Realizing the Promise and Competitive Advantage of a

Realizing the Promise and Competitive Advantage of a Thriving and Sustainable Workplace and Workforce Strategies for 2013 and Beyond The University of Michigan Edington Associates Dee W. Edington October 10, 2012

Health Promotion – The value of meeting patients where they are The University of Michigan Edington Associates Dee W. Edington October 10, 2012

Leadership Buffalo 2012 dedicated to improving the health of people in western new york

Mission Dedicated to improving the health of people in Western New York Goals • Empower all in the WNY community to take responsibility for and act on their own wellness • Facilitate the development of a community-wide standard for the promotion of wellness • Work with physicians and provider organizations to enhance access to care and improve quality of care • Initiate dialog with government leadership to promote policy change

Board of Directors • Kevin Donovan • Northeast District Energy Corporation • • • Donald Boswell WNED-TV Channel 17 Karen Blount, RN, PNP Blue. Cross Blue. Shield of WNY Michael Cropp, MD Independent Health Michael Edbauer, DO Catholic Medical Partners Stephen Edges, MD, FACS Roswell Park Cancer Institute John Fudyma, MD State University of New York at Buffalo • George Gellman The Benchmark Group • • Pastor Richard Hague, Jr Mount Erie Baptist Church Maureen Hurley Rich Products Maureen Millane, Ph. D Daemen College Debra Quinn Consumer Patrick Reen Consumer Thomas Rosenthal, MD State University of New York at Buffalo Dan Scully Buffalo Medical Group, PC Arthur Wingerter Univera Healthcare

Three Core Disciplines Care Transformation • Improve the quality of care • Improve access to care • Focus on areas with low socio-economic status Community Health Planning • Help Communities to understand areas where they need improvement. • Provide facilitation services, data support, and assistance with resources. • Promote policy change Health Engagement • Create programs that empower patients to become active partners in their care, and take responsibility for and act on their own wellness.

Targeted Interventions For Every Aspect of Health Physical Environment (10%) • Western New York Community Health Planning Institute Social and Economic Factors (40%) • Western New York Health Equity Coalition • Community Medicaid Collaborative Clinical Care (20%) • PCMH Adoption • Care Transitions of Western New York • Prostate Cancer Quality Initiative Health Behaviors (30%) • Ounce of Prevention • Living Healthy • Diabetes Prevention Program

Does low health status present a threat to your organization or community? Does high health status present a competitive advantage for your organization/community?

Business/Community Problem Currently, most costs associated with workplace, workforce and community performance are growing at an unsustainable rate and a threat to the organization/community How are we going to be successful in this increasingly competitive world without a healthy and high performing workplace, workforce and communities? How can we turn costs into an investment?

What if you worked for the best company you could imagine: an organization that was a high performing and an employer of choice. What words would you use to describe the workplace and the workforce? VISION for 2013 and Beyond

Who is your target audience and what to they look like?

Estimated Health Risks Health Risk Measure Body Weight Stress Safety Belt Usage Physical Activity Blood Pressure Life Satisfaction Smoking Perception of Health Illness Days Existing Medical Problem Cholesterol Alcohol Zero 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% 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

Estimated Health Problems Self -Reported Allergies Back Pain Cholesterol Heart Burn/Acid Reflux Blood Pressure Arthritis Depression Migraine Headaches Asthma Chronic Pain Diabetes Heart Problems Osteoporosis Bronchitis/Emphysema Cancer Past Stroke Zero Medical Conditions Health Problems 33. 2% 26. 9% 16. 2% 15. 2% 14. 5% 10. 7% 9. 4% 7. 0% 6. 4% 3. 8% 3. 3% 1. 8% 1. 7% 1. 3% 0. 7% 31. 9% From the UM-HMRC Medical Economics Report Estimates based on the age-gender distribution of a specific corporate employee population

Risk Transitions (Natural Flow) 2, 373 (50. 6%) Time 1 – Time 2 Medium Risk (3 - 4 risks) 4, 546 (42. 6%) 1, 961 (18. 4%) 1640 (35. 0%) 10, 670 (24. 6%) 11, 495 (26. 5%) 5, 309 (19. 0%) Average of three years between measures Modified from Edington, AJHP. 15(5): 341 -349, 2001 4, 691 (10. 8%) 5, 226 (12. 1%) 678 (14. 4%) High Risk (>4 risks) 892 (3. 2%) 4, 163 (39. 0%) 27, 951 (64. 5%) 26, 591 (61. 4%) 21, 750 (77. 8%) Low Risk (0 - 2 risks)

Cost Transitions (Natural Flow) Time 1 – Time 2 127, 644 (35. 8%) 37, 701 (55. 7%) 67, 680 (19. 0%) 26, 288 (20. 6%) Medium Cost ($1000 -$4999) 75, 500 (59. 1%) High Cost ($5000+) 73, 427 (20. 6%) 9, 438 (5. 9%) 23, 043 (34. 0%) 130, 785 (36. 7%) 32, 242 (20. 0%) 6, 936 (10. 2%) 25, 856 (20. 3%) 160, 951 (45. 2%) N=356, 275 Non-Medicare Trad/PPO Modified from Edington, AJHP. 15(5): 341 -349, 2001 Low Cost (<$1000) 152, 063 (42. 7%) 119, 271 (74. 1%)

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

The Economics of the Total Threat to Organizations and Communities relative to High or Low Health Status Low or No Risks Health Risks Disease increase decrease Total Threat Medical/Hospital Drug Absence Disability Worker’s Comp Effective on Job Recruitment Retention Morale Where does the Threat turn into a competitive advantage?

