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Larry Chapman’s Blog
Results-Driven Worksite Wellness
The Good, Bad and Ugly of Worksite Wellness
Benjamin and Kerwynn Prinzing from Kadalyst, hosts guest, Larry Chapman, Founder & CEO of the Chapman Institute and with over 40 years in the industry over an interactive Live Stream event on what’s working on not working in the wellness industry.
Recommended Low-Cost Wellness Resources
Source: Chapman Institute
What is this about?
Budget is usually a major challenge for most employee wellness programs. Since employee wellness and well-being programs are completely discretionary or “optional” in terms of management decision-making around resource allocation, it makes it very hard to adequately fund these kinds of programs. Employee wellness professionals usually must work hard to secure adequate vendor budgets. The Connections document in this edition of the newsletter is a vetted listing of no-cost or low-cost wellness program resources that can be used to stretch your employee wellness vendor budget and enhance your program’s effectiveness. The key to low-cost wellness resources is getting them to the employees (and family members) that need them and can use them. How well we do that has a lot to do with how much value they bring to our programming effort.
Why is this important?
This issue is important for three major reasons. First, our limited program budgets need to be stretched with good wellness resources. You can do that by careful use of the resources identified in this Solution Set document. Second, our employee wellness programs need to address the widest range of health and wellness issues we can. The topical or issue “richness” of our programs is important in meeting the needs of our target populations. Low-cost wellness resources can add that “richness”. This Solution Set document identifies 57 different resources across 16 different topic areas that have been recommended either by the Chapman Institute or various WellCert graduates. (Actual contributors are recognized) The third reason this is important is that senior managers usually want to know if our programs are efficient at utilizing resources and that we are not wasting money. When we carefully integrate no cost or low-cost resources into our employee wellness or well-being program it provides an opportunity to demonstrate our efficient management of resources. It’s like saying…“Look how careful we are at using budgetary resources – we will use any additional funds you might want to give us to real advantage.”
What can you do with this document?
- First, look the document over to get a sense of the range of topics and interventions that are recommended.
- Next, see if you are already using any of these resources. For those you are using make sure they are made available in a way that is likely to get to the right person at the right time.
- Then, determine which of the remaining resources/interventions in the document table offer the most potential to help enhance the topic “richness” of your program and fill any recognized gaps.
- Then, decide for those resources or interventions you are considering using, how you plan to make them available to those who are likely to need them. The more “friction” you can take out of the process by making them easy to access the better.
- Then, once you have made the no-cost or low-cost resource available to your group write up a brief notice of the new program activity (pointing out its low-cost nature) and circulate it to key managers and your employee advisory members/wellness champions. If you do this 2 or 3 times a year the message od good budget stewardship will get across.
- Finally, take a look at least once a year at the list to see if new needs have arisen that can be met by any of these low-cost resources.
In summary, this document contains a large number of low-cost resources recommended by colleagues to help enrich your employee wellness/well-being program and to make it more effective at meeting the needs of your population while helping senior management feel better about the wellness budget and program.
Click here to download this document
NOTE: You will need to have an active WellCert Membership in order to download this document.
I hope this tool helps you reach your wellness programming goals! Drop me a note and let me know your thoughts and if you found it to be helpful: [email protected].
Assuring Long Term Behavior Change – Crossing the “Chasm”
Source: Chapman Institute
What is this about?
First, the good news… employer wellness programs have been proven to help people change their short-term wellness behaviors. Now, the bad news… those same wellness programs have been shown to be pretty poor at helping people change their long-term wellness behaviors. For our purposes, we will define “short-term” as 1 – 6 weeks and long-term as 6+ weeks. We obviously need to help people make as many long-term wellness behavior changes as possible if we want health improvement and economic return.
In the WellCert Program, we refer to this phenomenon as the “chasm” between short-term wellness behaviors and long-term wellness behaviors. It is vital for employee wellness programs to help all participants “cross the chasm” and move from doing wellness over short periods of time to doing that same behavior over long periods of time. The long-term wellness behaviors that become long-term habits enable individuals and wellness programs to gain the higher order results of wellness programming.
