Source: 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].

Source: 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].

Source: 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].

Source: Chapman Institute

What is this about?

A major challenge for all U.S. employers is implementing employee wellness programs without triggering any regulatory compliance problems.  Historically, the federal Equal Employment Opportunity Commission (EEOC) has been the main federal agency concerned about the potential for U.S. employers to use their wellness incentive features to discriminate unfairly against various groups of employees.  Much of this concern has turned out to be unfounded but was legitimately stimulated by a few over-zealous employers putting limitations on health benefits coverage for self-imposed health practices, such as smoking or not wearing seat belts or requiring unreasonable health outcomes to secure the incentive reward. The other major regulatory concern for U.S. employers in the wellness space has been the Health Insurance Portability and Accountability Act (HIPAA) and specifically the prevention of unauthorized disclosures of individual health information. Additionally, a few states have somewhat more detailed privacy and confidentiality provisions and a few have some tobacco use protections that apply to employees in their respective states. However, the incentive regulatory issues and the EEOC’s role have been the most problematic for U.S. employers.

The document in this edition of Connections newsletter contains a number of programming recommendations that are intended to completely prevent any potential incentive compliance problem with employee wellness initiatives. 

Why is this important?

This document is important because it provides programming strategies that are intended to virtually eliminate any potential for employee complaints and subsequent compliance problems associated with wellness incentive features.  This has the effect of removing an annoying and potentially risky unknown from the management of employee wellness programs while safeguarding the controversy-free operation of your program.

What can you do with this document?

• First, read it to get a sense of what it calls for from wellness program and incentive management.
• Next, determine which of the recommendations should be included in your program management strategy for the next programming cycle.
• Then, layout which additional recommendations should be incorporated into the wellness program incentive feature over the next couple of years.
• Periodically evaluate the effects of the changes in securing effective and efficient program operations.

In summary, this set of recommendations about wellness incentive design and operation are intended to provide a pragmatic approach to minimizing the potential for employee complaints regarding wellness incentives and significantly reducing the risk of compliance problems with the EEOC.

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].

Source: American Journal of Health Promotion

What is this about?

A major challenge for all employers is understanding how other employers are approaching employee wellness. National data on employer wellness efforts has been spotty at best. This documents reports on the fifth national randomized, stratified sample of employer wellness efforts that was conducted primarily in 2017 through the federal Centers for Disease Control and Prevention (CDC). This survey reports on a wide range of issues around health promotion and wellness and occupational health in the American workplace and is stratified for employee size, industrial category and state. Additional comparisons are made with the previous national survey conducted in 2004.

Some interesting highlights contained in the survey results include:

• 35,584 employer organizations with 10 or more employees were contacted to complete the survey. (Initial sample)
• 2,843 employers completed the survey (10.1% of the final sample)
• 46% of respondent organizations had worksite wellness programs for employees.
• 72% of respondents had a designated employee managing the wellness program.
• 59% of respondents had an employee advisory committee for the wellness and/or safety program.
• 36% did not have a budget for the wellness program.
• 50% evaluated their wellness program with data.
• 26% of respondents have offered an HRA in the previous 12 months.
• 22% of respondents have offered health screening in the previous 12 months.
• 45% of respondents offer an EAP.
• 53% of respondents offer incentives for wellness.
• 28% used health plan premium discounts as incentives for wellness.
• 58% rated cost of programming as the major challenge to wellness programming.
• 17% of respondents have a “comprehensive health promotion” program according to these 5 elements.
  1. health education programs,
  2. supportive social and physical work organization,
  3. integration of the program into the organization’s structure,
  4. linkage to related programs such as employee assistance programs (EAPs) and
  5. health screening with appropriate follow-up and education. (From DHHS, Healthy People 2010)

Why is this important?

This document is important because it provides many in-depth insights into the current status of health promotion and wellness programming conducted by American employers. These insights provide valid reference and comparison points for employers interested in examining their own employee health improvement efforts. The validity of the survey methodology used in the study allows many useful implications to be drawn from its findings.

What can you do with this document?

