The world we have made as a result of the level of thinking we have - PowerPoint PPT Presentation

The world we have made as a result of the level of thinking we have done thus far creates problems we cannot solve at the same level of thinking at which we created them. - Albert Einstein University of Michigan Health Management Research Center

Zero Trends: Health as a Serious Economic Strategy THE UNI VERSI TY OF MI CHI GAN HEALTH MANAGEMENT RESEARCH CENTER University of Michigan Health Management Research Center

UM-HMRC Corporate � Ford � Delphi Consortium Steelcase (H) � Kellogg � General Motors � US Steel � Progressive (H) � We Energies � Crown Equipment � JPMorgan Chase � Affinity Health System � Delphi Automotive � SW MI Healthcare Coalition (H) � Southern Company � Navistar Corporation � University of Missouri *The consortium � Medical Mutual of Ohio members provide health care insurance � Florida Power and Light for over two million � St Luke’s Health System Americans. Data are � Allegiance Health System available from three to 20 years. � Cuyahoga Community College � United Auto Workers-General Motors Meet on First Wednesday of each � Wisconsin Education Association Trust December in Ann Arbor � Australian Health Management Corporation University of Michigan Health Management Research Center

Zero Trends Wellness at the Workplace 28 th Annual Conference March 18, 2009 Mission: Change the Strategy for Health and Disability from a Health Strategy to a Business Strategy: Natural Flow: High Risks and Costs in Americans 5 Business Case: Health as an Economic Strategy 5 Solutions: Five Pillars to Support a Culture of Health 30 Slides available University of Michigan Health Management Research Center

Mission Change the Strategies for Health and Disability to A Serious Business or Economic Strategy University of Michigan Health Management Research Center

Section I The Current Healthcare Strategy Wait for Sickness and then Treat (…in Quality terms this strategy translates into “wait for defects and then fix the defects” …) University of Michigan Health Management Research Center

Total Medical and Pharmacy Costs Paid by Quarter for Three Groups 9000 8000 Serious Cost The 20-80 rule is always true but 7000 Medium Cost terrifically flawed 6000 as a strategy Low Cost 5000 4000 3000 2000 1000 0 Q_12 Q_10 Q_8 Q_6 Q_4 Q_2 Q0 Q2 Q4 Q6 Q8 Q10 Q12 Musich,Schultz, Burton, Edington. DM&HO. 12(5):299-326,2004 University of Michigan Health Management Research Center

Costs Associated with Risks Medical Paid Amount x Age x Risk Annual Medical Costs $11,965 $11,909 $10,785 $7,991 $12,000 $8,927 $5,710 $5,114 $7,989 $9,000 $6,625 $8,110 $6,636 $4,620 $6,000 $5,212 $3,353 $3,800 $2,565 $5,756 $2,944 High $3,000 $4,613 $1,414 $3,734 Med Risk $2,740 $2,193 $1,776 Non-Participant $0 Low 19-34 35-44 45-54 55-64 65-74 75+ Age Range Edington. AJHP. 15(5):341-349, 2001 University of Michigan Health Management Research Center

Section I I Build the Business Case for the Health as a Serious Economic Strategy Engage the Total Population to get to the Total Value of Health Complex Systems (Synergy and Emergence) versus Reductionism (Etiology) University of Michigan Health Management Research Center

Business Concept Change in Costs follow “Don’t Get Worse” University of Michigan Health Management Research Center

Estimated Health Risks Health Risk Measure High Risk 41.8% Body Weight 31.8% Stress From the UM- 28.6% Safety Belt Usage HMRC Medical 23.3% Physical Activity Economics Report 22.8% Blood Pressure 22.4% Life Satisfaction Estimates based on 14.4% Smoking the age-gender 13.7% Perception of Health distribution of a 10.9% Illness Days specific corporate 9.2% Existing Medical Problem employee population 8.3% Cholesterol 2.9% Alcohol 14.0% Zero Risk OVERALL RISK LEVELS Low Risk 55.3% Medium Risk 27.7% High Risk 17.0% University of Michigan Health Management Research Center

Risk Transitions 2,373 (50.6%) High Risk (Natural Flow) (>4 risks) Time 1 – Time 2 4,691 (10.8%) 1,961 5,226 (12.1%) Medium Risk (18.4%) (3 - 4 risks) 892 4,546 10,670 (24.6%) 1640 (35.0%) (3.2%) (42.6%) 678 11,495 (26.5%) (14.4%) 5,309 (19.0%) 4,163 (39.0%) 27,951 (64.5%) Average of three years 26,591 (61.4%) between measures Low Risk (0 - 2 risks) 21,750 (77.8%) Modified from Edington, AJHP. 15(5):341-349, 2001 University of Michigan Health Management Research Center

