Source: America’s Health Insurance Plans (AHIP)

What is this about?

This edition of Connections newsletter provides an informative 5-page infographic plus explanatory text describing the typical distribution patterns of commercial health insurance expenditures for 2018 to 2020.  The methodology for the infographic is also described.

The top five (5) types of expenditures from commercial health insurance plans are:

1^st     Prescription Drugs                         22.0%

2^nd   Outpatient Hospital Costs           19.9%

3^rd   In-patient Hospital Costs              19.0%

4^th   Doctor visits                                      11.8%

5^th  Other Outpatient Care                      6.2%

Why is this important?

This document can be used to help educate employees about the general expenditure pattern for commercial health insurance.  This gives employees a sense of what health care dollars are spent on and the general magnitude of those expenditures.  Particularly with the uptick in health care claims costs after COVID, this is good for employees to know and understand.

What can you do with this document?

• First, this document answers the general question…”What are our employer health care dollars spent on?”
• Next, skim the document for the types of health care services that your health plan dollars are spent on and the magnitude of those expenditures on average.
• Next, examine the specific components of health insurance expenditures that define overall health care expenditures.
• Next, lay out in your program work plan how you plan to use this information during the year ahead.
• Next, implement your work plan details.

In summary, this document contains a detailed national overview of how employer health care dollars are spent and their relative magnitude. This is helpful information for employees to learn about their local health plan’s expenditures.

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Source: United States Preventive Services Task Force (USPSTF) Recommendation Statement

What is this about?

This edition of Connections newsletter provides an 8-page article published recently in JAMA from the USPSTF with recommendations for behavioral counselling interventions to promote a healthy diet and physical activity for cardiovascular disease prevention in adults without cardiovascular disease health risks factors.  This applies to a large percentage of U.S. employees and can be integrated into preventive screening and HRA activity conducted in the workplace. This updated set of recommendations examines both benefits and harms from this particular preventive services intervention.

Cardiovascular disease (CVD), which includes heart disease, myocardial infarction, and stroke, is the leading cause of death in the US. A large proportion of CVD cases can be prevented by addressing modifiable risk factors, including smoking, obesity, diabetes, elevated blood pressure or hypertension, dyslipidemia, lack of physical activity, and unhealthy diet. Adults who adhere to national guidelines for a healthy diet and physical activity have lower rates of cardiovascular morbidity and mortality than those who do not; however, most US adults do not consume healthy diets or engage in physical activity at recommended levels.

Why is this important?

This document is important because it provides detailed recommendations for how employer wellness programs can address the clinical prevention needs of employees that do not have current Cardiovascular Disease (CVD) risk factors.  This helps workplace wellness heart disease prevention efforts to be more closely aligned with Primary Care Practitioner (PCP) based clinical prevention efforts.

What can you do with this document?

• First, this document answers the general question…”How should our employee wellness program address behavioral counselling of CVD risk factors?
• Next, skim the document for the major recommendations about behavioral counselling for healthy diet and exercise.
• Next, examine the specific recommendations for employees completing preventive screening and use of an HRA and decide which of these you plan to incorporate in your program during the next programming cycle.
• Next, lay out in your program work plan how you plan to modify the current screening and HRA interventions .
• Next, implement them.

In summary, this document contains a detailed set of recommendations and the evidence base for behavioral counselling for healthy diet and exercise for adult employees without known CVD risk factors.  These recommendations help to more closely align employer-based heart disease prevention efforts with PCP and specialist provided advice and counselling to prevent CVD.

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Source: Chapman Institute and the WellCert Program

What is this about?

This edition of Connections newsletter provides an 8-page document with recommendations for how employee wellness programs can better protect their employees and family members from a future pandemic threat.  It is based heavily on lessons learned from the recent COVID-19 pandemic.

The document is a tool from the newly updated WellCert Level 2 CWPM certification course designed to help identify more proactive actions that workplace wellness practitioners can take to help their employees contend with a future pandemic threat.  It also is intended to help us appropriately capitalize on the enhanced health awareness and concern that often accompanies all the attention and fear that a pandemic generates.

This home-grown set of detailed programming recommendations are divided into actions that can be taken now (i.e. “Before” the next pandemic) versus when the pandemic is gaining momentum (i.e., “During” the next pandemic) versus when the pandemic is burning out or receding (i.e., “After” the next pandemic).

Why is this important?

This document is important because it provides detailed recommendations for how employer wellness programs can better protect employees and family members from the next pandemic threat.  It also has direct application to the currently receding COVID-19 pandemic.  It also provides practical advice on how to better integrate ongoing wellness program activity with pandemic-related interventions and protective measures.

