When Life Hands You Lemons, Make Arnold Palmers

It’s that time of year when summer is pretty much over, but the weather finally starts heating up.  In the hot afternoons, I like to make an iced drink that happens to also double as a phytofood bioflavonoid bonus that helps to reduce inflammation, supports skin/capillary health, provides lots of vitamin C and, more importantly, tastes great.

Here’s what you will need:

• 6 organic lemons
• 1/2 cup water – or just enough to create a blend
• Fresh brewed green tea – hot or iced
• Stevia, to taste (I love the Truvia brand, but any brand you like is good)

Directions:

Remove stems, or ends of organic lemons.  Scrub clean under running water.  Cut up into quarters, remove seeds, and place the lemons and the water in a Vitamix.  If you don’t have a Vitamix, use a sturdy blender.  Blend on low at first and then on high until the lemon mush is liquified and as fine as it can get in the blender.  If you don’t have a Vitamix, you may need to strain out larger chunks that would be difficult to pass through a straw.  Now, fill ice cube trays with the lemon mixture and freeze.

To prepare your Arnold Palmer, place 2 lemon cubes in a glass, plus a few regular ice cubes.  Add iced tea and sweeten to taste with stevia.   Shake or stir, and as the lemon cubes melt, the drink becomes an Arnold Palmer.  You will be surprised that the lemon is not too tart or too bitter at all, and has a mellow, sweet, lemon-y taste.  Try with organic Meyer Lemons for a special treat!

Enjoy!

3 Proven Paths to Workplace Wellness: Understanding the Return on Investment (ROI)

In my previous posts, I reviewed the following common corporate wellness strategies:

1.  Outcomes Based

2.  Participation Based

3.  Culture of Wellness Based

Clients often ask “What is the ROI on each program, so I can decide which direction to in?”  My answer is usually “It depends.”  There are several sources that site ROI of 1.2-3.0 as the return on wellness programs.  The problem is that there are so many variables, and few industry standards on what defines each component.  For example, if you ask clients, health plans, physicians, and individuals “What is wellness?”, you will get a wide variety of different answers.  The dictionary defines it as follows:

wellness:  wel-nis

-noun

1. the quality or state of being healthy in body and mind, especially as the result of deliberate effort.

2. an approach to healthcare that emphasizes preventing illness and prolonging life, as opposed to emphasizing treating illness.

Depending on whose point of view you are seeking, wellness is defined in the context of their available knowledge, while vendors are defining wellness in the context of the programs they offer.  For example, most health insurance companies categorize wellness into 3 buckets:

1. Lifestyle Modification – this is prevention-oriented, and usually focused on weight, smoking, stress, and physical activity.

2. Health Coaching – this is used to address individuals who have 1-2 risk factors that, if addressed, will prevent the transition to a disease state.  These might include dyslipidemia, elevated blood pressure, or BMI of greater than 27.

3. Disease Management – this is when an individual has a diagnosed chronic condition that can be managed with care, but is likely to not revert back to a healthy condition.  These are the most costly risk factors that have a high likelihood of advancing to very expensive complications without proper treatment.  Some examples are:  diabetes, asthma, chronic back pain, cardiovascular disease, metabolic syndrome, etc.

But when I ask my friends and family?  They associate the term wellness with yoga, massages, vitamins, meditation, juice fasting, and losing weight.  Each group and each person has their own idea of wellness.  In the workplace, in general, above mentioned areas are where metrics such as completion of a program, or change in health status can provide data.  Employers need data points to determine ROI.  Wellness as a business strategy is a healthy proposition that makes logical sense.  Healthier employees feel better, and therefore are likely to work better.  ROI can be tough to measure if the wellness program doesn’t have data points that align to the wellness strategy.  For example, if you have a wellness strategy that has a goal of achieving 65% participation in completion of health risk assessments, the only way to determine if you achieved it is by being able to pull a report.  All ROI numbers must be calculated on year over year numbers.  Hard data such as claims, program completions, and measured change in health can be tied to an estimated cost figure to determine savings.