• First, familiarize yourself with the issues that are reported from this survey.
• Next, for each of the relevant attributes draw a comparison with your own wellness program for senior management.
• Then, provide a set of recommendations for management about how your wellness program should evolve during the next 2 -3 years.

In summary, this survey can help bring perspective to employee wellness programming efforts by comparing your own efforts with national data on the characteristics of other employer wellness 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].

Source: Chapman Institute

What is this about?

A major challenge for all employers is how to align their health plan design so that it supports wise personal health care choices and wellness behaviors.  Historically health plan design has been either agnostic with regard to wellness or in the worst situations, actively in conflict.  We know that rich or generous health plan design leads to higher cost and can undercut wellness and wise plan use choices of employees and their family members.  Issues such as plan type, out-of-pocket cost sharing levels and forms, utilization incentives, health cost management requirements, provider panels and preventive benefit design all have a significant impact on the health effects and cost of health benefit coverage.

The various health plan design features that are addressed in this Solution Set document include:

• Core health plan functions
• Plan Type
• Employee Premium Contribution Level
• Employee Share of Future Plan Increases
• Size of Individual Deductible
• Number of Family Deductibles/year
• Co-insurance rate
• Annual Maximum Out-of-Pocket (Individual) MIOP
• Annual Maximum Out-of-Pocket (Family) MFOP
• Emergency Room Co-pay
• Prescription Drug Cost Sharing (All drugs must be included in a formulary and unusually high-cost drugs must be used under case management oversight.)
• Preventive Medical Benefit Coverage
• Separate Employee Premium Contribution for Wellness Incentive
• Case Management Requirement
• Management and operating principles

Why is this important?

This document is important because it addresses the major elements of health plan design that lead to efficient and effective health care utilization and provide the strongest support for individual employees to engage in wise health consumer and wellness supporting behavior.  My experience with more than a thousand employer wellness programs and benefit re-design projects underscores that the best worksite wellness programs will only produce mediocre results if the health plan involved are not fully aligned and compatible with the wellness behaviors (and attitudes) that the employer wants to promulgate among employees and their family members.    This document is an important resource because it can help you get the most out of your worksite wellness efforts.

What can you do with this document?

• First, familiarize yourself with the issues that are addressed in this Solution Set.
• Next, assess for all these issues the current status of each recommendation for each health plan offered to employees.
• Then, provide a set of recommendations on how each health plan involved can be modified to enhance its alignment with wellness goals and objectives.
• Then, conduct after the modifications are in place for a minimum of 12 months, conduct an evaluation of the effects of the recommendations.

In summary, this Solution Set document can help bring greater effectiveness to employee wellness programming efforts by modifying and aligning health plan design to support the behaviors and attitudes that are embodied in our 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].

Source: Chapman Institute

What is this about?

A major challenge for worksite wellness program managers is finding the many useful free websites on the Internet that can help with some aspect of the design or operation of an employee wellness program. This edition of the Connections newsletter contains the Solution Set that identifies many of these websites.  Links are provided and a quick assessment of the value of the website.  These websites have all been validated at the time of the publication of this Connections newsletter.

The various websites identified in this document include the following wellness program functions and activities:

• Find out the status of ACA wellness provisions
• Find out authoritative science position on preventive interventions
• Get program intervention tools
• Get low-cost wellness education tools
• Get comparison data on employer benefits, productivity and costs
• Get comparison data on health risks, health behaviors and practices
• Find out federal wellness efforts and activities
• Get low or no cost federal wellness resources
• Find out about the most prestigious award for employer wellness programs
• Find out an easy way to stay current on new developments

Why is this important?

There is a large number of useful resources on the Internet but it usually requires a fair amount of time to find them.  Most of us don’t have the time to do that and consequently we usually discovery valuable resources in a very haphazard manner.  This document is important because it can save you a significant amount of time.

What can you do with this document?

• First, look over the list and identify which websites are new to you and have potential value to your work.
• Visit those websites and familiarize yourself with their content.
• Based on the need or problem you need to address use the website that you select.
• Distribute this listing to your wellness advisory committee members and wellness champions and ask them to take a quick look at the ones that look interesting.
• If you decide that selected websites have high potential to be useful ask one of your committee members or champions to dive deep into a few and bring back useful resources that are discovered.

