Garry M. Lindsay, MPH, CHES
Managing Senior Fellow & Managing Project Officer
Partnership for Prevention
Leading by Example:
Commitment Starts at the Top!
International Association for Worksite Health Promotion
2010 Executive Summit
April 7, 2010 Austin, TX
About Partnership for Prevention®
Who We Are
Nonprofit, non-partisan national health policy organization
What We Do
 Work to improve the health of all Americans by increasing the
priority on disease prevention and health promotion
 Develop, disseminate and advocate for science-based policies,
practices, and programs
 Convene various sectors to address priority health concerns
 Translate evidence-based public health evidence and research
into policy and practice
 Leverage the workplace to improve health
Outline
•
About Partnership for Prevention
•
Understanding Management Support: The importance of
leading by example and setting priorities
•
Health Management Initiative Assessment Discussion
•
Andrew Liveris DVD
•
Q&A
Mean Health Insurance Costs Per Worker Hour for
Employees with Access to Coverage 1999 - 2005
Source: Kaiser Family Foundation calculations based on data from the National Compensation Survey,
1999-2005, conducted by the Bureau of Labor Statistics.
http://www.kff.org/insurance/snapshot/chcm030808oth.cfm Accessed March 23, 2010
International Comparison of Spending on Health, 1980–2005
Average spending on health
per capita ($US PPP*)
Total expenditures on health
as percent of GDP
* PPP=Purchasing Power Parity.
Data: OECD Health Data 2007, Version 10/2007.
Source: Commonwealth Fund National Scorecard on U.S. Health System Performance, 2008
5
Poor Value for Healthcare Expenditures
Most Expensive Healthcare System in the World
($2.2 Trillion per Year)
•
Highest expenditure at 15.2% of GDP
•
Highest expenditure per capita at $6347
Health Results are Poor
•
Ranked 25th in the world for Infant Mortality
•
Ranked 23rd in the world Life Expectancy
Source: Organization for Economic Co-operation and Development. OECD Health Data 2008, Version: June 2008 Copyright OECD 2008, http://www.oecd.org/health/healthdata.
Chronic illness affects more than 33% of working-age
Americans
During 2006, the U.S. spent almost $2.2 trillion on health care
Of every dollar
spent…
…75 cents went
towards treating
chronic disease
Actual vs. Leading Causes of Death
Actual Causes of Death2
Leading Causes of Death1
Tobacco
Heart Disease
Cancer
Poor diet/
lack of exercise3
Stroke
Alcohol
Chronic lower
respiratory disease
Infectious agents
Unintentional Injuries
Pollutants/toxins
Firearms
Diabetes
Sexual behavior
Pneumonia/influenza
Motor vehicles
Alzheimer’s disease
Illicit drug use
Kidney Disease
Percentage (of all deaths)
0
Sources:
1
5
10
15
20
25
30
35
Percentage (of all deaths)
0
National Vital Statistics Reports, Vol. 53, No. 15, February 28, 2005.
Adapted from McGinnis Foege, updated by Mokdad et. al., 2000.
3 JAMA, April 20, 2005—Vol 293, No. 15, pg 1861.
2
5
10
15
20
Situational Awareness: A Broken System
How Executives are Addressing High Cost of Healthcare
Survey of 1,400 CFO Executives - March 2006
53%
Cuttting other spending
46%
Premium & cost shifting
34%
Increasing costs to customers
46% said they address high
costs by increasing
premiums & cost shifting.
Yet, studies have shown
increased cost shifting
creates barriers to healthy
behaviors and may reduce
patients’ efforts to engage in
preventive care.
24%
Reducing benefits offered
19%
Outsourcing functions
9%
Relocating to lower cost state
22%
None
0%
10%
20%
30%
40%
Source: Robert Half Management Resources, March 2006; and, Goldman DP, Joyce GF, Escarce JJ,
et al. Pharmacy benefits and the use of drugs by the chronically ill. JAMA. 2004;291:2344-2350; and
Goldman DP, et al, JAMA 2004:291:2344-2350.