These higher order results include HRA improvements, health status or biometric improvements, health risk mitigation, lower disease incidence and prevalence rates, lower health care utilization and claims cost, and positive ROI. But without getting more people to adopt healthy habits and positive wellness behaviors over the long term we are not likely to realize the full potential of results that wellness programming potentially provides.
Why is this important?
This issue is absolutely critical to the future of the field of worksite wellness and it is also critical for the future competitiveness of our employee and employer communities. This Solution Set document identifies 14 possible strategies that employers can use to help assure that their employee wellness programs help more people get “across the chasm”, and successfully adopt long term wellness habits. If we want more than just the lower order results from our employee wellness efforts (knowledge change, attitude change, readiness to change, and short-term behavior change), we have to use these strategies to secure those desired higher order results (long term behavior change, health status changes, health risk changes, improvements in disease and condition prevalence, health care utilization changes, health care claims changes and VOI and ROI). Without meaningful results our programs are not likely to be around over the long haul.
What can you do with this document?
- First, look the document over to get a sense of the range of strategies that are recommended.
- Next, examine your current wellness programming initiative for the present use of these strategies. Eliminate those strategies you are already using, but before you do that make sure they are now being deployed in an optimal way.
- Then, determine which of the remaining strategies offer the most potential to help participants …”cross the chasm.”
- Then, decide how you will introduce each of the applicable strategies into your program.
- Then, begin the process of introducing the various strategies.
- Then, determine how you are going to measure the effects of the various strategies on key metrics.
- Then, monitor the metrics to observe the change.
- Then determine your next steps.
In summary, this list of specific programming strategies for helping employee participants to ..”cross the chasm” and adopt more long term wellness habits is designed to significantly enhance the effectiveness of your employee wellness effort and to produce both more lower order and higher order program results.
Click here to download this document
NOTE: You will need to have an active WellCert Membership in order to download this document.
I hope this tool helps you reach your wellness programming goals! Drop me a note and let me know your thoughts and if you found it to be helpful: [email protected].
Getting management to be serious about Wellness
Source: Chapman Institute
What is this about?
Unfortunately, most employee wellness programs in the U.S. are both under-funded and relatively ineffective. They also tend to be more tactical in nature with limited strategic or business value. A recent article in JAMA documented the ineffective nature of the typical employee wellness program using an admittedly elegant research design.1 The unfortunate reality is that the management of most U.S. companies is not very serious about wellness or wellness programming. As a field, we need to help them see the strategic potential and strategic importance of employee wellness programming. This is particularly important for the average employee and the average employer.
1 Song, Z., and Baicker, K., Effect of a Workplace Wellness Program on Employee Health and Economic Outcomes, JAMA, Vol. 321, Number 15, April 16, 2019, 1491-1501.
Why is this important?
This is also important for the future of the field of worksite wellness. This Solution Set document is designed to provide a draft of a brief email for use in polling your senior management team on their perceptions about the strategic value and nature of employee wellness. The draft email is designed to focus your executive teams’ attention on your current employee wellness efforts and to raise the question of desired results. It is important because it is intended to get senior management’s attention and provoke them to action. Without a catalyzing email like this one, they are likely to continue the “same old – same old” approach that has not produced much in the way of meaningful results. The bottom line is – what have we got to lose?
What can you do with this document?
- First, look the document over to get a sense of what it attempts to do.
- Next, review the entire process with your supervisor and get approval to proceed. Don’t forget to brief your “champion” if he/she is not your supervisor.
- Then, decide if any of the draft text in the email should be modified and make the changes.
- Then, determine which managers should receive the email.
- Then, decide when you would like a response. Be sensitive to their work pressures, vacations, travel etc.
- Then, send the email out.
- Then, monitor the responses around the requested date.
- Then, follow-up with any late respondents and summarize the responses.
- Then determine your next steps.
In summary, this draft email is intended to get senior management’s attention and to catalyze a re-examination of your employee wellness program effort with the potential of upgrading your current programming efforts and helping your organization get more serious about their employee wellness initiative.
Click here to download this document
NOTE: You will need to have an active WellCert Membership in order to download this document.
I hope this tool helps you reach your wellness programming goals! Drop me a note and let me know your thoughts and if you found it to be helpful: [email protected].