Medical and Wellness Strategies in 2012 and Before Wait for Disease or Health Risks and then Treat In Quality terms this strategy translates into “wait for defects and then fix the defects”

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

Where do we need to go in 2013 and beyond? TO A NEW LEVEL OF THINKING… (Deming, Drucker, Blanchard…)

Vision for Zero Trends “…organizations ensure a sustainable and thriving workplace and workforce…” Zero Trends was written to be a transformational approach Based upon over 800 Publications and Presentations

Strategies for 2013 and Beyond Integrate the Whole Person into the Environment and Culture (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)

Characteristic of a Champion Company and Community Strategic Vision Systematic Strategy Systemic Solutions Sustainable Policies VISION: “…organizations ensure a sustainable and thriving workplace and workforce”

Thriving and Sustainable Workplace and Workforce for 2013 and Beyond: Strategic Create a Thriving and Healthy Work. Force Create a Supportive Environment and Culture Create the Vision and Strategy Champion Company Move Healthy Well. Being into the Culture Senior Leadership Operations Leadership Self-Leadership Recognize Positive Acts Quality Assurance 1981, 1995, 2000, 2006, 2008, 2011 Dee W. Edington Gains in Organizational Objectives Health Status Economics Absence Worker’s Comp. Presenteeism Financial Metrics Engaged Workers Recruitment Retention Happiness Company Visibility Social Responsibility

Five Fundamental Next Practice Pillars Strategic, Systematic, Systemic and Sustainable Communication, Engagement &Culture Communication and Enrollment Pillar 1: Senior Leadership Strong Vision Committed Leadership Courage Engagement and Culture Programs Along the Health Continuum Prevention and Wellness Pillar 2: Operations Leadership Build Culture of Wellness Build the Brand Train all Levels Case Management Pillar 3: Self. Leadership Disease Management Create Winners One step at a time Don’t get worse Build Self-Efficacy Build Self-Leaders Pillar 4: Reward Actions Program Impact Self-leaders Health Status Economics Performance Champion Company Pillar 5: Quality Assurance Reward Positive Continuous Improvement Actions Feedback Reinforce Every Sustainable Touch Point

Lifestyle Scale for Individuals and Populations: Self-Leaders High-Level Wellness, Energy and Vitality Feeling OK Chronic Signs & Symptoms Edington. Corporate Fitness and Recreation. 2: 44, 1983, Modified 2009 Premature Sickness, Death & Disability

Living and Thriving Assessment Supportive Community Supportive Self-Leader 21 st Century Living and Thriving Assessment Supportive Family and Friends Supportive Workplace Determinates of Living and Thriving

Self-Leadership and High Performance • Purpose-Values-Mission-Vision • Environment and culture • Personal Control • Resilience • Consumerism • Engagement • Optimism Self-leadership • Knowledge • Health Literacy • Negotiation Skills • Selfesteem • Vitality/energy/ • Social Vigor Support –Colleagues –Community –Family • Low-Risk Health Status • Confidence / Selfefficacy Other possible characteristics: Change, Integrity, Trust, Thrive, Enthusiasm, Ethical, Spiritual, Creative, Flexible, © 2010: Edington Associates

Implementation

CEO Enterprise Strategy GAP Analysis Metrics Environmental Audit Vision Perception of Culture Training Courses Senior Leaders Human Resource All Managers Wellness Champions All Employees Resilience Concepts of Change Decision Making Self-Leadership Commitment Wellness Programs Focus Groups Reward Positive Actions Steering Team Attention to Gaps ES and Outcome Integrated Database Corporate Positioning System

Corporate Positioning System • Where do you want to go? • Are we there yet ? • Where are you today? • How do you get there ? • Roadblocks, Detours ? • Are you on track? Online platform with views for all stakeholders in the organization • Senior Leaders • Operations Leaders • Managers • All Employees (Vision Objectives) (Success Metrics) (Gap Analysis) (Training, Modules, Wellness) (Ongoing Evaluation) (Real Time Tracking)

Summary

Summary advice for Organizations and Communities Don’t get worse Help the healthy people stay healthy

What’s Your Vision? Create a Strategy Senior Leadership Champion Vision from Leaders Comprehensive Speech from Leader Traditional Do Nothing Operational Leadership Healthy System & Culture Reduction in Risks Self. Leadership Everyone a Self. Leader Reward Positive Actions Quality Assurance Reward Sustained Results Progress in All Areas Reduce Health Risks Reward Achievement Change in Risk & Sick Costs Inform Leader Programs Targeting Risks Health Risk Awareness Reward Enrollment Change in Risks Status Quo Status Quo © 2011 Edington Associates, LLC

What’s the Point

Thank you for your attention Please contact us if you have any questions Phone: (734) 998 -8326 Email: dwe@edingtonassociates. com Website: www. edingtonassociates. com Edington Associates LLC North Campus Research Center 1600 Huron Parkway , Ann Arbor MI 48109 Twitter, Facebook, Linked. In