However, we know that wellness programs rarely see a pay off sooner than 3 years, and sometimes it takes 4-5 years.  Due to employee turnover, it can sometimes be difficult to assess ROI that is reliable.  Employers choosing to go the path of building a Culture of Wellness can expect to see positive returns in the long run, but it would be unrealistic to expect a hard ROI in the near term.  It takes time for employees to adopt the new culture and it takes time for participation to spread across departments, locations, and attitudes.  In the long run, it’s the way to go but if you are looking for a quick fix to your out-of-hand medical claims, you may not get the results you expect right away.  The best scenario for mapping out ROI in the short run is outcomes based, but if your employee population is already suffering poor morale and has little trust you have their best interests in mind, this strategy can sometimes backfire.   If your company is highly motivated to reduce medical claims, and is willing to truly invest in making some strong gains in just one year, it is possible.  It requires a careful and thoughtful strategy and the correct incentive structure in place.  It also requires a strong communication and marketing plan targeted to catch your employee’s (and their dependents!) eyes and ears.  When you consider that insurance and medical claims costs are typically the #2 cost behind human capital, it’s easy to see how a successful wellness strategy could be your number one business plan.  The National Institutes of Health has a great primer (albeit a bit dated) on employee wellness that deserves reading here.  Health and Human Services has passed down initiatives to promote employers and health plan administrators to implement wellness programs in an attempt to curb the nation’s rising healthcare costs.  This report details the findings in a report to Congress on workplace wellness.

Are you overwhelmed by all the vendors and choices out there?  Are you armed with a strategy to improve the health of your workforce?  Wellness is not as easy and simple as it sounds, but with consultative guidance, a quality strategy and a strong commitment, it’s an investment that pays off in health improvement gains as well as dollars saved.  Not to mention, you might just spark a social wellness movement with your employees!

3 Proven Paths to Workplace Wellness Series: Developing a Culture of Wellness

In this post, we will cover the 3rd of the most commonly implemented workplace wellness strategies.  In my previous posts, I covered Outcomes Based and Participation Based strategies.  This post will cover Culture of Wellness strategies, and in the next post I will explain the expected participation rates and various incentivizing strategies based on different wellness budgets.  In the final post, I will outline some great resources to access and Key Performance Indicators (KPI) to look for when evaluating results and measuring success.

Developing a Culture of Wellness (COW) is when an organization works to implement a wellness program that supports changes in individuals, but in a way that is different than simply applying a premium differential or monetary incentive.  When an organization chooses to focus first on a COW first, they will be more likely to land on a wellness program that resonates with employees and increases engagement and participation.  The basics of any wellness program include a focus on tobacco cessation, improving nutrition, increasing physical activity, and improving compliance with recommended health initiatives from one’s own physician or care provider.  Additional elements that may be added include dental health, stress management and sleep quality.  At the outset, developing a COW might appear to take more time and effort than a Participation or Outcomes strategy because it is a more systemic approach to creating change.  Some examples of supporting and developing a COW include:  adding yoga classes at lunchtime, lunch and learn seminars, providing healthy options for vending machines, offering primarily healthy options if there is an onsite cafeteria, chair massages, fun wellness challenges like Health Enhancement Systems’ Walktober , having treadmill workstations like the amazing Trekdesk, and most anything that communicates and markets efforts to support employees activating their personal wellness plan in a convenient, fun, and pleasurable way.   Team challenges present a great platform to engage employees as well.

Like any good design, developing a COW takes more thought and effort at first, but then it becomes easier over time to sustain as grassroots efforts take hold and employees begin to adopt changes and become advocates within the workforce.  Harvard Business Review provides great insight in this article  that speaks to choosing a program that complements your current business model and structure to ensure longevity and support.  Once you lay the ground work and demonstrate with action to employees that you care about their health and our willing to make it easy and convenient to improve their health at work, then employees will begin to trust you have their best interests at heart.  As employees acclimate to the new environment, you can begin to make incremental changes to the healthcare plan that they will be receptive to,  such as implementing a tobacco-free policy.  If an employee has a positive experience, they are highly likely to influence their coworkers and their family members.  And since dependents on a plan tend to incur a larger portion of the claims cost, doesn’t it make sense to leverage employees to influence their family members?  The best part about Culture of Wellness strategies is that they tend to be sustainable and broader reaching.  They also limit the need for complex administration and steep regulatory hurdles.  Next up I’ll go over ROI expectations for each type of strategy and discuss some examples, as well as best practices.

What’s your favorite example of implementing a Culture of Wellness?

