a study (sponsored by Humana) of 255 executives. It found that roughly 70 percent of the respondents believe their organization’s wellness programs are effective, even though only 31 percent deploy some sort of “rigorous evaluation methods.”

Kevin Volpp, founding director of the Leonard Davis Institute Center for Health Incentives and Behavioral Economics, is quoted in the report saying he believes asking whether wellness [programs] have value based solely on return on investment is a mistake. Instead, the question should be, “Do we improve health at a reasonable price.”

185998025At this year’s Benefits Forum & Expo at the Boca Raton Resort in Florida, there seemed to be ample evidence that the business community’s commitment to wellness is very much alive and well, even if the data isn’t nearly as visible as some might like.

As might be expected, many of the employers featured on the program are, with the help of the vendor community, applying tools such as biometric screenings, health coaches and gamification in their attempts to improve the well-being of their workforces and, in turn (hopefully), reap meaningful productivity gains. (Such approaches will also be explored at HRE‘s Health and Benefits Leadership Conference next April.)

During a session titled “Domino’s Pizza: Evolving Wellness Strategy into Business Strategy,” Domino’s Director of Benefits Sandra Lollo shared some of the outcomes her company has achieved through the use of Quest Diagnostics’ Blueprint for Wellness tool, which has served as the cornerstone of its wellness efforts for quite some time. Lollo noted that Domino’s uses four key performance indicators to gauge its progress: participation, a health-quotient score (including a wellness scorecard combined with HRA), metabolic-syndrome risks (targeting BMI) and tobacco use.

Eight years into its effort, Lollo reports, Domino’s has seen discernible improvement on each of these fronts. In the case of the tobacco-use KPI, for instance, the percentage of tobacco users has been cut in half, dropping from 26 percent to 13 percent over that period.

The company’s benefits team is currently in the process of rebranding its effort (“dusting it off,” Lollo says) and pursuing a more holistic approach to wellness, including adding components that address issues such as financial wellness.

As might be expected, gamification found a decent amount of air time at the conference. In a session titled “Gamifying Wellness: How to Challenge Employees to Lead Healthier Lives,” Goldenwest Credit Union Assistant Vice President of HR Ashley Shreeve co-presented with hubbub Vice President of Sales and Marketing Brian Berchtold and shared some of the ways her 421-employee firm has used the hubbub platform to drive engagement and change behaviors.

Through simply named challenges such as “Walk the Dog” (a 14-day challenge that involves, yes, dog walking) and “Home Cooking” (a 14-day challenge aimed at eating healthier foods), Goldenwest is getting employees to take a small but valuable step in a better direction. (In other words, don’t bite off more than you can chew?)

One of the goals, Berchtold said, is to get employees to understand that wellness doesn’t end at 5 p.m.; it’s something that needs to be 24/7.

Goldenwest is attempting to undo the fact that “we’re asking our employees to be unhealthy by having them sit behind a desk all day,” Shreeve said.

For the 421-employee credit union, encouraging participation has not been a problem. All of its employees are currently on the platform and have, last count, completed more than 18,440 challenges.

(Here’s another interesting stat I jotted down from the session: There are more than 43,000 weight-loss/fitness apps out there today.)

Of course, gamification may not be the answer for every organization.

Elkay Manufacturing Co. Corporate Manager of Compensation and Benefits Carol Partington offered me a preview of a session she was slated to present later in the day with Interactive Health Senior Wellness Strategies Sandi Eskew: “Elkay Manufacturing: Tune Up Your Wellness Program.”

Elkay is entering its third year of on-site screening through Interactive Health. Under the program, employees who participate in the screening and independently declare they’re not tobacco users pay 20 percent less for their healthcare than a person who doesn’t do either of those things. From a financial standpoint, Partington said, that translates to about a $1,000 per year.

As with most things, the success of these initiatives often hinges on how well they’re communicated.

