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Realizing the promise and Competitive Advantage of a:
“Thriving, Healthy, High-Performing and
Sustainable Workplace and Workforce”
January 23, 2014©2014 Edington Associates
Edington Associates LLC
Shared Values-Shared Results, Positive Health and Measure What Matters
©2012 Edington Associates 2
Respect for and by Self, Others and the Organization
• In a stress-producing world, where it seems we can’t control very much. We each can impact our own Health and Lifestyle. And when we do, it makes a difference to others, our family and to the organization.
• Each manager should take a minute out of each day to look into the faces of the people we manage. And to realize that they are our most important resource.
• Each organization should provide supportive leadership, and a supportive environment , climate, and culture. And when they do it makes a difference to everyone in the organization.
©2012 Edington Associates 3
Estimated Prevalence of Health Risks
OVERALL RISK LEVELS
Low Risk = 0-2 risks
Medium Risk = 3-4 risks
High Risk = 5 or more
From the UM-HMRC Medical Economics Report
Estimates based on the age-gender distribution of a specific corporate employee population
Health Risk Measure
Body WeightStress Safety Belt UsagePhysical ActivityBlood PressureLife SatisfactionSmoking Perception of Health Illness DaysExisting Medical ProblemCholesterolAlcoholZero Risk
High Risk
41.8%31.8% 28.6% 23.3% 22.8%22.4% 14.4% 13.7%10.9% 9.2% 8.3% 2.9%14.0%
Less than 45 45 to 64 Greater than 650.0%
20.0%
40.0%
60.0%
80.0%
100.0%
3.00% 10.50%18.60%9.50%
32.00%
61.40%
25.30%
56.40%
80.00%
Low Risk
Excess Diseases Associated with Excess Risks (Heart, Diabetes, Cancer, Bronchitis, Emphysema
Percent with Disease
Med Risk
Age Range
High
Musich, McDonald, Hirschland, Edington. Disease Management & Health Outcomes 10(4):251-258, 2002.
©2012 Edington Associates 5
Low Risk (0-2 Risks)
HRA Non-Par-ticipant
Medium Risk (3-4 Risks)
High Risk (5+ Risks)
$0
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$840 $1,261
$3,321
Excess Costs
Base Cost
Excess Medical Costs due to Excess Risks
Edington, AJHP. 15(5):341-349, 2001
6©2012 Edington Associates
Natural Flow: by Risk Status
1640 (35.0%)
4,163 (39.0%)
678(14.4%)
High Risk(>4 risks)
Low Risk(0 - 2 risks)
Medium Risk(3 - 4 risks)
2,373 (50.6%)
21,750 (77.8%)
4,546(42.6%)
10,670 (24.6%)
4,691 (10.8%)
27,951 (64.5%)
11,495 (26.5%)
5,226 (12.1%)
26,591 (61.4%)
892(3.2%)
1,961 (18.4%)
5,309 (19.0%)
Modified from Edington, AJHP. 15(5):341-349, 2001
Average of three years between measures
Change in Costs follow Change in Risks
-$600
-$400
-$200
$0
$200
$400
$600
3 2 1 0 1 2 3Co
st
red
uc
edC
os
t in
cre
ase
d
Risks Reduced Risks Increased
Updated from Edington, AJHP. 15(5):341-349, 2001.