Medical and Drug Cost (Paid)* Slopes differ $4,000 P=0.0132 $3,500 $3,000 Non-Impr Paid Improved $2,500 $2,000 $1,500 2001 2002 2003 2004 Impr slope=$117/yr Year Nimpr slope=$614/yr *per employee , Improved=374, Non-Improv=103 HRA in 2002 and 2004 Improved=Same or lowered risks University of Michigan Health Management Research Center *Medical and Drug, not adjusted for inflation

The Economics of Total Population Engagement and Total Value of Health Total Value of Health Medical/Hospital Drug Health Low or Disease Absence Risks No Risks Disability Worker’s Comp increase Effective on Job Recruitment increase Retention decrease Morale Where is the I nvestment? University of Michigan Health Management Research Center

Section I I I The Evidence-Based Solution: I ntegrate Health into the Culture (…in Quality terms this strategy translates into “…fix the systems that lead to the defects” …) University of Michigan Health Management Research Center

Health Benefit Plan Design Sickness & 9000 Care Management Serious Costs Opportunity 8000 Medium Cost 7000 6000 Low Cost Condition Management 5000 Opportunity TMS and Wellness 4000 Opportunities 3000 2000 1000 0 Q_12 Q_10 Q_8 Q_6 Q_4 Q_2 Q0 Q2 Q4 Q6 Q8 Q10 Q12 Medical and Drug Costs only University of Michigan Health Management Research Center

I ntegrate Health into the Culture Healthier Better Gains for The Person Employee Organization 1. Health Status 2.Life Expectancy 3.Disease Care Costs 4. Health Care Costs Lifestyle Company Culture 5. Productivity Change a. Absence Senior Leadership b. Disability Operations Leadership c. Worker’s Self-Leadership Compensation Reward Positive Actions d. Presenteeism Quality Assurance Health e. Quality Multiplier Management 6. Recruitment/Retention Programs 7.Company Visibility 8. Social Responsibility 1981, 1995, 2000, 2006 D.W. Edington University of Michigan Health Management Research Center

First Fundamental Pillar Senior Leadership Create the Vision • Commitment to healthy culture • Connect vision to business strategy • Engage all leadership in vision University of Michigan Health Management Research Center

Vision from the Senior Leadership � Clear Vision within Leadership � Vision Connected with Company Strategy � Vision Shared with Employees � Accountability and Responsibility Assigned to Operations Leadership � Management and Leadership of the Company and Unions transition to the Cheerleaders University of Michigan Health Management Research Center

Second Fundamental Pillar Operations Leadership Align Workplace with the Vision • Brand health management strategies • Integrate policies into health culture • Engage everyone University of Michigan Health Management Research Center

Environment I nterventions � Mission and Values Aligned with a Healthy and Productive Culture � Policies and Procedures Aligned with Healthy and Productive Culture � Vending Machines Job Design � Cafeteria Flexible Working Hours � Stairwells Smoking Policies � Benefit Design Aligned with a Healthy and Productive Culture � Management and Employees prepared to integrate health into the company culture (small group meetings, shared vision, expectations,…) University of Michigan Health Management Research Center

Third Fundamental Pillar Self Leadership Create Winners • Help employees not get worse • Help healthy people stay healthy • Provide improvement maintenance resources University of Michigan Health Management Research Center

I ndividual Strategy for Engagement Health Risk Appraisal Plus Biometrics Screening and Counseling Plus Contact a Health Advocate Plus Two Other Activities University of Michigan Health Management Research Center

Population-Based Resources Weight Management Business Specific Modules Physical Activity Career development Stress Management Communications Safety Belt Use Financial Management Smoking cessation Social/ I nformation Networks Nutrition Education Disease Management Clinic or Medical Center On-Line I nformation Ergonomics Nurse Line Newsletters Vision Dental Behavioral Health & EAP Hearing Pharmacy Management Chiropractic Complementary Care Case Management I ntegrative Medicine Absence Management Physical Therapy Disability Management University of Michigan Health Management Research Center

Fourth Fundamental Pillar Reward Behaviors Reinforce the Culture of Health • Reward champions • Set incentives for healthy choices • Reinforce at every touch point University of Michigan Health Management Research Center