Proposal for Wellness Program Redesign
Source: Chapman Institute
What is this about?
Unfortunately, most employee wellness programs in the U.S. need to be redesigned for greater effectiveness, but few wellness coordinators know how to make a simple redesign proposal “pitch” to their senior management team. The proposal they put forward needs to be seen as feasible and logical for senior management to endorse it. Another part of the challenge is making the redesign process robust enough to produce a stronger redesigned wellness program without getting too much into the “weeds” and losing your senior managers’ attention. This requires a carefully balanced approach and a little finesse.
Why is this important?
This Solution Set document is designed to provide a sample of a brief proposal for redesigning your employee wellness program. It is important because it is intended to get senior management’s attention and provoke them to action. Without a catalyzing event/proposal like this, they are likely to continue the “same old, same old” approach that has not produced much in the way of results.
What can you do with this document?
- First, look the document over to get a sense of how it positions the key organizational issues around a possible program redesign.
- Next, decide if any of the statements or redesign planning steps contained in the draft document should be modified. (You may be proposing a new wellness program versus a redesign of an existing wellness program.)
- Then determine which employees should be involved in the redesign project and add them to the proposal.
- Decide who should facilitate or lead the effort.
- Then, show the proposal to your supervisor or senior management “champion” to get their feedback and approval to proceed.
- Then, distribute the proposal through the appropriate “chain of command” channels with a requested date for feedback or a decision.
- Follow-up with your principal contacts at the appropriate time.
In summary, this sample proposal for requesting a redesign of your employee wellness program is intended to help your management staff re-examine the way your organization is approaching employee wellness and well-being and to improve the effectiveness of your programming effort.
Click here to download this document
NOTE: You will need to have an active WellCert Membership in order to download this document.
I hope this tool helps you reach your wellness programming goals! Drop me a note and let me know your thoughts and if you found it to be helpful: [email protected].
Solution Set #13 – Sample Request for Health Plan Claims Analysis
Source: Chapman Institute
What is this about?
Employer health benefit costs are headed up again. Estimates range from 6% to 9% or higher annual increases for 2020 renewals. For larger organizations, a health plan claims analysis of their employee wellness program is certainly desirable. Yet few wellness professionals know much about how to request a valid health plan claims analysis. In this edition of Connections, we provide a sample health plan claims analysis request. You can use this document to help prepare your own request. This sample request applies primarily to employers with several thousand employees that are concentrated in a few health plans and have a clear definition that separates “participants” from “non-participants.”
Why is this important?
This Solution Set document is designed to provide a template for your health plan claims request. It is important because it establishes the technical parameters for the effort and helps contain the analysis to those issues that are relevant. A critical issue in health plan claims analysis is how very large or catastrophic claims costs are handled. This issue confounds most of the peer review articles that have been published in the field and creates non-random bias which unfairly prejudices these analyses. It is not fair to expect a garden variety employee wellness program to have a significant effect on the rare and very large catastrophic claims of employees and family members. The important econometric assumption recommended here is the use of the conventional attachment points associated with individual stop-loss reinsurance as a way of more fairly adjudicating what claims expense should be included in the analysis. This becomes even more important when considering the highly skewed distribution of typical employer claims patterns. The analysis needs to be conducted in a reasonable business-based manner in order to appropriately guide business decision-makers.
What can you do with this document?
- First, look the document over to get a sense of how it positions the key technical issues of the health plan claims analysis.
- Next, decide if the proposed position on those technical issues is appropriate for the analytical expectations of your senior managers. (Note: This is where the use of a survey of senior managers such as the one included under Solution Set #1 – Quick Senior Management Survey on Wellness becomes critical.)
- Then, determine which of these technical issues needs to be modified for use in your request and then adapt it to the specifics of your own health plan situation.
- Also, remember that the sub-populations to be studied (“Participants” and “Non-Participants” should each have a minimum size of 1,000 individuals to assure the actuarial credibility of any analytic results. Some actuarial techniques can be used with smaller populations but are limited.
- When you have received the raw data from your health plan, go ahead and do the summary analysis of savings and costs and make the comparison with the total direct cost of your employee wellness program to derive ROI (Return-on-Investment).