Overall: Cost per risk reduced: $215; Cost per risk avoided: $304 Actives: Cost per risk reduced: $231; Cost per risk avoided: $320 Retirees<65: Cost per risk reduced: $192; Cost per risk avoided: $621 Retirees>65: Cost per risk reduced: $214; Cost per risk avoided: $264
8©2012 Edington Associates
Natural Flow of a Population by: Risks-Costs-Age
19-34 35-44 45-54 55-64 65-74 75+$0
$3,000
$6,000
$9,000
$12,000
$1,776 $2,193 $2,740
$3,734 $4,613
$5,756
$1,414
$2,944
$3,800
$5,212
$6,636
$8,110
$2,565
$3,353
$4,620
$6,625
$7,989
$8,927
$5,114 $5,710
$7,991
$10,785
$11,909 $11,965
Low
Annual Medical Costs
Med Risk
Age Range
High
Non-Participant
Edington. AJHP. 15(5):341-349, 2001
©2012 Edington Associates 9
Cluster Analysis
Health MeasureCluster 1:
Risk taking(N=6688)
Cluster 2:Low Risk(N=3164)
Cluster 3:Biometrics(N=3100)
Cluster 4:Psychological
(N=3927)
Baunstein, Yi, Hirschland, McDonald, Edington. Am. J. Health Behavior. 25(4):407-417, 2001
SmokingAlcoholPhysical activitySafety belt usageBody mass indexSystolic blood pressureDiastolic blood pressureCholesterolHDL cholesterolSelf-perceived healthLife satisfactionStressIllness days
Overall RisksLow risk (0-2 risks)Medium risk (3-4 risks)High risk (5+ risks)Average Number of risks
50.2%35.7%14.1%
2.8
97.6%2.4%
00.6
26.5%48.9%24.7%
3.6
18.9%35.9%45.2%
4.4
31%10%28%36%27%9%5%
19%34%13%4%9%
21%
0%0%0 %0 %
25 %0 %0 %
19 %10 %0 %0 %0 %0 %
16%3%
19%22%38%81%61%27%33%9%2%2%
12%
27%5%
26%31%27%23%20%22%24%28%73%76%26%
Development and Consequences of Metabolic Syndrome
Risks: Waist Circumference Hypertension Glucose Intolerance Triglycerides HDL Cholesterol
Pre-Metabolic Syndrome
Metabolic Syndrome
Heart Disease
Diabetes RetinopathyNeuropathyNephropathy
Costs to Individual: Quality of Life Morbidity Mortality
Costs to Employers: Health care costs Productivity costs
Where do you want to intervene in the process?
©2014 Edington Associates 11
Development and Consequences of Mental Health Issues
Risks: Perception of Health Life Satisfaction Job Satisfaction Stress Job Related Non-Job Related Illness Days
Pre-Mental Health Issues
Mental Health
Syndrome
Job Issues
Family Issues
Serious Mental Health Diagnoses
Costs to Individual: Quality of Life Morbidity Mortality
Costs to Employers: Health care costs Productivity costs
Where do you want to intervene in the process?
Where do you want to intervene in the process?
©2012 Edington Associates 12
Medical and Drug Cost (Paid)*
2001 2002 2003 2004$1,500
$2,000
$2,500
$3,000
$3,500
$4,000
Non-Impr
Improved
Year
Pai
d
Improved=Same or lowered risks
©2012 Edington Associates 13
Total Value of Health Medical/Hospital Drug Absence Disability Worker’s Comp Effective on Job Recruitment Retention Morale
Disease
HealthRisks
The Economics of Total Population Engagement and the Total Value of Health
BeyondLow or No Risks
Where does cost turn into an investment?
increase
increase
14©2012 Edington Associates
Wellness Strategies: 2013 and Before
HealthierPerson
BetterEmployee
Gains for theOrganization
Health Status Life Expectancy Disease Care Costs Health Care Costs Productivity Absence Disability Worker’s
Comp. Presenteeism Recruitment/Retention Company Visibility Social Responsibility
1981, 1995, 2000, 2006, 2008 Dee Edington
Lifestyle Change
Health and Disease Management Programs
Behavior Change (Wellness)
Treating Disease (Medical)
©2014 Edington Associates 15
Disease Emphasis results in
1. Focus on Treatment of Disease
2. Emphasis on Whose is at fault?
Government, Health Plans, Providers, Employers, Individuals
3. Leads to Lowest Cost Solutions and to Higher Numbers of Uninsured
©2012 Edington Associates 16
What’s Next?
