Findings The Affordable Care Act has made significant progress toward solving long-standing challenges facing the US health care system related to access, affordability, and quality of care. Since the Affordable Care Act became law, the uninsured rate has declined by 43%, from 16.0% in 2010 to 9.1% in 2015, primarily because of the law’s reforms. Research has documented accompanying improvements in access to care (for example, an estimated reduction in the share of nonelderly adults unable to afford care of 5.5 percentage points), financial security (for example, an estimated reduction in debts sent to collection of $600-$1000 per person gaining Medicaid coverage), and health (for example, an estimated reduction in the share of nonelderly adults reporting fair or poor health of 3.4 percentage points). The law has also begun the process of transforming health care payment systems, with an estimated 30% of traditional Medicare payments now flowing through alternative payment models like bundled payments or accountable care organizations. These and related reforms have contributed to a sustained period of slow growth in per-enrollee health care spending and improvements in health care quality. Despite this progress, major opportunities to improve the health care system remain.
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What is your employee wellness program missing?
You’ve got your company wellness plan all ready to go. The newest technology has been implemented, health assessments and biometric screenings have been completed and a wellness coach is in place. Now all you have to do is spread the word and your program will be a success, right? Wrong. So, what is your employee wellness program missing?
Wellness programs are more than technology, screenings and coaches. Underlying every successful wellness program is a huge commitment–to people. What many of these programs lack is true passion, genuine empathy and qualified leadership.
But let’s back up. What is the heart and soul of wellness?
Defining wellness
Wellness is not all about physical health. There are many social factors that tie into physical health. Not to mention, natural and acquired competencies, such as coping with stress and forming relationships, that all contribute to the big picture called “health.”
These are fluid states that drift with the world economy, family situation, community changes and workplace environment. The best program managers and business analysts know that wellness programs are continual works in progress.
Striving to be your best is never finished. But it starts with tracking your journey. Take a mental snapshot: Where are you now? Stressed? Broke? Content? Assessment and goal setting are the foundation of any wellness program. This is where technology comes in to measure tangible health conditions like high blood pressure, diabetes or obesity.
But that’s just the physical. Wellness includes much more, so it is critical that assessments include psychological and emotional factors.
The Gallup-Healthways Well-Being 5
Through extensive research, Gallup-Healthways, a household name in research and development across healthcare, developed a five-part definition of wellness and assessment of the essential components to employee global wellness:
1. Purpose: Are you happy and motivated in what you’re doing daily?
2. Social: Do you have loving and supportive relationships?
3. Financial: Are your finances (and stress) in control?
4. Community: Do you like where you live? Is your community safe and a source of pride for you?
5. Physical: Do you have enough health and energy to meet your life demands?
The post-assessment diagnosis: thriving, struggling or suffering.
Thriving physically is not enough. Gallup-Healthways notes that thriving in all five areas leads to significant reductions in:
* Sick days
* Worker’s compensation claims
* Employee turnover
* Poor adaptability to change
* Apathetic charitable contributions
So what does your wellness program need? A holistic approach. Wellness programs must look at employees from where–and who–they are.
Passionate and empathetic leadership
It takes strong leadership, company-wide culture and tools to implement a successful wellness program.
Leaders need to be qualified to promote a successful program with all of these:
1. The right attitude: To reduce apathy, leaders need to energetically reinforce that well-being is the company, not just an implemented program–and is here to stay.
2. Clear and consistent message. Strong leaders define well-being clearly and persistently so employees can internalize the message.
3. Model behavior. They lead by the example they want their employees to follow–from working out at the company gym to supplying the company with healthy foods.
4. Genuineness. Commitment to employee health must be more than lip service or providing services. Employees need to know their company is genuinely interested in their well-being.This means taking personal interest in employees’ lives outside work too.
5. Ongoing adaptive assessment. Program monitoring keeps it fresh and alive, often tweaking the program to fit the company population.
Knowing who works for you
Each generation has specific characteristic traits and needs. For example, Millennials want different things from their home, community and work life than Baby Boomers.
According to a Gallup Poll, 57% of Millennials (born 1980-1996) report that well-being in their job and work-life balance matter most. However, this same generation thrives least on the Gallup-Healthways well-being scale. Here is where wellness programs can do serious work.
Again, strong, meaningful leadership is key.
- Managers must be sincerely open to talking to their teams about subjects beyond work: their hobbies, home life and relationships.
- Managers must build trust. This takes ongoing care, empathy and attention.
- Managers must be educated. Sensitivity to time and place builds trust and openness. Walking the line between too personal and interested is delicate, so leaders need resources, training and education.
- Managers are uniquely positioned to personally inform employees about company wellness offerings.
- Managers can create incentives, encourage participation and utilize accountability for results and rewarding goal achievements.
Company Culture
No doubt, company culture starts at the top. Wellness programs thrive in a complementary culture to the program’s goals. Their design and reach should weave naturally into the ongoing company practices and messages.
Leaders need to set goals that target each component of well-being. These could include offering financial courses, gym memberships, counselors and incentives for community volunteering.
Providing resources is not enough. Work-life balance and company culture should integrate, incorporate and reinforce encouragement for career and good living.
Engaging employees
Nurturing a company culture of well-being first requires engaging employees privately, intimately and without forcing them. How can this be achieved?