What can you do with this document?

• First, this document answers the general question…”How should we address a future pandemic in our employee wellness program?
• Next, skim the document for the major recommendations before, during and after the next pandemic.
• Next, determine which of the three states (“Before:, “During” or “After”) you are in currently.
• Next, examine the specific recommendations for the state you are in currently and decide which of these you plan to implement.
• Next, lay out in your program work plan how you plan to implement the recommended actions.
• Next, implement them.
• Finally, periodically examine or evaluate how prepared your work force is to deal with a future pandemic.

In summary, this document contains a detailed set of recommendations on how a future pandemic can be addressed within an employee wellness program and how to better protect your organization’s work force from its health and well-being threat.

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Source: United States Preventive Services Task Force (USPSTF) and JAMA

What is this about?

This edition of Connections newsletter provides a copy of 3 articles and a patient education insert in this week’s online JAMA publications. The 4 articles have been combined into one PDF and include:

• The USPSTF issuance itself
• An explanatory article with summaries of data findings for physicians
• An objective analysis of the pro’s and con’s of the recommendations
• An educational insert for patients/employees about the recommendations

This new issuance of recommendations from USPSTF covers vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer.  Cardiovascular diseases and cancer accounts for slightly more than half of all annual deaths in the U.S. each year.  Approximately half of the U.S. adult population that have been surveyed by the National Center for Health Statistics (NCHS) indicate they had used at least one dietary supplement in the previous 30 days. Dietary supplements constitute a $50 billion industry in the U.S. The recommendations of the USPSTF include the balance of harms and benefits of the preventive practice under review.

The summary of the main recommendations from the USPSTF are:

* = This means adults that are not institutionalized and not pregnant.

** = “D” means enough evidence to recommend against,  “I” means insufficient evidence to recommend for its use.

Why is this important?

These 3 articles and an educational insert combined into one PDF document are important because they provide an in-depth explanation of the research methodology and scientific conclusions concerning the use of vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer. The practice of dietary supplementation is a huge industry and I believe is used by a significant portion of American adults as a substitute for adopting healthy lifestyle choices.  “Denial” is not just a river in Africa.  The economic ramifications and behavior change implications of dietary supplementation are likely to be enormous and pivotal to adoption of healthy behaviors by individual employees and their family members.

What can you do with this document?

• First, the PDF answer the questions…”Can some portion of our national heart disease and cancer deaths be prevented by selected dietary supplement use? And “What specific dietary supplement (i.e., beta carotene or Vitamin E) should be avoided?”
• Next, skim the 4 document for the major findings that are particularly relevant to your organization and population.
• Next, determine what specific uses you might put this information to and the communication channels that might be used, particularly the 4^th document which is a patient/employee education piece.
• Next, examine the role that the covered dietary supplements play in your wellness program targeting and interventions and consider introducing this information while pointing out the confirmed health effects of regular physical activity and sound nutrition practices.
• Next, if you choose to hold an educational session on recommended dietary supplement strategies use it to help people review the objective evidence for various practices and explain how powerful the placebo effects are in all of us.
• Finally, periodically examine the dietary supplement issues of your work force and consider whether additional program interventions and activities are needed.

In summary, this evidence-based set of recommendations on selected dietary supplement use is an important new finding that has significant economic and behavioral implications for all working populations.

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Source: The Lancet Psychiatry

What is this about?

This edition of Connections newsletter provides a copy of the recent article published in the respected peer review journal The Lancet Psychiatry on the Global Burden of Mental Health Diseases and Conditions and includes nine major mental health diseases/conditions as well as a catch-all category. The authors measured the global, regional, and national prevalence, disability-adjusted life-years (DALYS), years lived with disability (YLDs), and years of life lost (YLLs) for these 10 mental disorders from 1990 to 2019. This information covers some 204 countries and represents a comprehensive world-wide look at global mental health needs.  The 14-page peer reviewed article also contains a number of useful graphics highlighting the data which is particularly valuable for companies involved in global markets and global trade.

The mental health issues addressed in the article include:

• depressive disorders
• anxiety disorders
• bipolar disorders
• schizophrenia
• autism spectrum disorders
• conduct disorders
• attention-deficit hyperactivity disorders
• eating disorders
• idiopathic developmental intellectual disabilities
• and a residual category of other mental disorders

Why is this important?