“We need to get employees to understand what we’re doing and that there’s a partnership; they’re not in it all by themselves,” Partington said. To that end, Partington and her team have worked hard to get the messages out into the workplace and employee homes. “You’d have to have your head in the sand if you didn’t know what’s going on,” she said.

What’s proven to be the most effective way to get these messages out there at Elkay? Through the organization’s plant managers, says Partington, because “it’s not corporate giving the message” … it’s coming from someone the employees know and trust.

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Adding to ACA Uncertainty

ACAA pair of appeals court rulings made just hours apart yesterday seem to have compounded employers’ confusion surrounding the Affordable Care Act.

First, the 4th Circuit U.S. Court of Appeals in Washington ruled in the case of Halbig v. Burwell that the ACA does not permit the Internal Revenue Service to distribute premium subsidies in the 36 states where exchanges are run by the federal government.

Later in the day, a federal appeals court panel 100 or so miles down the road in Richmond, Va., took the opposite view, determining the ACA’s “ambiguity” affords the IRS the authority to issue the subsidies.

Reaction to the contradictory rulings—which seem to pave the way for a likely Supreme Court case—was swift, strong and, politically speaking, true to party lines.

Noting his dissent in the later ruling, D.C. Circuit Judge Harry T. Edwards described the decision as a “not-so-veiled attempt to gut the Patient Protection and Affordable Care Act.”

Meanwhile, the conservative side of the aisle commended the Richmond panel’s decision.

Speaker John Boehner, for example, described the ruling as “further proof that President Obama’s healthcare law is completely unworkable,” saying in a statement that the Affordable Care Act “cannot be fixed.”

For employers in the majority of the U.S., what happened yesterday just seems to further cloud an already uncertain future with regard to the ACA.

“The D.C. Circuit’s decision is significant in that it calls into question whether employers [in the affected states] could be subject to a penalty under the ACA’s ‘pay or play’ penalty scheme,” according to Peter Marathas, a Boston-based partner in Proskauer’s employee benefits, executive compensation and ERISA litigation practice center.

Yesterday’s decisions are “not the final say on this issue,” he says, “but [they] certainly underscore the thin thread much of the employer penalty hangs on, particularly if other courts agree with this decision.”

The matter “seems destined for the U.S. Supreme Court,” said American Benefits Council President James A. Klein, in a statement.

Klein also offered his take on how things may ultimately shake out.

“Since the employer mandate penalty is triggered when employees receive a subsidy, some employers may be relieved of penalties, or may have different levels of penalties, depending on which states their workers reside.”

In addition, some companies have weighed whether employees may be better served through steady coverage in exchanges, especially those who frequently change jobs, said Klein.

“The lack of subsidies for workers in some states certainly would change the dynamics in that decision making,” he noted, adding that further uncertainty over the implementation of the healthcare law “chills” the decision-making process for employers.

“The courts need to quickly resolve this critical issue,” he said, “one way or the other.”

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A Few Surprises in Study on Hourly Workers

490136049 -- gavel and clockI met with some folks from St. Louis-based Equifax Workforce Solutions during the Society for Human Resource Management’s conference in Orlando (June 22 through 25) and they shared with me some stats they compiled recently reflecting the potential impact of the Affordable Care Act that even they admitted had some surprises in them.

Working toward Jan. 1, 2015, when the majority of the ACA’s employer mandate takes effect, the company had just released its Equifax Workforce Solutions June 2014 report, highlighting “key indicators of how the ACA will affect business[es] and what they can do to ensure compliance [thereby avoiding penalties] as the regulations continue to go into effect,” as Mike Psenka, senior vice president of Workforce Analytics for Equifax Workforce Solutions (formerly TALX), put it.

For the record, and some important reading, here is the press release and here is the infographic, based on Equifax data culled from 500 million consumers and 81 million businesses worldwide.