Gallup-Healthway suggests five strategies to make employees feel appreciated and connected to the company:
- Encouragement: When setting career goals and job expectations, companies can customize well-being activities to each employee.
2. Recognition: Reward achievement and improvement while recognizing challenges.
3. Communication: Discuss specific goals to achieve the five parts of well- being through activities designed to promote individual success.
4. Cooperation: Make employees part of the company culture by encouraging opinions, ideas and feedback.
Accountability: Include well-being discussions into performance reviews, milestones and future goals. Ask employees what management can do to help them achieve their wellness goals.
Equipping employees with information on how well-being can positively impact their life supports voluntary participation. Rather than mandating participation, show employees how wellness lowers their health insurance premiums.
When employees understand that they are not merely earning prizes or gym memberships but lowering their bottom line, they may strive to pass or improve screenings and biometric measurements.
In this way, employers can steer their employees who don’t pass screenings into wellness programs that will help them eventually access those discounts.
Thriving wellness is thriving business
Respect, privacy, compassion and connection: these are the ingredients to an effective, long-running wellness program. Holistic approaches to employees as invaluable living assets with individual needs and capacities.
Companies that build trusting relationships with care and communication run not only successful wellness programs but businesses–that thrive.
Health Hero provides smart, multi-channel and integrated health engagement experiences that are powerful and simple to deploy to employees in seconds. Contact us today to learn how we can create a customized plan for you!
Be ashamed to die until you have won some victory for humanity.
Health-Care “Value” Must Include Patient Perspectives
by Brad Smith, Director, Policy
FasterCures has always believed that patients need to be at the center of the medical research process. And in no stage is this more essential than recent efforts to define value.
That is why we submitted public comments recently on a proposal from the Centers for Medicare & Medicaid Services (CMS) that would change the way that Medicare Part B reimburses physicians when they administer infusible and injectable drugs in outpatient settings (e.g., anti-cancer drugs). The government spent $18.5 billion on these drugs in 2014, and CMS is seeking to reduce spending without lowering quality of care. There has been considerable controversy about whether or not CMS’s proposal can achieve this laudable goal.
The 7 Habits of Highly Patient Centric Providers
Why the focus on patient engagement? Leonard Kish aptly called patient engagement the blockbuster drug of the century for its profound impact on improving outcomes. Combining patient engagement with other proven approaches such as choice architecture can further improve health outcomes. Evidence is overwhelming that healthcare providers who engage with their patients and caregivers have dramatically better outcomes. Further evidence of patient engagement moving mainstream has come in during the first month of 2013 from government, academia and industry.
Though it’s fallen out of favor, “compliance” is the common phrase still used by some in healthcare. This contrasts with engagement.
What can patients do to make the most of their time with doctor visits? What questions should they be asking?
Answer by Evan Falchuk, President of BestDoctors.com
There is no question that when physicians have more in-depth, personalized discussions with their patients and encourage them to take an active role in their health, both doctor and patient feel more confident that they have reached a correct diagnosis and a good treatment path.
A doctor’s approach to the patient is key. Taking the time to examine every piece of a person’s medical history, and then applying his/her expertise to the patient’s particular condition is critical to making the correct diagnosis.
The first piece of advice I would offer a patient is to ask questions, and to keep asking until they’re satisfied with the answers. It’s all too easy to be referred to a specialist and start treatment without having all of your questions answered, or having your doctor ask – and answer – the right questions in the first place.
For example, if you have a test, don’t assume that no news is good news. Ask about your results. Also, treatment recommendations based on the latest scientific evidence are available from the National Guidelines Clearinghouse™ at www.guideline.gov. Ask the doctor if your treatment is based on the latest evidence.
A recent study in Israel (http://tinyurl.com/3wehvcw) determined that examining patients and taking a medical history are more useful to hospital doctors in diagnosing patients than high-tech scans. The study showed that patient history alone or history plus a physical exam were most important to a doctor’s correct diagnosis in almost 60 percent of cases. When basic tests were included, they were the basis of more than 90 percent of correct diagnoses along with history and exams.
According to Dr. Jerome Groopman, one of the world’s foremost researchers on how doctors think (he’s written the definitive book on it http://tinyurl.com/28pom7), doctors desperately need patients and their families and friends to help them think. Asking questions won’t just make the patient comfortable – it can disrupt a doctor’s thought process and make him think about a case in a way that may save a life.
While we urge patients to be their own advocate, it’s also smart to have a family member or friend with you at doctor’s visits, someone who can help get things done and speak up for you if you can’t.
Also, I can’t stress enough the importance of researching and compiling a family medical history. BreastCancer.org reports that a woman’s risk of breast cancer approximately doubles if she has a first-degree relative (mother, sister, or daughter) who has been diagnosed with the same, and about 20-30 percent of women diagnosed with breast cancer have a family history of it. A Cleveland Clinic study (http://tinyurl.com/25azwa8) shows that a family history may be a better predictor of disease than even genetic testing. Find out about your family’s medical history, write it down (the Surgeon General has a good on-line tool to help you do thishttp://tinyurl.com/a675nl), and make sure your doctor knows about it.
Even if you do have charts dating back to childhood, however, don’t assume your physician has digested or will remember everything. Adam Dickler, M.D., a radiation oncologist in Evergreen, Ill., says,“There really isn’t enough time. If your doctor flips open your file while entering the exam room, it may be the first time she’s looking at it, so be ready with a recap. A full recap.”