Green Beans

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Green Beans Ice Cream The Recipe for Wellness
Behavior Change Lower Health Costs

• Bill Sims Jr., President
• The Bill Sims Company Inc.
• www.billsims.com

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Ask any group of managers if they believe
wellness programs are a good idea

• Why should I PAY people to be healthy? Its
  part of their job
  
• how do we measure wellness activity and prevent
  fraud and abuse?
  
• Wellness programs have never produced any
  REAL ROI! You cant change peoples behavior
  

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The Other Side of the Coin

• We went from 1 participation to over 70 in
  just 2 years. Deedy Rogers
  
• We increased fitness center participation by
  72 in 3 monthsBank South
  

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Healthcare Costs Threaten Profits
Healthcare cost is already more than after-tax
profits at most corporations. Healthcare already
consumes 16 of our Gross Domestic Product in the
U.S.A. It is projected to grow to 20 by 2015. C
an your company afford to lose 4 percentage
points of after-tax profits?
Source Centers for Medicare and Medicaid
Services, February 2006
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Where Is the Most Leverage?70 of Medical Claims
Are from Poor Lifestyle Choices! (NEJM)
Source Summex, 2004
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Best Strategy to Control Costs?
The underlying and overwhelming cause of
healthcare increases is poor lifestyle choices.
Treating other causes is like negotiating volume
discounts on buckets to fix a leaky roof!
The only solution that can provide lasting relief
is to identify those poor choices and help
employees minimize them. Case studies have proven
that aggressive strategies to improve health and
increase consumerism can reduce
demand/utilization and control costs!
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Why wellness failed to produce Return on
Investment

• T-shirts, Water Bottles, Pedometers to VisaCards
  to HealthSavings Accounts
  
• Same old story, different carrots
• Jane, Earl Bubba
• The Church of the Here and Now vs. Health
  Savings Accounts
  

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Which group do you aim for?
Bubba?
Earl?
Jane?
Earl Bubba
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Do wellness programs Really Work?
Bank of America Blue Shield of CA BP Amoco Citi
bank Coors Dupont General Foods General Motors
GlaxoSmithKline Indiana BCBS Johnson Johnson
Life Assurance Nortel Prudential Travelers
Cost / Benefit Ratio
Study Number
Source Chapman, Larry, Proof Positive An
Analysis of the Cost-Effectiveness of Wellness,
2005
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Heres the Bottom Line
Employee healthcare costs are a strategic issue.
Most of those costs are preventable.
These costs will increase greatly in the future.
There is a limit to how much cost can be shifted.
Wellness has evolved into a systematic approach.
Wellness is affordable and cost-effective. The
ROI on aggressive employee health management can
be an order of magnitude better than the target
ROI. Health improvement can be delivered anywher
e. The entire effort can be funded by employees.
Metrics can be used to document savings and
effects.
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Which Trend Do You Want?
Note Assumes conservative 31 Benefit to Cost
Ratio for each investment in Population Health
Management (PHM).
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What Are Best Practices of a Wellness Strategy
for Cost Control?

• Health Risk Assessments to identify bad health
  habits
  
• Medical Screening to get engaging, objective
  data
  
• Personal Coaching for all with significant health
  risks
  
• Education and Awareness to promote healthy
  living
  
• Self-Care Guides to avoid unnecessary doctor
  visits
  
• On-Site Medical Care, where possible
• Incentives to drive majority participation
• Health-conscious culture to reinforce good habits

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Coaching Intervention Programs the Source of Real
Savings

• For 40-80 with greatest health risk
• Uses Prochaskas stages of change
• Telephone-based coaching with mail or internet
  educational supplements
  
• Professional coaches set goals, build confidence,
  develop plans, motivate and educate
  
• Usually 2-12 coaching sessions/yr.
• Increases odds of success by 170-350!

Health Risks Addressed  Exercise Nutrition Str
ength Weight
Stress Smoking Depression Alcohol
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Some Coaching Is MUCH Better!
The industry typically stratifies 93 for
coaching, and only engages 5.5. The High Risk
employees may only be half of the engaged group
in the industry model.
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Every Health Risk Eliminated Saves 100s per
Employee Every Year!
Depression 2725 High blood sugar 1638 Overw
eight 1348 High stress 1279 Tobacco 80
6 No exercise 801 High blood pressure 734
High cholesterol 513
Source Health Enhancement Research Organization
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Reduction in Health Risks after First Year of
Coaching
High-risk participants change after 1 year of
health coaching in one vendors program.
n 1,321
Source Summex Health Management
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Population Health Management Pilot Cut Cost
Increases by Two Thirds
Association of Washington Cities (12K)
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Why Negative Recognition Wont work

• Well FIRE YOU if
• You dont lose weight
• Stop Smoking
• Exercise More
• Obviously a carrot approach is the only answer!

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What Works In Wellness Behavior Change
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Why coaching recognition works

• The Hawthorne Study
• Dr.Frederick Herzberg
• Top 2 Satisfiers Achievement
• Recognition (long lasting)
• Top 2 Dissatisfiers Unfair Pay (cash award)
  Unfair Boss (favoritism)
  
• Bob Nelson 68
• Prochaska
• Motor Convoy Biff Wilson
• Health Coaches Recognition WORK!!!

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Most Popular Excuses NOT to Use Wellness
Programs
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Excuse 1 How would we prevent abuse and fraud?