Change the questions
Get to a new level of thinking
Adjust our vision of the future
Have foresight to change our definitions
Have the courage to change our beliefs
©2012 Edington Associates 17
Health Strategies for 2013 and Beyond
Integrate the Whole Person into the Environment and Culture and
Engage in Population Health(Follow the lead of Safety and Quality)
(…in Quality terms this strategy translates into “fix the systems that lead to the
defects”)(Deming, Drucker, Blanchard)
18©2013 Edington Associates
Thriving and Sustainable Workplace and Workforce for 2013 and Beyond: Strategic
Create a Thriving and Healthy Workforce
Champion Company
Gains inOrganizational Objectives
Health Status Economics Absence Worker’s Comp. Presenteeism Financial Metrics Engaged Workers
Recruitment Retention
Happiness Company Visibility Social Responsibility
1981, 1995, 2000, 2006, 2008, 2012 Edington Associates
Create a Supportive Environment and Culture
Create the Vision and Strategy
Move Healthy Well-Being into the Culture
•Senior Leadership •Operations Leadership •Self-Leadership •Recognize Positive Acts •Quality Assurance
19
Senior Leadership Lack of supportLack of clear vision
Operations Leadership Supervisor lack of supportLack of supportive cultureIncomplete communications
Self Leadership Don’t understand why, what, how
Lack of self-efficacy Lack of time, convenience
Recognize Strengths Lack of positive recognition
Quality Assurance Lack of feedback on progress
Lack of shared values, vision
Previous Barriers during Implementation
©2013 Edington Associates
©2013 Edington Associates 20
Journey towards a Shared Values Company
Communication and
Outreach
Enrollment and
Engagement
Prevention and
Wellness
RiskManagement
Disease Management
Workforce• Engaged• Thriving
Best Place to Work
Workplace• Shared Values•Positive Return
Clear Vision, Metrics, Culture and Environment
Vision, Commitment,
Leadership
Supportive Culture and
Environment
Workforce• Engaged• ThrivingPrevention
and Wellness
RiskManagement
Disease Management
Initiatives Along the Health Continuum
Program Impact
Best Place to Work
Workplace• Shared Values•Positive Return
Enterprise Commitment and Support
Impactful Thriving, Healthy and Well-Being Programs
Sustainable Initiative to support the Vision
C
©2013 Edington Associates 21
Committed , vocal and enthusiastic leadership promotes:•Increased awareness•More motivated employees •Shared Values•Clear Vision and Metrics
Levers of Program Success: Pillar 1-Strategic
Pillar 1: Senior
LeadershipStrong Vision
Visible Committed Leadership
Communication and
Outreach
Enrollment and
Engagement
Prevention and
Wellness
RiskManagement
Disease Management
Workforce• Engaged• Thriving
Best Place to Work
Workplace• Shared Values•Positive Return
Clear Vision, Metrics, Culture and Environment
Vision, Commitment,
Leadership
Supportive Culture and
Environment
Workforce• Engaged• ThrivingPrevention
and Wellness
RiskManagement
Disease Management
Initiatives Along the Health Continuum
Program Impact
Best Place to Work
Workplace• Shared Values•Positive Return
Enterprise Commitment and Support
Impactful Thriving, Healthy and Well-Being Programs
Sustainable Initiative to support the Vision
C
22
Vision
Vision for a Culture of Health
“… a sustainable culture of health where individual’s happiness, quality of life, state of well-being and engagement in family and the organization are thriving”
©2013 Edington Associates 23
Supportive culture and environment:•Create supportive employee health in
the Environment and Culture •Reduce barriers to self-leadership•Further increases participation and
strengthens engagement•Support for self-leadership
Pillar 1: Senior
LeadershipStrong Vision
Visible Committed Leadership
Pillar 2: Operations Leadership
Culture of Health
Supportive Environment
Communication and
Outreach
Enrollment and
Engagement
Prevention and
Wellness
RiskManagement
Disease Management
Levers of Program Success: Pillar 2-Systematic
Workforce• Engaged• Thriving
Best Place to Work
Workplace• Shared Values•Positive Return
Clear Vision, Metrics, Culture and Environment
Vision, Commitment,
Leadership
Supportive Culture and
Environment
Workforce• Engaged• ThrivingPrevention
and Wellness
RiskManagement
Disease Management
Initiatives Along the Health Continuum
Program Impact
Best Place to Work
Workplace• Shared Values•Positive Return
Enterprise Commitment and Support
Impactful Thriving, Healthy and Well-Being Programs
Sustainable Initiative to support the Vision
C
24
Clear goals established by Senior Leaders
Well communicated goals Understand the culture gaps and
create employee work teams to fix the gaps
Train everyone on how to achieve a high-quality, healthy and thriving culture
Wellness program audit to align goals Corporate scorecard available to all employees
How Do You Add Health to the Culture?