Surprisingly — and in keeping with employers making employee-schedule-and-status adjustments to prepare for the ACA’s mandate that all employees working an average of 30 hours or more per week be offered healthcare coverage — 66 percent of the current U.S. workforce is now hourly, accounting for more than 73.6 million active employees, and 59 percent of them are working more than 30 hours per week, according to the study. (Those numbers were higher than anticipated, the folks from Equifax told me.)

Remember, for these workers, employers must track hours for each employee over a 3-to-12-month measurement period to determine healthcare-coverage eligibility. The study found average workloads vary greatly by industry and can be a key indicator of workforce eligibility. “For example,” the report states, “hourly employees in the finance industry work an average of 37 hours per week while those in the restaurant industry work an average of 23 hours per week.”

Also somewhat surprising — to me as well — was the fact that 71 percent of hourly employees have been at their jobs longer than 12 months, which represents “a significant number of workers who may become eligible for coverage after their employer’s first measurement period,” the report says.

And don’t forget employers must also offer affordable coverage to all eligible employees, meaning the monthly premium cannot exceed 9.5 percent of the employee’s income. Based on the average hourly pay rate by industry, as computed by Equifax, estimated maximum premiums can range from $108.80 per month (in the restaurant industry) to $251.20 per month (in the healthcare industry).

The goal here in releasing these stats, Psenka said, is not only to offer employers a few more tools for protection from potential penalties, “but also [to] ensure their valued employees receive appropriate — and affordable — coverage.”

Just bear in mind, as was underscored in an otherwise enjoyable, stress-free SHRM meeting, the clock is ticking and time to get this whole hourly, ACA-eligibility thing right is running out.

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Listening to the Data

I was having lunch the other day across the street from a noisy construction site. It wasn’t the best location in the world to read a book and enjoy a sandwich, but it was one of the few places I could find with some comfortable shade.

122399493As I sat there consuming my sandwich (and drink), I remember thinking to myself, “How in the world do these folks work eight hours straight with all that banging and clanging? I’m sure they were wearing protective gear to diffuse some of that noise, but despite the protection, it still had to be loud enough to drive a sane person crazy. (I eventually moved.)

If you’re like me, you probably know a few folks who’ve lost a decent amount of hearing as a result of the work they do. Some recognize they have a problem and have taken steps to remedy it, say by acquiring a hearing aid. Others are less aware, perhaps in denial or simply reluctant to do something about it. (According to the National Center on Hearing Assessment, only one in four people with hearing loss use hearing aids.)

When we think of the health and well-being of employees, a host of issues comes to mind. Diet. Exercise. Regular checkups. Hearing loss? Not really. But as a Better Hearing Institute press release sent out the other day to raise awareness on this issue points out, the problem of hearing loss is widespread, affecting more than 40 million Americans. And costly.

In an effort to bring attention to the issue, the American Tinnitus Association recently sent out its own press release, encouraging both employers and employees to be proactive. It urged employers to develop engineering controls to reduce overall noise output and implement administrative procedures to minimize workers’ noise exposure. Meanwhile, it asked workers to take control of their hearing health by using appropriate ear and noise protectors.

Of course, before either of these things are going to happen, employers and employees alike are going to have to get on the same page and acknowledge that a noise problem exists. Soon-to-be-released research suggests there’s a definite disconnect here between the perceptions of the two.

According to a survey of 1,500 full-time workers and nearly 500 benefits professionals by EPIC Hearing Healthcare ( a hearing-care provider), employees and employers each have a somewhat different take on the situation. Asked how many hours a day they believe their workplace is noisy, more than half (55 percent) of the employee respondents said it is noisy for more than one hour a day and more than one-third (36 percent) said it was noisy for more than three hours a day. In contrast, nearly 80 percent of employers said their workplace is hardly ever noisy.

The EPIC research also found nearly half of the employees felt the level of noise at work was damaging their hearing, even though less than one in four have had their hearing checked in the past two years.