- Don’t forget to conduct an analysis that answers the question of whether any other variable or factor could have accounted for the observed change in expected health plan claims cost between participants and non-participants. If no other alternative explanation is identified, then it is reasonable to propose that the attribution of the observed change is likely due to the effects of your employee wellness program. It is also advisable to look for any intermediate results (i.e., participation, risk prevalence changes, screening results, morbidity changes, etc.) to help establish attribution and to help document the “cause and effect” relationship of your wellness program to employee health plan cost.
In summary, this sample request for a health plan claims analysis can be used to examine the effects of an employee wellness program on an employee’s health plan claims cost experience and is critical in establishing the primary economic effects of the program on a particular workforce
Click here to download this document
NOTE: You will need to have an active WellCert Membership in order to download this document.
I hope this tool helps you reach your wellness programming goals! Drop me a note and let me know your thoughts and if you found it to be helpful: [email protected].
Solution Set #12 – List of Wellness Integration and Linkage Points
Chapman Institute
What is this about?
Most of us know that better-integrated wellness programs achieve more results, both the lower and higher-order results from our Results Hierarchy Solution Set (S3). The challenge all employers face is knowing what elements in their wellness program need to be integrated. This Solution Set document provides a complete list of integration points where your wellness program activity can be linked to other wellness activities and other related organizational activities. They are divided into “program activities”, “policy positions” and “environmental aspects.” In addition, the most productive Google search string is provided to enable you to acquire actual examples of the integration steps or language involved.
Why is this important?
This Solution Set document is designed to determine how integrated your wellness and well-being programming is and how to improve its degree of integration. Integrating your wellness program usually involves some level of personalization, use of personal information to shape programming, provision of reminders, linkage of messaging, repetition of key messaging, creation of supportive environment including organizational policies and ease of use of programming. Ultimately a major portion of the potential results of your wellness program will be determined by the degree of integration of your wellness activities. By using the recommended search string, you can access examples of policies, approaches and messaging that can strengthen the integration of your wellness programming and its effectiveness.
What can you do with this document?
- First, look the document over to get a sense the span of issues that integration addresses
- Next, decide which of these points you feel are adequately addressed now and check the “OK” box.
- Then, determine which of the remaining items need attention and number them in the “OK” box as to how you are going to work on them. (Number “1” is first up, “2” is second-up. etc.)
- Then, slowly work through each one using the search string to get actual examples of each.
- Then, introduce the improvements you come up with.
- Then, perform a follow-up evaluation of the effectiveness of your wellness program on the key results you desire.
- Periodically write up that evaluation and distribute it to key stakeholders.
In summary, this fairly comprehensive listing of integration and linkage points can be used to enhance the overall effectiveness of your employee wellness efforts and provides a useful framework for better integrating your wellness programming efforts.
Click here to download this document
NOTE: You will need to have an active WellCert Membership in order to download this document.
I hope this tool helps you reach your wellness programming goals! Drop me a note and let me know your thoughts and if you found it to be helpful: [email protected].
Estimating Presenteeism Costs in Your Organization
Chapman Institute
What is this about?
Another major challenge facing all U.S. employers involves estimating the current organizational cost associated with employees who are at work but have an underlying health problem that impairs their productivity. Whether it is the effects of cannabis addiction, poor sleep patterns, excessive screen time, a bout of mild depression or a pesky reflux condition, employers need to know how much lost productivity is occurring from health-related causes in their workforce. Once they know how large the problem is then the opportunity to manage it logically arises. Recent research establishes that presenteeism losses typically amount to 1 to 3 times the cost of health plan coverage for individuals in a workforce. This translates into between $17,000 and $51,000 per employee per year in lost value from the level of total compensation involved.
Why is this important?
This document is intended to be used to help you estimate the actual value of presenteeism losses associated with your employee’s health problems. If worksite wellness is to be viewed seriously by senior managers, we need to credibly measure and ultimately reduce the significant economic drain that health problems create for all employers. Without the ability to consistently track all worker health costs including presenteeism losses, management will likely under-value and under-fund employee wellness efforts.
What can you do with this document?
- First, read the document to get a sense of how presenteeism issues might be addressed.