In summary, this Solution Set document can be used to help you efficiently find websites with free or low-cost resources for your worksite wellness 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].

Source: Chapman Institute

What is this about?

The vast majority of U.S. employer wellness programs suffer from the major challenge of relatively low levels of employee participation.  Typically, less than 50% of eligible employees and/or spouses participate in their employer’s wellness program.  Usually, this is because employers are not utilizing well-designed incentives or not using incentives at all!  If they chose to use well-designed incentives, they would likely have many more employees participating in their employee wellness programs and doing wellness.  With a set of well-designed incentives, you can usually get 90%+ of eligible employees and spouses actively participating and engaged. Technically we usually refer to participation in incentive programs as the “motive force” of the wellness incentive, which computationally is the percent of eligibles that participate in each incentive opportunity. Participation is obviously a prerequisite for engagement, so therefore you clearly want the highest level of motive force that you can get from your incentive efforts.

A key starting point in overcoming the major challenge of low participation begins with the sound design of your wellness incentive feature or program. A well-designed incentive has several key attributes. This includes:

• Good promotional activity
• Easy entry for participants
• Reasonable qualifying behavior(s)
• Appropriate choice and magnitude of reward(s)
• Efficient record-keeping and tracking
• Good administrative follow-through on the provision of the reward(s)
• Follow-up reporting that reinforces future participation

In this edition of Connections Newsletter, we provide a useful Solution Set document that allows you to test your incentive design knowledge and to learn how to maximize the motive force of any wellness incentive that you use.  In this document we look at a wide range of possible qualifying behaviors including: attendance at a health fair, completion of an HRA, attendance at a lunch and learn series, use of a fitness facility, completion of preventive screening, use of an e-health portal, participation in a walking challenge and achievement of multiple wellness criteria.  You can first test your knowledge on the worksheet provided and then consult the answer sheet to find out more about how to design the incentive to get the highest level of “motive force” or participation.

Why is this important?

Incentives are one of the only ways we have of attracting the roughly 80% of employees who are not intrinsically motivated toward wellness and usually ignore our employee wellness programs.  If we don’t have people participating in our wellness programs our science says they are not likely to change their wellness behavior. No wellness behavior change- no health improvement – no health improvement – no desired (or expected) economic results.  This Solution Set document from the Chapman Institute is a tool you can use to improve your ability to design effective wellness incentives.  This is important because a well-designed incentive is a key to achieving high levels of participation and producing the desired results that management wants from our worksite wellness efforts.

We believe that high levels of participation by employees and their spouses are associated with effective wellness programs and much greater levels of both lower and higher order program results.  (Remember the Results Hierarchy for Your Employee Wellness Program?) It is very important for our wellness programs to achieve both the lower order results (attitude change, readiness to change, short term wellness behavior change) and the higher order results (long term wellness behavior change, health risk mitigation, lower chronic disease prevalence, lower health claims cost) desired by senior management. Well-designed incentives are critical to this program calculus.

What can you do with this document?

• First, read the Worksheet and put your own answers into the worksheet related to identifying the expected motive force, key issues and improvements for each of the 8 incentive examples.
• Then compare your answers to the ones provided on the Answer Sheet.
• Summarize the common strategies that are reflected in the suggested improvements on the Answer Sheet and relate these back to the key attributes of effective wellness incentives.
• Use this document to help volunteers and staff improve the design of future wellness incentives.

In summary, this Solution Set document can be used to help you improve the design of your wellness incentives helping you get the participation and results you need from your employee wellness 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].

Source: Chapman Institute

What is this about?

The vast majority of U.S. employer wellness programs suffer from the major challenge of relatively low levels of employee participation.  Typically, below 60% of eligible employees and/or spouses participate in their organization’s wellness program.  Usually, this is because employers are not utilizing well-designed incentives with strong enough pay values resulting in relatively low levels of motive force (i.e. “motive force” is the percent of eligibles responding to the incentive opportunity).