In light of the above data and the impact hearing loss can have on productivity, employers shouldn’t be turning a deaf ear to this issue (excuse the pun). Indeed, they certainly have no shortage of tools available to them, ranging from reducing noise levels in their workplaces and providing employees with better protection to offering “financial support” through insurance products (EPIC’s business) and raising employee awareness.

Being this month is National Employee Wellness Month, I would think it might be as good a time as any for employers to revisit the state of their respective workplaces as far as noise exposure is concerned and the efforts that they’re taking to address the problem.

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The Cost of Cancer in the Workplace

I came across some pretty alarming statistics the other day regarding cancer’s impact on the workplace.

78770849-- cancer at workThe report, from the Integrated Benefits Institute, shows cancer typically costs employers about $19,000 annually per 100 employees in lost work time and medical treatments.

Broken down, lost work time and underperformance at work, the latter also known as presenteeism, due to cancer costs employers $10,000 per 100 workers, and medical and pharmacy treatments cost about $9,100. Employees with cancer, the report says, are absent 3.8 more days per year than workers without cancer, and also lose the equivalent of 1.8 more days per year to presenteeism.

In the words of Tom Parry, IBI president:

Cancers present complex challenges for the workplace. At a basic, human level, a cancer diagnosis is a frightening, sometimes emotionally devastating, event. It is natural that co-workers and supervisors will want to provide support to a friend and colleague when told he or she has cancer. At the same time, balancing privacy and workplace accommodation is a critical, but sensitive, issue. Many employees with cancer will frequently feel too sick to work, while others report that remaining on the job keeps them ‘connected’ and provides a sense of routine as they undergo treatment.”

Considering there are very few of us who have not been touched by cancer, myself included (my father is undergoing chemo as we speak), I’m thinking the disease must touch just about every workplace as well. So, given the prevalence and inherent challenges in addressing it, what are employers to do?

The IBI report suggests upping your commitment to workplace-based cancer screening and job accommodations. Here are some of those advantages, according to the study:

  • Compliance rates with cancer-screening guidelines are highest when there is access through insurance-plan coverage.
  • Workplace educational programs have been shown to raise awareness of and screening for colorectal cancer.
  • Workplace screening for breast cancer reduces lost productivity.
  • Employees whose breast cancer was detected early through on-site mammography experienced half as many lost workdays for treatment as employees whose cancer was detected later.
  • Providing job accommodations or other workplace stay-at-work or return-to-work opportunities has been shown to help employees with cancer remain on the job.

Also worth looking into, if you haven’t already, is the National Business Group on Health’s cancer guide, An Employer’s Guide to Cancer Treatment and Prevention, which I blogged about back in November.

In that post, I suggest we’re only going to see cancer cases at work grow as baby boomers age and stay in the workplace. It’s … well … increasingly part of life. And getting older. Ask my dad.

As Helen Darling, retiring NBGH president and CEO, puts it in the November post:

Today, more than ever, employers are facing the growing impact of cancer … . With significant gains in cancer survival rates and most cancer survivors staying at work during their treatment or returning to work after their treatment, employers need a comprehensive benefits plan to ensure that their current strategies to address cancer in the workplace complement the needs of their employees. Cancer casts a wide net, affecting not only those diagnosed with the disease, but also family members, friends, managers and co-workers. The impact on a company’s culture can be profound.”

 

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Will Employers Stop Offering Health Benefits?

Ezekiel Emanuel (an oncology doctor, professor of ethics at Penn and brother of Chicago mayor Rahm Emanuel) was one of the architects of the Affordable Care Act — which, as we all know, mandates that employers with at least 50 full-time-equivalent employees provide health insurance. So it’s a bit surprising to learn that Emanuel has just written a new book in which he predicts that, as a result of the ACA, most employers in the United States will have stopped offering health benefits to their employees by 2025.