This article is important because it provides in one place all the relevant data on the changing prevalence of major mental health needs, diseases and conditions on a global basis. This data is particularly useful due to the current employer concern for the mental health needs of employees and their family members.  This primarily post-COVID concern ranges from the traditional clinical mental health conditions described in the DSM (Diagnostic and Statistical Manual of Mental Disorders) published by the American Psychiatric Association to the emerging issues of mental well-being that have gained popularity as we recover from 2+ years of unprecedented global pandemic. This article helps identify the magnitude of the current mental health clinical disease burden facing employers, health care providers, governmental healthcare funders and private health plans

What can you do with this document?

• First, the article answers the questions…”How much mental health disease/disorders are we currently experiencing? And “How has this disease burden changed over the past 30 years?”
• Next, skim the document for the major types of findings that are relevant to your organization and population.
• Next, determine what specific mental health issues identified in the article are relevant given the comparative data available through your health plan vendor(s).
• Next, examine those data points for their significance in defining the mental health needs of your population and whether they can be used as baseline measures for future comparison purposes.
• Next, if you chose to implement any mental health interventions for your organization determine if the data in this article can be used to help you design the intervention(s).
• Finally, periodically examine the presenting mental health needs of your work force and consider whether additional program interventions and activities are indicated.

In summary, this very credible measurement of the mental health disease burden on a global basis provides a useful evidence-based set of reference points for estimating and measuring current and future mental health needs of working populations.

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Source: Community Prevention Services Task Force (CPSTF) , DHHS

What is this about?

This edition of Connections newsletter provides an easy-to-read set of evidence-based interventions for reduction of obesity and overweight status among working adults.  It is a set of formal recommendations from the Community Prevention Service Task Force (CPSTF) within the federal Department of Health and Human Services (DHHS). The recommendations highlight communities, worksites, schools and healthcare settings.  It is very short on definitive guidance for worksite-based obesity interventions but the span of evidence from other settings helps define what is likely to work in workplace settings.

Why is this important?

This infographic is important because it provides in one place all the recommended federal guidance on evidence-based interventions for weight management and control.  This is important because it potentially places in the hands of workplace wellness professionals the best science, we have on interventions for reducing obesity and overweight status in our working population. This document provides a clear and concise reference starting point for researchers, practitioners, and program administrators to move forward with science-based modifications for improved population health. The Centers for Disease Prevention and Control (CDC) recently estimated that obesity accounts for approximately 40% of all the cancer cases in the U.S. and an equally large proportion of the heart disease and diabetes care in our national population.

What can you do with this document?

• First, the document answers the question…”What weight management interventions should be implemented in which settings?”
• Next, skim the document for the major types of interventions that can be implemented in your worksite.
• Next, determine the interventions you would like to introduce in your organization.
• Next, have those interventions and the accompanying budget resources approved by senior management.
• Next, implement those interventions that are approved by senior management.
• Next, determine if aggregate screening data or aggregate health risk assessment data comparisons from previous to current periods indicate any improvement in the prevalence of obesity and overweight status in your work force.
• Finally, review your progress in managing this health risk periodically and consider whether additional weight management interventions are needed.

In summary, this evidence-based infographic provides a very useful piece of guidance for all workplace wellness professionals in dealing with the major health risk of obesity and overweight status in their working populations.

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Source: CDC, March, 2022

What is this about?

This edition of Connections newsletter provides the just-released, definitive guidance on all recommended immunizations over the human lifespan for the U.S. population. The recommendations are in two parts; Part 1 is for adults 19 and up and Part 2 is for infants and children through age 18.  This is the most comprehensive set of vaccination recommendations issued by the federal government to date and supersedes all previous federal guidance. A very handy, graphically attractive reference with plenty of detailed qualifications and comments. A timely issuance in an era where vaccine hesitancy has been steadily growing and where all parties involved need a common reference point for disease prevention.  However, I do believe that we still need to maintain a fairly high level of personal vigilance when considering our own and our family members potential reactivity to the vaccines involved for both health status effects as well as economic liability issues.

Why is this important?

This infographic PDF is important because it provides in one place all the recommended federal guidance on all currently available immunizations.  This is important because it potentially places in the hands of every employee the best science we have on the use of vaccination as a major health protection and disease prevention strategy for our population. This document provides a clear and concise reference starting point for researchers, administrators and clinicians to move forward with science-based modifications for improved population health.

What can you do with this document?

• First, the document answers the question…”What immunizations(aka vaccinations) should be given at what ages and what are the possible contra-indications?”
• Next, skim the document for the major diseases that affect the population you are working with.
• Next, identify where, when and how this infographic should be used to educate volunteers, staff, employees and managers.
• Next, determine your preliminary plan for its distribution and use and have it approved by management.
• Next, carry out your distribution and use strategies.
• Next, determine if the immunization issue should be included in your annual screening protocol and consider whether you should print out the document and provide it to participants as part of your screening process.
• Finally, review your progress periodically and consider whether additional activities regarding immunizations are needed.