• The pedometer the hunting dog
• Reward for Results
• Validate Behaviors
• Trust but Verify

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Excuse 2 I thought my insurance company did all
this

• Why the insurance companies dont do it well,
  often enough
  
• What about your data?

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Switch to a Proactive Approach
Smartcard program Reward participation (upstream
healthy behaviors) Reward for compliance Reward
for results
Reward for leadership
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Unhealthy Behaviors
Eliminate these and you trim health costs.
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New School vs. Old School Wellness
Old School t-shirts, water bottles, fun
Old School lack of measurement, spray pray
New School educate motivate
New School stratify risk reward accordingly
(Jane, Earl, Bubba)
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Wellness Incentive Programs
Behavior Change is what you want
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Elements of Behavior Change

• Green Beans Ice Cream
• Train
• Recognize

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Elements of Behavior Change

• The Chrysler Study
• HRAS Coaching

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Effective Training.

• Make it Custom not Canned
• 91 of all training is forgotten
• Measure Training Effectiveness by Middle Manager
  Employee
  
• Case History of SportChalet

Smartcard
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Effective Recognition

• Tax Free/Non-Cash
• Soon, Sudden, Specific
• Weighted by Health Risk
• Inspires the Heart

Smartcard
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Rewarding and Measuring Wellness Champions

• Quality, production 1
• Wellness can become the flavor of the month
• Most behavior change programs fail to reward the
  supervisor

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Rewarding and Measuring Middle Managers

• Reward
• Hold Accountable for training and Recognition
• Track involvement

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Tax Consequences of Cash Gift Cards

• The Tax Man Turkeys
• Poor Oprah Winfrey
• The 400 Tax Free Myth
• Kiplinger Unredeemed Gift Cards Amex Home
  Depot
  

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Why Cash Isnt King

• Is Cash all it takes?
• University of Waterloo
• IBM and the Six Figure Suggestion Award Winners

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Why cash isnt king

• Gulf Oil-Three Principal Findings
• Any incentives are likely to produce some
  results
  
• Doubling the value of merchandise awards does not
  automatically double incremental performance
  
• Cash does work...but it can take up to six times
  as much to do the job of non-cash incentives

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Cash Gift Cards

• No Trophy Value
• Taxes Eat up 40, Groceries the other 60
• Up to 40 Dont Redeem
• Confused with compensation
• Tough to take awayentitlement

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Logo Awards Survey

• Have you ever received a gift that you didnt
  want/need/use? Maybe a logod t-shirt for
  instance?
  
• Yes? Or No?
• Did you say Thank You?
• Yes or No?
• Is it possible that many times the giver assumes
  the recipient values the gift but they do not?
  

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The Boss Who Loved Clocks
Award Giftsdo you pick it, or do they?

• So often we assume that we know what motivates
  people. In reality all we really know is what
  motivates ourselves.Ken Blanchard

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Conclusions

• Cash is a dis-satisfier
• Recognition is a satisfier
• Show employees that you CARE they MATTER
• The Blue Ribbon Story

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The Blue Ribbon
A teacher gave each of her students three blue
ribbons and instructed them to go out and spread
this acknowledgment ceremony. Then they were to
follow up on the results, see who honored whom
and report back to the class in about a week.
One of the boys in the class went to a junior ex
ecutive in a nearby company and honored him for
helping him with his career planning. He gave him
a blue ribbon and put it on his shirt. Then he
gave him two extra ribbons, and said, "We're
doing a class project on recognition, and we'd
like you to go out, find somebody to honor, give
them a blue ribbon then give them the extra blue
ribbon so they can acknowledge a third person to
keep this acknowledgment ceremony going. Then
please report back to me and tell me what
happened."
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The Blue Ribbon
Later that day the junior executive went in to
see his boss, who had been noted, by the way, as
being kind of grouchy fellow. He sat his boss
down and he told him that he deeply admired him
for being a creative genius. The boss seemed very
surprised. The junior executive asked him if he
would accept the gift of the blue ribbon and
would he give him permission to put it on him.
His surprised boss said, "Well, sure." The junior
executive took the blue ribbon and placed it
right on his boss's jacket above his heart.
As he gave him the last extra ribbon, he said, "
Would you do me a favor? would you take this
extra ribbon and pass it on by honoring somebody
else? The young boy who first gave me the ribbons
is doing a project in school and we want to keep
this recognition ceremony going and find out how
it affects people."
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The Blue Ribbon Story
That night the boss came home to his 14-year-old
son and sat him down. He said, "The most
incredible thing happened to me today. I was in
my office and one of the junior executives came
in and told me he admired me and gave me a blue
ribbon for being a creative genius. Imagine. He
thinks I'm a creative genius. He gave me an extra
ribbon and asked me to find somebody else to
honor. As I was driving home tonight, I started
thinking about whom I would honor with this
ribbon and I thought about you. I want to honor
you. "My days are really hectic and when I come
home I don't pay a lot of attention to you.
Sometimes I scream at you for not getting good
enough grades in school and for your bedroom
being a mess, but somehow tonight, I just wanted
to sit here and, well, just let you know that you
do make a difference to me. besides your mother,
you are the most important person in my life.
You're a great kid and I love you!" The startled
boy started to sob and sob, and he couldn't stop
crying. His whole body shook. He looked up at his
father and said through his tears, "I was
planning on committing suicide tomorrow, Dad,
because I didn't think you loved me. Now I don't
need to."
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Free Research DVD
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seminar, please email us at bill_at_8006901860.com
or
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