3. Employee Wellness Programs
The most successful programs have six essential pillars:
1. Engaged leadership at multiple levels
2. Strategic alignment with the company’s identity and aspirations
3. A design that is broad in scope and high in relevance and quality
4. Broad accessibility
5. Internal and external partnerships
6. Effective communications
• Companies in a variety of industries have included all six pillars in their employee
wellness programs and have reaped big rewards in the form of lower health care
costs, greater productivity, and higher morale.
• Employee wellness programs have often been viewed as a nice extra, not a
strategic imperative; however, the data shows otherwise.
• The ROI on comprehensive, well-run employee wellness programs can be as
high as 6 to 1.1
1 Harvard Business Review, What’s the Hard Return on Employee Wellness Programs, 2010
4. What are Worksite Wellness Programs?
Two Categories
• Participatory
• Health-contingent/Outcome-based
Activities
• Biometric Screenings
• Health Risk Assessments
Employer-based
• Focus on improving health of employees,
decrease medical spend
Notable Changes with PPACA
• Employee Rewards increased to 30%
and up to 50% (in some cases)
• Effective: January 1, 2014
5. Benchmarks for Success
1. Make the Business Case for a Wellness Program
Collect and Analyze Data
2. Capture CEO Support
3. Create a Wellness Team
4. Create a Supportive Environment
5. Implementation
6. Choose Appropriate Interventions
7. Evaluate Outcomes2
2 WELCOA, WELCOA’s Seven Benchmarks, 2016
6. 1. Make the Business Case
6
Normal Weight
(BMI 18.5 to 24.9)
Overweight
(BMI 25 to 29.9)
Obese
(Class I)
(BMI 30 to 34.9)
Obese
(Class II)
(BMI 35 to 39.9 )
Extremely Obese
(Class III)
(BMI 40 or more)
1 Centers for Disease Control and Prevention, CDC Lean Works! - Workforce Assessment Tool
950 1520 760 380 190
Category numbers were derived from the CDC’s BMI workforce
calculator based on inputted age, gender, industry and state.
*Does not reflect our dependents.
City of Mesa’s Employee Body Mass Index
7. City of Mesa’s Projected Chronic Disease
950 1520 760 380 190# of City of Mesa Employees
8. Economic Costs of Obesity to Self-Insured
Employers
2007 Duke University Study
• 6.8 times the medical costs
• 2 times as many workers
compensation claims
• 13 times more days lost
attributed to illness and injury
• Lost productivity due to
restricted activity
• Spend 77% more on
medication
8
9. City of Mesa’s Cardiovascular Disease
The expected lifetime costs of cardiovascular disease (including coronary
heart disease, heart attack, and stroke ) increases by:
• 20% with mild obesity (BMI 30 to 34.9)
• 50% with moderate obesity (35 to 39.9)
• 200% with severe obesity (BMI>40)
Strong correlation between diet, cardiac disease, obesity and diabetes.
Diabetes at Work, a CDC related website
Approximately 213 employees
Diet and exercise that achieves a 5-7% weight loss reduces diabetes
incidences by 58%
City of Mesa Diabetes
9
$500,000
$5,500,000
$10,500,000
$15,500,000
$20,500,000
$25,500,000
$30,500,000
Quarterly Annually 5+ years 10+ years
1Healthy Business Group Cost Calculator
Obesity-Related Expenditures1 (n= 3800)
City of Mesa
National
Average
City of Mesa Obesity
Economic Costs of Chronic Disease
10. 2. Capture CEO (City Manager) Support
Commitment from executive management in:
• Evolving the worksite to support wellness activities
• Recognizing the value of employer-based worksite wellness initiatives
• Strategic alignment with the organization’s identity and aspirations
• Allocating resources to develop and sustain a worksite wellness program that was
broad in scope and high relevance
• Developing incentives to encourage participation from employees (accessible,
inclusive and cost conscious)
• Ongoing awareness of the evolving needs of employees
• Leverages internal and external partnerships
Involved leadership a prerequisite for success!