3 Proven Paths to Workplace Wellness Series: Understanding Outcomes Based & Participation Based Programs

In my last post, we talked about the 3 most utilized wellness strategies that employers use, which include:

• Be Healthy Or Else (Outcomes Based)
• Jump Through The Hoops (Participation Based)
• Have Some Fun (Culture of Wellness)

In this post, I want to concentrate on the Be Healthy or Else strategy.  Outcomes based strategies are often referred to as “stick” strategies.  The idea is that employees must meet minimum health risk standards for the most common biometrics tested.  In most cases, employers do biometric testing on the following:  BMI, blood pressure, total cholesterol, HDL cholesterol (the good kind), glucose, waist cirumference, and sometimes LDL cholesterol (the bad kind) and cotinine (an indicator of nicotine use).  The employees are required to the have their values within the normal or moderate range in order to qualify for a discount on their insurance benefit, or to avoid a surcharge on their premium.  For example, let’s say that Joe is a single, 32-year old smoker.  He shows up at the biometric screening event offered at his workplace.   Joe’s employer is offering a 20% discount on health insurance premiums if he can meet the normal/borderline values for 3 biometric values:  BMI, blood pressure and cotinine.  Joe’s employer chose those 3 risk factors, because they are trending high and costs are escalating each year as a result.   It turns out that Joe has tried to quit smoking unsuccessfully at least 5 times.  In order to be eligible to still receive the 20% discount on his insurance premium, he must prove to his employer that he is attempting to quit smoking.  He enrolls in a tobacco cessation program, and he demonstrates that he is trying to change his ways by talking to a coach a specified number of times, or by completing a program.  He must either provide proof of program participation or participate in his company’s tobacco cessation program, which will provide reporting to his employer that he satisfied the participation requirements to still receive the premium discount.  Some employers pick only one biometric risk factor, such as tobacco, while other employers might pick 3-4 risk factors.

There are pros and cons to implementing an outcomes strategy.  The pros are that you drive home the point to employees that health status matters, and you hit employees where it hurts most – in the pocketbook.  The other pro is that there is no reliance on self-reporting.  The reporting is based on data points gathered by a vendor.   Seems solid, right?  Let’s take a look at the cons.  Administration, administration, administration.  Did I mention administration?  This is where things get dicey.  In order to know which employee gets the discount, and which one doesn’t get the discount, you must have timely, accurate reports with the correct data.  The trouble is, each party involved (vendor, employer, payroll provider, carrier, broker) has a different idea of “timely”, and a different idea of “correct data.”  And the more vendors at the party, the more difficult it is to reach an agreement on the necessary reporting and the higher chance of data errors.  The other con of this method is that, as heavy handed as it is, it doesn’t always work!  In fact, it rarely turns the ship around to lower medical claims costs as expected.  I have a theory on this one.  Employees go to work to make a living.  Oh sure, there are a few out there who find great satisfaction in a job well done without compensation, but most people need to pay the bills and feed their family.  In the nature of being efficient, they want to get in and get the work done and move on.  Benefits are part of the entire work-for-pay structure, so saving money on premiums is essentially maximizing your paycheck.  However, the health literacy of American workers is notoriously low.  Health literacy translates to understanding benefits, knowing how to navigate the health insurance and provider network, etc.  What this all means is that you must choose your “communication battles” wisely with employees.  They can only handle so much communication material beyond the absolute necessary.  Let’s say employees can handle about 4 communication pushes a year.  I’m talking about big pushes that require them to do something or take action beyond the normal expectation.  When you want to move to outcomes, you have to walk employees through multiple steps to get to the premium discount.  They must: 1) Get their biometrics 2) Figure out how to still get the discount if they didn’t pass 3) Possibly talk to a coach or enroll in a lifestyle management program, and 4) Verify that HR has everything right so they don’t leave any money on the table.  There goes your 3-4 of 4 big communication pushes for the year.  Now you are left with possibly 1 communication topic to push for the entire remainder of the year.  What this tells you is that you must choose wisely.

Just like each meal matters, each workout matters, and each extra bite of cheesecake matters, each decision made in the wellness strategy process matters, too. If you choose this route, you must have a qualified wellness consultant to guide you through best practices, PPACA legislation, and vendors to ensure you land on the most efficient method to manage the “Be Healthy or Else Approach.” Doing so is critical to saving time, money, and lawsuits.

Next up, I will discuss the pros and cons of a “Jump Through The Hoops” wellness strategy.  I will wrap up the series with a final post on the details and success rates for each approach.

Choose wisely my friends!