A key starting point in overcoming this major challenge begins with finding out why your employee/spouse participation and engagement levels are low.  We often use a survey, focus groups or a series of interviews with key informants to nail down the underlying reasons for low participation. Once we have an idea of why employees are ignoring the wellness program we can then adopt the right counter-strategies to increase the general levels of participation among the eligible population.

In this edition of Connections Newsletter, we provide a useful table that allows you to match the major reasons for non-participation in the organization’s wellness program with one or more of 12 different participation enhancement strategies intended to increase employee/spousal participation levels in your wellness program.

Why is this important?

No participation – no behavior change.  No behavior change – no desired (or expected) results.  This Solution Set document from the Chapman Institute is a table that identifies the major reasons for low participation and then recommends specific participation enhancement strategies and the suggested order of their use.  This is important because it makes it much easier to select participation enhancement strategies that are specifically matched to the reasons for low participation in the group of employees you are working to serve.

High levels of participation are associated with effective wellness programs and much greater levels of both lower and higher order program results.  It is very important for our wellness programs to achieve both the lower order results (attitude change, readiness change, short term wellness behavior) and the higher order results (long term wellness behavior change, health risk mitigation, lower chronic disease prevalence, lower health claims cost) desired by senior management.

What can you do with this document?

• First, read it over and make sure you understand the major reasons for low participation and the basic nature of the 12 participation enhancement strategies.
• Decide what methods you are going to use to find out why employees/spouses are not participating in the wellness program. (Survey of non-users, use of focus groups with non-users, or key informant interviews)
• Carry out your research methods and then summarize the results. Strive to prioritize the major reasons for low participation in your employee wellness program.
• Using that prioritized set of reasons and starting with the most prevalent reason for low participation, use the table to select the participation enhancement strategies from the Solution Set document.
• After implementing the participation enhancement strategies within your wellness program track changes in participation to determine the “lift” these strategies create in participation.
• At the end of the program cycle or year determine if additional participation enhancement strategies should be introduced.
• Monitor participation patterns and start the process over again if participation levels have not increased enough or participation is not at an acceptable level.

In summary, this Solution Set document can be used to help you select the most appropriate participation enhancement strategies for your employee wellness program, assuring you get the results you want from the wellness 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].

Source: Chapman Institute

What is this about?

Author:  Larry Chapman. One of the toughest challenges wellness professionals face is planning an evaluation of their wellness program. It’s a hard thing to do because evaluation can be both difficult and time-consuming for wellness staff.  It is also difficult to keep evaluation projects from creeping beyond their boundaries or appropriate limitations designed to help focus and keep the evaluation feasible to perform each year.  Often it can be hard to enlist management support for program evaluation without managers having unreasonable expectations about the evaluation.

Senior managers often want a comprehensive evaluation of their employee wellness efforts, performed with rigorous research methods, producing highly valid outcomes, while not requiring any additional resources to perform.  Not an easy task for anyone to achieve! These unrealistic expectations sometimes cause program managers to ignore evaluation entirely – which often comes with its own perils.

Therefore, the major evaluation challenge for wellness professionals is to: keep their proposed evaluation feasible and simple to understand, approved ahead of time by senior management, producing valid and objective evaluation feedback while assuring that the evaluation can be repeated consistently each year in a sustainable manner. This Solution Set is designed to help you meet this programming challenge.

Why is this important?

This one-page draft of an evaluation plan for your employee wellness program is important because it provides an easy and quick template you can use with senior management to get advanced approval for how you can evaluate your organization’s wellness effort and report back to your executive team.

What can you do with this document?

Here’s what you could do with this document:

• First, read it over and make sure it includes the evaluation questions you want to address and the appropriate timing of reporting to senior management.
• Using the draft, discuss it with your employee advisory committee members.
• Circulate it to your Wellness Ambassadors and request feedback.
• Either directly or through your supervisor, send it to your executive team and ask them if this proposed evaluation of the employee wellness effort meets with their approval. (Suggestion: request a desired response date from them.)
• Once approved by senior management, use the plan to set up your program evaluation and reporting structure.
• At the end of the program, year use the plan to put an annual evaluation report together.

In summary, this 1-page document can be used to help organize and gain agreement from senior management on the evaluation plan for your employee wellness 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].