25©2013 Edington Associates
Promote self-leadership •Greater self efficacy• Increased commitment to stick to it
•Develop Life Skills•Promote Engagement
Pillar 1: Senior
Leadership
Pillar 2: Operations Leadership
Strong VisionVisible
Committed Leadership
Culture of Health
Supportive Environment
Communication and
Outreach
Enrollment and
Engagement
Prevention and
Wellness
RiskManagement
Disease Management
Levers of Program Success: Pillar 3-Systemic
Pillar 3: Self-
LeadershipCreate Winners• Help Employees Not Get Worse• Help Healthy People Stay Healthy
Workforce• Engaged• Thriving
Best Place to Work
Workplace• Shared Values•Positive Return
Clear Vision, Metrics, Culture and Environment
Vision, Commitment,
Leadership
Supportive Culture and
Environment
Workforce• Engaged• ThrivingPrevention
and Wellness
RiskManagement
Disease Management
Initiatives Along the Health Continuum
Program Impact
Best Place to Work
Workplace• Shared Values•Positive Return
Enterprise Commitment and Support
Impactful Thriving, Healthy and Well-Being Programs
Sustainable Initiative to support the Vision
C
© 2012 Edington Associates 26
What is SELF-LEADERSHIP?
Self-leadership is the process of purposefully…
engaging in change
making thoughtful decisions
having resilience
which builds on strengths and is continuously learning and growing
in thriving relationships
27
Incorporate Determinates of Health
IndividualSupportiveCommunity
Supportive Family and
Friends
Supportive Workplace
ThrivingEmployee
©2012 Edington AssociatesLiving and Thriving Assessment
© 2012 Edington Associates 28
Vision for Self-Leadership
Personal Control
Optimism
Self-Leadership
Resilience
Confidence/ Self-efficacy
Self-Esteem
Knowledge Health Literacy Negotiation Skills
Vitality/Vigor
Consumerism Engaged
patient role
Social Support− Colleagues− Community − Family
Environment and culture
Other characteristics: Change, Integrity, Trust, Thrive, Enthusiasm, Ethical, Spiritual, Creative, Flexible,
Low-Risks and Behaviors
Purpose, Values, Mission, Vision
Positive Outlook
Happiness
Brain Health
Emotions & Intuitions
Mental
Shortcuts and Biases
Environment
Values
Purpose
Vision
Focusing on Strengths
Positive
Reframing
Creating a Plan for Change
Fundamental Skills for Self-Leaders
30
RayGrace April Will
User-tested Design Elements
© 2012 Edington Associates
31
Surveys and Quizzes
© 2012 Edington Associates
© 2012 Edington Associates 32
Interactive Activities – Example (Values)
33©2013 Edington Associates
Recognize positive actions:• Reinforces healthy,
well-being behaviors• Promote Shared Values• Develop intrinsic
motivation• Promote Self- Efficacy
Pillar 4: Recognize
Actions
Pillar 1: Senior
LeadershipStrong Vision
Visible Committed Leadership
Recognize Champions Reinforce at every touch
point
Clear Vision, Metrics, Culture and Environment
Vision, Commitment,
Leadership
Supportive Culture and
Environment
Workforce• Engaged• ThrivingPrevention
and Wellness
RiskManagement
Disease Management
Initiatives Along the Health Continuum
Program Impact
Best Place to Work
Workplace• Shared Values•Positive Return
Enterprise Commitment and Support
Levers of Success: Pillar 4-Systemic