- Next, decide your position on those issues for your organization.
- Then, determine what interventions you plan on taking and when you should implement them.
- Then, perform a baseline measurement to find out your presenteeism starting point.
- Then, implement your interventions or remedial action to reduce presenteeism losses.
- Then, perform a follow-up measurement to find out the effects of your interventions on your presenteeism losses.
- Periodically write up the evaluation of the effects on your organization and distribute it to key stakeholders.
In summary, this Q & A piece on addressing and measuring presenteeism in your organization provides a useful framework to help move your employee wellness activities to a more strategic and relevant position with your management team.
Click here to download this document
NOTE: You will need to have an active WellCert Membership in order to download this document.
I hope this tool helps you reach your wellness programming goals! Drop me a note and let me know your thoughts and if you found it to be helpful: [email protected].
Measuring Health and Productivity Management (HPM) Effects
Chapman Institute
What is this about?
A major challenge facing all U.S. employers is measuring the current status of their Health and Productivity Management (HPM) and the effects of their employee wellness/well-being intervention efforts over time. Without believable Return-on-Investment (ROI) evidence for their wellness efforts limited investment and priority will likely result. These resulting “tactical” wellness activities have even been referred to by some as “minimalist” or “zombie” style wellness programs. Repeating in a lock step manner the same few methodological steps (HRA, screening, lunch and learn events, etc.) resulting in minimal demonstrable effects or effectiveness.
If employee wellness is ever going to become “strategic” or vital to a work organization, it will need to have clear evidence of its positive effect on the organization’s HPM. Measuring employee HPM is how we document the economic evidence or ROI rationale for employee wellness.
The document in this edition of Connections newsletter contains a detailed set of instructions and a worksheet on how to measure current worker health and productivity-related costs of your workforce allowing you to document the Health and Productivity Management (HPM) status associated with your employee wellness/well-being initiative.
Why is this important?
This document is important because it provides a detailed methodology for measuring the economic and productivity effects of workplace wellness initiatives. If senior managers don’t understand or regularly quantify and track these economic metrics, they will usually not devote the resources, time and organizational priority to any activity like wellness programming. That’s why at least three-quarters of current employer wellness/well-being activity currently conducted in the American workplace is under-funded, overly simplistic and relatively ineffective. We believe that If we want to change that situation, work organizations will have to quantify their current HPM status and consistently track the effect that wellness activity has on their status.
HPM measurement should not have to adhere to an impossibly high academic standard of proof regarding attribution of causality for wellness but instead needs to meet a reasonable business standard for how we determine what activities benefit our work organizations. Tracking basic trends over time and examining for plausible alternative explanations for the effects we observe makes much more sense than holding out for randomized controlled trial (RCTs) evidence. The question is not…”do wellness programs work?” but rather..” how should we do wellness so that it does work for us?” Also we need to consistently examine the widest possible set of relevant economic and productivity variables in our approach. This needs to include at a minimum, health plan cost, sick leave absenteeism, workers compensation costs, disability insurance costs and presenteeism costs.
We believe this measurement process is absolutely critical to the future of workplace wellness.
What can you do with this document?
- First, read the document to get a sense of what issues are to be measured.
- Next, decide which of those measurement issues are relevant for your organization.
- Then, determine what data sources and time periods you are going to use to derive the metrics.
- Then, perform your baseline measurement to find out your starting point for all the relevant metrics, either prior to the introduction of wellness programming or after its introduction.
- Then, begin a regular process of measurement for all the relevant HPM metrics and use the metrics to help refine the wellness programming that is planned and implemented in each annual cycle of activity.
- Periodically write up the evaluation of the effects of the observed changes in your organization and distribute it to key stakeholders.
In summary, this worksheet and set of instructions for measuring the HPM for your organization provides a pragmatic approach to help you move your employee wellness efforts from a minimalist or “tactical” position to one that considers the wellness initiative as a more “strategic” and organizationally relevant priority by your senior management team.
Click here to download this document
NOTE: You will need to have an active WellCert Membership in order to download this document.
I hope this tool helps you reach your wellness programming goals! Drop me a note and let me know your thoughts and if you found it to be helpful: [email protected].