Why will companies stop offering health benefits? Because, Emanuel argues in the book — Reinventing American Health Care: How the Affordable Care Act Will Improve Our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System (how’s that for a title?) — the online insurance exchanges will provide employers with a viable alternative for doing so. Now, after you’ve picked yourself up off the floor from laughing so hard at the idea of Healthcare.gov being described as a “viable alternative” (although many of its worst bugs appear to have been fixed), note that Emanuel does acknowledge the botched rollout of the federal online exchange and some of the state ones, yet he describes others (such as Connecticut’s state exchange) that are working well. If all of the exchanges are fixed to the point that consumers can obtain health insurance by spending only 30 minutes or so enrolling, he says, then companies will indeed have a viable alternative to the expense and administrative hassles of providing benefits and can instead simply give their employees money to go out and purchase benefits on their own. The ACA’s excise taxes on high-cost health plans scheduled for 2018 are yet another incentive to get out of the health-benefits game, says Emanuel.

Private exchanges, which are essentially a defined-contribution approach to health benefits, have certainly sparked a lot of interest among employers lately. As many as 33 percent of respondents said private health exchanges would be their preferred approach to managing health care in the next three to five years, up from 5 percent now, according to Aon Hewitt’s Health Care Survey of more than 1,230 employers covering in excess of 10 million employees (Aon happens to be one of the vendors that offers a private exchange; others include Towers Watson, Buck Consultants and many smaller vendors). Brian Poger, CEO of consulting firm Benefitter, said at the just-concluded Health & Benefits Leadership Conference in Las Vegas that for many employees — especially low-wage workers with families — the health coverage available on public exchanges might be a better deal than that provided by their employers, considering that many have cut back or eliminated coverage for spouses and families.

Jettisoning traditional health benefits has yet to become a major trend among U.S. employers: Accenture estimated that 1 million employees enrolled in private exchanges last year, a tiny percentage of the nation’s workforce (although it also estimated that number could grow to 40 million by 2018). There is also the risk that employees on private exchanges will “buy down” — that is, purchase less-costly plans that may ultimately leave them with less coverage and worse health outcomes than traditional health plans, which tend to have “marginal” price differences, Mike Thompson, healthcare practice leader at PwC, told me last year. Companies that switch to private exchanges may also risk breaking the linkage between benefits and wellness, he said.

The expression “paradigm shift” is an overused cliché, but it’s clear we’re in one now when it comes to health benefits. Rest assured we’ll continue to cover this area closely.

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Lessons from a Trusted Source

Consumer Reports has been a trusted source of information for folks in the market for a new car, a toaster oven or a snowblower. So why not healthcare?

I could be mistaken, but as a long-time subscriber, I’ve been noticing an increasing number of healthcare-related articles in Consumer Reports as of late. Articles86507521 like “Six Last-Minute Health Insurance Buying Tips” and “Six Tips for The Last Month of 2014 Health Care Open Enrollment.” But as Tara Montgomery made quite clear in her March 18 keynote during HRE‘s Health & Benefits Leadership Conference at Caesars Palace in Las Vegas, CR‘s commitment to healthcare these days goes well beyond an article here or there.

In its very first issue, Montgomery pointed out, CR covered healthcare, with a story on Alka Seltzer and whether it lived up to all of its claims.

But it wasn’t until around 2003, she explained, that CR expanded its efforts in the healthcare arena. Then, five or six years ago, she said, CR really stepped up its efforts as quality data started to emerge.

Montgomery, who is senior director of health partnerships and impact at CR, walked attendees through the multitude of products CR offers, and the partnerships it’s engaged in, that are aimed at informing consumers and giving them tools for making better decisions. (HRE also recently interviewed Montgomery, if you’d like to read more.)

Leveraging the trust inherent in the CR brand, Montgomery said, “We want to teach consumers how they can become better shoppers for healthcare.”