In summary, this infographic document provides a very useful science-based piece of comprehensive guidance for all employees to consider (and potentially pass on to their PCP.) to consider the best science we have on the use of immunizations for health protection and improvement.

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Source: JOEM

What is this about?

This edition of Connections newsletter provides a important recent JOEM article that suggests a practical approach for examining an employer’s capability and efforts to provide mental health support for their employees.  This article further highlights an extensive effort to develop evidence-based recommendations for employers in dealing with how they support the mental health needs of their employees. This issue is particularly timely and relevant because of the recognition of COVID-19 related anxiety, depression and social isolation effects associated with the recent pandemic.  These evidence-based criteria are being developed for use in a national program of recognition awards for employers that seek to use “best practices” to help care for their employees’ mental health and mental well-being needs. A detailed table of suggested criteria is included in the article.

The 8 areas of recommended criteria for further refinement presented in the article include:

• Culture
• Robust Mental Health Benefits.
• Employer-Sponsored Mental Health Resources
• Workplace Policies and Practices
• Healthy Work Environment
• Leadership Support
• Outcomes Measurement
• Innovation

Why is this important?

This articles provides a blueprint for assessing the efforts of employers to protect and improve the mental health illness and well-being of their work force.  It lays out possible criteria that can be used to score how an employer is doing in meeting the mental health and well-being needs of their population. This useful evidence-based typology provides an excellent starting point for examination of employer support for employee mental health and mental well-being practices. This article can help you address a growing concern of most senior management groups.

What can you do with this document?

• First, the article answers the question…”How can we improve our employee’s mental health and mental well-being?”
• skim the document for the major issues and the suggested criteria presented by the authors.
• Next, identify where and when this information should be used to educate volunteers, staff, employees and managers.
• Next, determine how adequate your current approach is to addressing employee mental health and mental well-being issues.
• Next, determine how you might enhance your employer’s or client’s approach to this issue.
• Finally, review your progress periodically in developing an enhanced practical approach to employee mental health and mental well-being.

In summary, this article provides a useful evidence-based framework for assessing your organizations’ efforts in meeting the mental health and mental well-being needs of your work force. This framework can be used to open up the organizational discussion on these issues.

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Source: Forrester Reports

What is this about?

This edition of Connections newsletter provides an important report produced by the well-respected business consulting and analytics company Forrester.  The report examines 4 large clients of the Virgin Pulse Engage platform with 264,500 eligible employees and approximately 50,000 users of the platform.  The report examines economic savings projections for both selected traditional ROI and selected VOI components which makes this a very unusual program evaluation report. The Report highlights a proprietary framework and methodology for risk-adjusted economic analysis developed by Forrester called the Forrester Total Economic Impact^TM  methodology.   All savings were risk-adjusted over a three year period. All 4 of the Virgin Pulse clients have used the Engage platform for several years.

Highlights from the Report include:

• Avoided cost of employee attrition equaled $9,048,242 .
• Reduced healthcare costs of $8,280,615.
• Avoided cost of fatigue related mistakes of $1,479,231.
• Avoided cost of sick leave absenteeism of $6,655,413.
• Decreased administrative costs of $5,489,776.
• Total program direct costs of $11,622,577.
• A cost/benefit ratio of 1:1.62 or an ROI of 162% for the 3 year period.
• An Net Present Value (NPV) of $19,137,500.

Why is this important?

This Report is important because it provides a detailed business-based rather than academic analysis of a virtual Wellness platform combined with incentives and it examines important traditional ROI and non-traditional VOI metrics.  It is also important because it establishes a risk-adjusted analytic methodology that has business credibility.  It is a conservative projection of economic return using newer Wellness technologies. This Report offers some excellent insights for reinstituting ROI methodology for today’s employee Wellness efforts that is driven by business realities rather than academic expectations.

What can you do with this document?

• First, skim the document for the major issues and findings presented by the authors.
• Next, identify where and when this information should be used to educate volunteers, staff, employees and managers.
• Next, determine what analytic methods outlined in the Report can be applied to your own employee wellness program ROI assessment.
• Next, determine how you might capitalize on the implications of these findings in the design and execution of your employee wellness program and implement them.
• Finally, review your progress periodically in developing a business-centric approach to ROI evaluation of your Wellness program.

In summary, this Report provides an important newer perspective on the economic analysis of employee Wellness programming and supports a much more strategic perspective on the role of these kinds of efforts in enhancing the Human Capital in our work organizations.

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