11. Why is it important to remain focused on
Wellness?
City of Mesa’s internal healthcare expenses are continuing to increase
annually…unsustainable costs necessitated strategic action
Obesity and chronic disease drives up costs—medical costs,
absenteeism costs, disability, workers compensation and presenteeism
costs
If not, who else?
◦ Workers spend much of their lives at work; therefore, the setting has a
significant impact on employee attitudes, behaviors and weight
◦ Those employee experiences and learned behaviors are passed to their
dependents
◦ Dependents add to the cost equation both tangibly and intangibly
Reduces employee turnover and improves morale
12. Employee Health and Wellness –
City of Mesa
Employee Health & Wellness Manager – Nicole Stec, MBA, CSCS
Objective:
◦ Improve overall wellness of City of Mesa employees
◦ Lead the way to healthy lifestyles
◦ Increase productivity
◦ Reduce medical costs and prevent chronic disease
13. 3. Create a Cohesive Wellness Team
Establish a workgroup with
representatives (“Champions”) from
departments in your organization
• Examples: Administration, Human
Resources, Facilities, Operations
Roles of Wellness Champions
• Contribute to and oversee development
of your organization’s Wellness Program
• Provide guidance and leadership
• Communicate the wellness activities,
events and messages to staff
• Be a “Champion” for healthy living in
your organization!
14. City of Mesa Wellness Committee
• Established the workgroup in January
2016
• Led by Employee Health & Wellness
Manager
• Fire and Police Departments
• Parks & Recreation, Benefits, Safety
• Transportation, Energy, Engineering,
Environmental Management, Information
Technology
Goal: To improve the quality of life of our employees and families by
building a culture of health through education, motivation and engagement
of all employees and their families to participate in maintaining a healthy
lifestyle.
16. 4. Create a Supportive Environment
• Shared Wellness Vision
• Example of a Vision or Mission Statement: Dedicated to providing a supportive
environment for employees, their families and the community to improve their health
and well-being.
• Serve as Role Models
• Participation is key and support
• Align Cultural Touch Points
• Policies
• Negative feedback
• Identify areas of improvement
• Empower employees
• New Employee: Orientation
• Monitor & Celebrate Success
• Ongoing attention and recognition
17. 5. Implementation: Wellness Program
Design
PHASE I: Preparation
December 2015– March 2016
◦ Assess Environment
◦ Develop Program
◦ Establish Partnerships
◦ Build Communication Plan
◦ Acquire Equipment & Materials
◦ Transform City of Mesa
Environment
Resources
• Employee Health & Wellness Manager
• Wellness Committee
• Wellness Center Providers
• InsideMesa, Wellness Website
KPIs
• Establish a Program Timeline
• Branding and Materials
• Contact with Community Partners
• Equipment and material needs established
• Collaboration IT on website adjustments
• Wellness Survey (Dec 2015 & Mar 2016)
18. City of Mesa Wellness Program
Introduced January 2016
Program Goal: To improve the quality of
life of our employees and families by building
a culture of health through education,
motivation and engagement of all employees
and their families to participate in maintaining
a healthy lifestyle.
Target Areas
1. Nutrition
2. Fitness Promotion
3. Weight management
19. City of Mesa Wellness Program
Open to all employees, separate
from the Health & Wellness Center
Several opportunities open to City
of Mesa family members
Holistic focus on 8 dimensions
Program includes:
• Diabetes & Tobacco Cessation
Programs
• Healthy Living Workshops
• Health Assessments and
Coaching
21. City of Mesa Wellness Initiatives
Health & Wellness Center
Healthy Living CDSMP classes
Nutrition Classes
Employee Interest & Climate
Survey
Healthy Arizona Worksite
Recognition
HealthyWage Team Challenge
FitPick Vending
Newsletters, LiveWell Mesa
22. SHORT TERM
• Participation
• Satisfaction Levels
• Quarterly Surveys assessing
behaviors and cultural climate
• Testimonials
• Physical Environment Changes
LONG TERM
• Changes in biometric measures
• Reduction in health risk factors
• Productivity
• Return on Investment
• A healthier and happier
organization
7. Evaluate Outcomes
23. City of Mesa Climate Survey
December 2015 March 2016 June 2016
Healthy Level of Physical Activity 39.7% 44.5% 34.6%
Healthy Eating Habits 28.9% 35.7% 43.1%
Stress Management 40.6% 49.2% 50.0%
Overall Population with Healthy
Behaviors
36.4% 43.1% 42.7%
Supportive Work Environment 38.9% 44.1% 46.8%
Leadership’s Value of Wellness 49.5% 52.1% 54.8%
24. How Do I Get Started?
Get Top Management
Support
Create a Team
Determine health needs of
your organization
Create an Operating Plan
Evaluate Outcomes
25. Resources & Toolkits
• CDC Wellness at Work:
http://www.cdc.gov/features/workingwellness/
• Healthy Arizona Worksite Program (HAWP):
http://healthyazworksites.org/
• WELCOA: https://www.welcoa.org/services/build/welcoas-seven-
benchmarks/
• Minnesota Department of Health Worksite Wellness Toolkit:
http://www.health.state.mn.us/healthreform/ship/implementation/w
orksite/apprps4toolkit.pdf
• Wisconsin Department of Health Services Worksite Toolkit:
https://www.dhs.wisconsin.gov/physical-activity/worksite/kit.htm
28. 3. Create a Cohesive Wellness Team
Wellness Committees
Establishing, supporting and maintaining a
wellness committee provides opportunities for
all employees to:
◦ Create a healthy worksite
◦ Foster collaboration and partnerships
◦ Establish healthy lines of communication between
staff, supervisors and top management
Formally meet and plan activities to promote
good health
Promotes participation, advocates for
worksite policies and environments that
support improved health
29. 2ND PHASE: INVOLVEMENT
April – December 2016
◦ Diabetes Education Classes
◦ CDSMP Classes
◦ Health Coaching
◦ Interactive Challenge
◦ Establish Fitness Partnerships
◦ Host October Health Fair
KPIs
• Diabetes Education: Complete four sessions with 75
attendees
• CDSMP Classes: Complete three sessions with at least
10 participants
• Health Coaching: Conduct at least 150 sessions
• Fitness Partners: Establish 1-2 partners
• Interactive Challenge: Capture at least 380
• Health Fair HRA & Biometrics: Complete 570
assessments
Cultural
Climate
Sense of Community
29
5. Implementation: Wellness Program
Design
Resources
• Employee Health and Wellness Manager,
Wellness Committee
• Wellness Center
• Wellness Digital Platform
• Employee Benefits Trust
30. 3RD & 4TH PHASES:
INTEGRATION & SUSTAINMENT
◦ Monthly & Quarterly activities/events
◦ Continued engagement
◦ Incentive Program
◦ Achievement
KPIs
• Increased staff awareness of Wellness Program
and Wellness Center
• Establish Incentive Rewards Program
• Meet criteria for HAWP Gold Level
• Apply for AHA Fit-Friendly Worksite Gold Level
Award
• Positive changes in biometric measures seen from
2016 to 2017 HRA and screening
30
5. Implementation: Wellness
Program Design
Resources
• Employee Health and Wellness Manager,
Wellness Committee
• Wellness Center
• Wellness Digital Platform, InsideMesa, Wellness
Website
• Budget for incentive program
31. What is Wellness?
Definition: Wellness is an active process through which people become
aware of, and make choices toward, a more successful existence.1
1National Wellness Institute
33. Workplace Wellness
Committee
Establishing, supporting and maintaining a wellness committee provides
opportunities for all employees to:
◦ Create a healthy worksite
◦ Foster collaboration and partnerships
◦ Establish healthy lines of communication between staff, supervisors and top management
Definition:
◦ Team of employees who formally meet and plan activities to promote good
health for themselves and fellow coworkers
◦ Represents employees from all organizational levels
◦ Creates and maintains open lines of communication between committee
and employees
◦ Promotes participation, advocates for worksite policies and environments
that support improved health
◦ Serves as a leader/champion for wellness activities at the worksite
Hinweis der Redaktion
Participatory Wellness Programs (p.33160), which are a majority of wellness programs, are defined by the final regulations as “programs that either do not provide a reward or do not include any conditions for obtaining a reward that are based on an individual satisfying a standard that is related to a health factor.” Participatory wellness programs are required to be made available to all similarly situated individuals. They are not required to meet the requirements applicable to health-contingent wellness programs (p.33161). Examples of Incentives-based Participatory Wellness Programs
Reimbursement for all or part of fitness membership costs
A reward for participating in a diagnostic testing program that does not base any part of the reward on outcomes
A reward to employees for attending a monthly, no-cost health education seminar
Waiver of co-payment or deductible requirement under a group health plan for preventive care (e.g. prenatal care, well-baby visits)
Reimbursement for costs for participating in a smoking cessation program, regardless of whether employee quits or not
Reward for completing a health risk assessment (HRA) without any further action required
Health-Contingent Wellness Programs (p.33161) are defined by the final regulations as programs that “require an individual to satisfy a standard related to a health factor to obtain a reward (or require an individual to undertake more than a similarly situated individual based on a health factor in order to obtain the same reward).” Health-contingent wellness programs are subdivided into two categories, both of which are permissible only if they comply with the regulatory requirements.
Activity-only wellness programs: When an individual is required to perform or complete an activity related to a health factor in order to obtain a reward. They do not require an individual to attain or maintain a specific health outcome.Examples: Walking, diet or exercise programs
Outcome-based wellness programs: When an individual must attain or maintain a specific health outcome (such as not smoking or attaining certain results on biometric screening) in order to obtain a reward. This approach is intended to ensure that outcome-based programs are more than mere rewards in return for results in biometric screenings or responses to a health risk assessment and are instead part of a larger wellness program to promote health and prevent disease. These programs generally have two tiers.
Tier 1: A measurement or test or screening as part of an initial standard
Tier 2: A larger program that then targets individuals who do not meet the initial standard with wellness programs
Examples: Program that tests individuals for specified medical conditions or risk factors (such as high cholesterol, high blood pressure, abnormal BMI, or high glucose level) and provides a reward to employees identified within normal or healthy range (or at low risk for certain medical conditions), while requiring employees who are identified as outside the normal or health range (or at risk) to take additional steps (such as meeting with a health coach, taking a health or fitness course, adhering to a health improvement action plan, or complying with a health care provider’s plan of care) to obtain the same reward.
Regulatory Requirements for Health Contingent Wellness Programs (p.33162): Applies to both activity-only and outcome-based wellness programs.
Frequency of Opportunity to Qualify (p.33162): Eligible individuals are given the opportunity to qualify for the reward at least once per year
Size of Reward (p.33162): The total amount of the reward, whether offered alone or coupled with rewards for other health-contingent wellness programs, with respect to a plan cannot exceed the applicable percentage of the total cost of employee-only coverage under the plan, taking into account both employer and employee contributions towards the cost of coverage for the benefit package under which the employee is (or the employee and any dependents are) receiving coverage. Plans and issuers have flexibility to determine apportionment of the reward among family members, as long as the method is reasonable.
Applicable Percentage (p.33166): The applicable percentage increases the reward from 20 percent to 30 percent, with an increase of an additional 20 percent to as much as 50 percent for health-contingent wellness programs designed to prevent or reduce tobacco use.