Near the end of her presentation, Montgomery offered attendees some of the lessons CR has learned along the way, including:

  • How valued its brand is to employees. “There’s a lot to be said for using a trusted messenger in this alienating healthcare system,” she explained.
  • There are a lot of good, positive stories that can be told regarding health and well-being, and people who have taken responsibility for their health.
  • You have to “push” your messages, because people are not out there seeking this kind of information, just yet.
  • When you put the right tools at the point of decision-making, good things happen.
  • Personalize what you do.  “One size fits all is not very helpful,” she said. “Don’t talk to everyone at once, but segment your audience.”
  • Use entertainment and humor in your communications. The organization is able to take advantage of its team of journalists, who are talented storytellers—and that is much better than sending out official documents.
  • Put safety first, which almost always results in cost-savings, too.
  • Write your materials at the 7th grade level. CR‘s research has found that even consumers with a high literacy level are extremely comfortable with communications at that level and didn’t feel the material was dumbing down to them. (Also, don’t make it text heavy and use graphics.)
  • It’s OK to incorporate games, but make sure that they’re truly helpful and not just gimmicky.
  • Make sure your messages have cultural relevance. “Don’t just show generic individuals sitting in the doctor’s office,” she said.
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A Better Wellness Experience

It was only halfway through the first day of HRE‘s Health & Benefits Leadership Conference in Las Vegas, but already the topic of wellness and the ever-elusive ROI had come up a few times.

160476428If you ask Sarah Lecuna, benefits program manager for Intuit, maker of the popular TurboTax program, her organization has yet to reap an ROI from its wellness efforts.  (I suspect the company isn’t alone in that respect.) But that hasn’t diminished the software maker’s commitment to building a culture of wellness.

Intuit’s journey, which was recounted at an afternoon session yesterday that was titled “Beyond ROI: Wellness and the Employee Experience at Intuit,” has very much been a journey of trial-and-error. Lecuna pointed out that the company offers a rich menu of wellness tools, including walking tracks, health fairs, fitness centers at some sites (with basketball and volleyball courts), and the ability to borrow a company bike for an unlimited period of time.

Senior management gave the green light to a companywide wellness program in April 2007, according to Lecuna. The program, she said, was announced to employees through an intensive communication campaign that included emails, posters and the like. At the time, employees were given a $100 incentive to answer a 15-minute questionnaire.

In ensuing years, she said, Intuit’s wellness efforts seemed to run into something of a brick wall. “People,” she recalled, “didn’t want to participate in the health questionnaire. People weren’t engaging in coaching. People weren’t changing behaviors.”

To address this challenge, Lecuna said, Intuit decided to use a health-risk assessment as a gatekeeper. “We said ‘Not only do you need to do the questionnaire, but if you want to cover your spouse or domestic partner, they will have to do the questionnaire too.’ ”

As a company, Lecuna explained, Intuit is all about creating “delightful experiences” for its customers. “But this wasn’t delightful at all. Everyone hated the experience.” The negative feedback was “endless,” she said.

In an effort to fix the problem, Lecuna said, the benefits team decided to hold a series of focus groups to listen to what employees had to say.

Taking employees’ feedback to heart, Intuit decided to stop using the HRA as a gatekeeper (putting it back into the Virgin Pulse program) and moved to an outcomes-based incentive program, which turned out to be much better received by employees, Lecuna said.

In communicating the change, she added, “Intuit took a top-down approach,” featuring a videotape of the Intuit’s CEO telling his own story about how a biometric screening was an eye-opening experience for him personally. (One more example of a C-suite leader taking the lead, the subject of HRE‘s March cover story.)

Obviously, the Intuit story is still being written. Today, Lecuna told attendees, HRA participation is just a fraction of what it used to be; but the use of biometric screenings has increased, with 82 percent of employees and 79 percent of spouses now participating.

No doubt many factors have contributed to Intuit’s success, but I have to believe somewhere near the top of the list has to be its ability to pay close attention to what its employees were thinking and saying. There’s no guarantee that it will someday result in the company achieving a notable return on its investment, but one thing’s for sure: It certainly doesn’t hurt.

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