Pillar 3: Self-
Leadership
Pillar 2: Operations LeadershipCulture of
HealthSupportive
Environment
Create Winners• Help Employees Not Get Worse• Help Healthy People Stay Healthy
C
Impactful Thriving, Healthy and Well-Being Programs
Sustainable Initiative to support the Vision
©201s Edington Associates 34
Pillar 5: Quality Assurance
Continuous Improvement
Continuous feedback of information about program
processes and outcomes
Communication and
Enrolment
Engagement and
Culture
Prevention and
Wellness
CaseManagement
Disease Management
Levers of Program Success: Pillar 5-Sustainable
Pillar 3: Self-
Leadership
Pillar 4: Recognize
Actions
Pillar 1: Senior
Leadership
Pillar 2: Operations Leadership
Workforce• Engaged• Thriving
Best Place to Work
Workplace• Shared Values•Positive Return
Clear Vision, Metrics, Culture and Environment
Vision, Commitment,
Leadership
Supportive Culture and
Environment
Workforce• Engaged• ThrivingPrevention
and Wellness
RiskManagement
Disease Management
Initiatives Along the Health Continuum
Program Impact
Best Place to Work
Workplace• Shared Values•Positive Return
Enterprise Commitment and Support
Impactful Thriving, Healthy and Well-Being Programs
Sustainable Initiative to support the Vision
C
Systemic, Sustainable
Reinforce the Culture of Health
•Align recognition with the vision
• Reward champions
• Set incentives for what matters
• Reinforce at every touch point“What is rewarded is what is sustained”
Principles of Positive Actions
35©2010: Health Transformation Group, LLCNot for Distribution
Step #4
Sustainable• Integrate all data
• Measure What Matters
• Provide feedback on how progress was obtained and steps to get to vision
• Feedback on leadership, culture, self-leadership, positive actions, economic outcomes“Supports decisions with evidence”
Principles of Quality Assurance
36©2010: Health Transformation Group, LLCNot for Distribution
Step #5
©2012 Edington Associates 37
Vision for Your Organization
Summary
3 Strategic Vision from
Leaders
Systematic & Thriving
Culture
Systemic Engage all
in the Culture
Recognize Positive Actions,
WorkTeam
Sustained Progress
in all areas
2 Speech from
Leader
Internal Wellness Program
Screenings & Reduce High-Risks
Coaching
Incent High-Risk Reduction
Change in Risks, ROI
1 Inform Leader
Out-source Wellness
Screenings & Reduce High-Risks
Incent High-Risk Reduction
Change in Risks
0 Do Nothing
Do Nothing
Do Nothing
Do Nothing
Do Nothing
Pillar 1 Pillar 2 Pillar 3 Pillar 4 Pillar 5
Which Sustainability Level is for YouSustainability Rating
Do Nothing
Core to the Organization
Comprehensive
Traditional
Senior Leadership
Operations Leadership
Self-Leadership
Rewards for Positive
Actions
Quality Assurance
Five Pillars
©2012 Edington Associates 39
Vision for Your Organization
What’s the Point?
©2012 Edington Associates 40
Phone: 734.998.8326 (USA)
Email: [email protected]@edingtonassociates.com
[email protected]@edingtonassociates.com
Website: www.edingtonassociates.com
Address: Edington Associates LLC University of Michigan North Campus Research Center 1600 Huron Parkway Ann Arbor MI 48109
Thank you for your attention