Reasonable Design (p.33162): Wellness programs are considered reasonably designed if it has a reasonable chance of improving the health of, or preventing disease in participating individuals, and is not overly burdensome, is not a stratagem for discrimination based on a health factor, and is not highly suspect in the method chosen to promote health or prevent disease. Plans and issuers have flexibility and innovation is encouraged. Programs are not required to be accredited or based on particular evidence-based clinical standards; however, those that are may increase the likelihood for success and are encouraged as a best practice.Example: Programs based on CDC’s Guide to Preventive Services
http://www.public-health.uiowa.edu/hwce/employer/incentives-based.html
No delay in Wellness requirements: http://www.psafinancial.com/2013/08/ppacas-employer-reporting-requirements-penalties-delayed/
http://www.jonesday.com/play-or-pay-employer-mandate-delayed-until-2015-no-change-to-effective-date-for-most-other-affordable-care-act-requirements-07-03-2013/
ELT:
Participation: (engagement at multiple levels)
Teams, Events, Classes, Challenges
Providing Support at events
Supporting cultural changes food, activity and meeting policies
Celebrate and Monitor Success
ALT & ELT Roles
Cultural Norms
Wellness Walls
In all Wellness Programs, Leadership has four important responsibilities: shared, Serve, Align, Monitor/Celebrate. Currently, Leadership has been successful in several ways in the effort to make wellness “the way” at YRMC.
One of the largest ones: a Shared Wellness Vision has been supported via Strategic Goal #1: Population Wellness—starting with the wellness of employees and dependents. In addition, one of our core values is Wellness
-An opportunity lies in creating a Vision Statement of Wellness from LDRs—this statement would state WHY Wellness is important to YRMC, HOW employees can get involved and WHAT YRMC is doing. This is something that the WTC
Serves as Role Models: You are already doing so with your participation and support in these various events. Opportunities lie in encouraging and supporting participation and supporting your departments in their involvement
Align Cultural: These include modeling, training, recognition, traditions and norms, push-back (have employees refrain from being critical of healthy practices—let it go or choose not to participate)
-Encourage employees to identify areas that can be improved. Also, support and implement wellness –friendly policies
-Push-back: Ask employees to refrain from being critical of healthy practices. Endorse or let it go—employees may not realize they are being critical of a healthy practice..
Make the “healthy” choice the easy choice
“Healthy” is the way we do things around here
Fair: Attendance 260
HRA
Screenings (5 types)
WellSuite registration
Vendor Participation
Health Fair Passport-Participation and engagement
Ambassadors: Recruit 20 (1% of workforce)
Club Teams: Establish 2-3 (softball & basketball with the COY)
WellSuite: Completion of 50% of HRAs; based on # of accounts distributed between May-July 2013
Pedometer Challenge: Capture at least
KPIs: Measure changes in health, QOL, participation, satisfaction, corporate culture, risk factors
Staff Awareness:
# ambassadors
# Involved in at least one activity
# Using WellSuite
Quarterly Survey Measures: Use of Breaks, healthy snacks, physical activity
Walking Path, Walking Club, Biking Club
Wellness Rewards #
AHA Fit-Friendly Worksite: Gold Level: 9 key activities + Worksite & Community Innovation Award
Changes in Biometrics:
Self-reported:
Interviews
Surveys
WellSuite
Methods:
Surveys
Quarterly
HRAs
Biometric measures (BP, BMI, Cholesterol, Behavior Cha
Pre/Post-activity Evals
Staff Interviews
Wellness Rewards Utilization: 300
Participation (L&Ls, Events, Challenges)
Change in Health Status
Change in Behaviors (Diet, Activity, Participation in Program)
Changes in Morale
Time Commitment:
Personal time: Before & After Work; Breaks (Walks, L&Ls, Consults); E-mail
Cost: 2 hrs/mo * salary * # workers =
Emotional—Coping effectively with life and creating satisfying relationships
Environmental—Good health by occupying pleasant, stimulating environments that support well-being
Financial—Satisfaction with current and future financial situations
Intellectual—Recognizing creative abilities and finding ways to expand knowledge and skills
Occupational—Personal satisfaction and enrichment from one’s work
Physical—Recognizing the need for physical activity, healthy foods, and sleep
Social—Developing a sense of connection, belonging, and a well-developed support system
Spiritual—Expanding a sense of purpose and meaning in life