For example, when co-pays
were doubled, patients took
less medication in important
including
50% classes
60%
hypertension, cholesterol
and diabetes. In turn,
hospital ER visits and
hospital stays also increased
by more than 10 percent.
Shift in Thinking
Yesterday’s Assumption: Health is a COST driver
Initiatives to improve employee health are primarily a
strategy for controlling top line expense
VS.
Today’s Reality: Health is a PERFORMANCE driver
Investing in health not only controls expenses, but also
protects, supports and enhances human capital. It is
fundamental to a healthier bottom line
Partnership for Prevention: Leading by Example, 2005.
Total Value of Health
Relative Costs of Poor Health:
Total Value of Health
Direct
Costs:
Medical & Pharmacy
Workers’
Compensation
Indirect
Costs:
Presenteeism
STD
Absenteeism
LTD
Time Away from Work
Edington, Burton. A Practical Approach to Occupational and Environmental Medicine (McCunney). 140-152. 2003
Importance of CEO Support
Low Impact
High
Control
Medium Impact
Effective
Communications
High Impact
Link Programs to
Business Goals
Communicate
Evaluation Results
Medium
Control
Low
Evaluation
Component
Incentive Program
Strong Budget
Supportive Culture
Control
O'Donnell M. Health Promotion in the Workplace. 3rd ed. Albany, NY: Delmar; 2001, page 50.
Top Management Support
Leading by Example
•
Often CEOs Not Aware of Business Case
•
Continual rises in health care costs can be reduced through
health management initiatives
•
Employee health should be seen as an investment to be
maximized rather than a cost to be minimized
•  Employee Performance  Business Performance
•
Peer Influence
Leading by Example
•
Highlights the direct & indirect
costs of poor health
•
Convince CEOs of the
business case for investing in
worksite health through a
peer-level initiative
•
Transform the American
healthcare system to
emphasize prevention rather
than treatment through CEO
influence
Importance of Senior Leadership
Leading by Example Commitment ™
What Some Leading by
Example Companies are Doing
Safeway
“Too
oftencoverage
companies
look at wellness
• 100%
of annual
as just
another benefit. We have fully
physicals
integrated wellness into every aspect of
our
company’s
culture.
• Incentives
weight
loss,It’s a source of
pride,
and reflects
how
we care for one
tobacco
cessation,
stress
another.
As aand
result,
wellness has
reduction
positive
become
a critical
element of our
healthy
behaviors
success.”
• Premium discounts for
-- Steve Burd, Chairman, President, and
healthy decisions and higher
CEO(based) premiums for noncompliance
What Some Leading by
Example Companies are Doing
Intel Corporation
• Intel,
Wellness
program includes
onsite are a
“At
prevention
and wellness
fitness
centers,
fitness
challenges,
priority.
Intel
saves
on health
care costs,
weight management, flu prevention,
and mammography
our employees
andnutrition
their families
vans,
seminars,get
engaged
in managing
theirinhealth
for the
and healthy
choice meals
cafeterias.
rest of their lives. We hear from employees
• First
four
months
of onsite
biometrics this
every
day
how
much
they appreciate
and coaching yielded more than 10,000
approach.
By working together, we’re
participants
making a difference in both employee
• Employee
satisfaction
above 90%
health
and the
health ofranks
Intel.”
– Paul S. Otellini, President and CEO
What Some Leading by
Example Companies are Doing
Lincoln Industries
• Mandatory quarterly health
screenings
and individual
“Too often
companies
look at wellness as
coaching
just
another benefit. We have fully
integrated wellness into every aspect of
• Health Reimbursement Account
our company’s culture. It’s a source of
(HRA) with credits for being
pride and reflects how we care for one
tobacco free
another. As a result, wellness has become
critical element
of our success.”
• a Tobacco-free
campus
-- Marc LeBaron, Chairman and CEO
• Health care cost 50% below
national average
Outline
•
About Partnership for Prevention
•
Understanding Management Support: The importance of
leading by example and setting priorities
•
Health Management Initiative Assessment Discussion
•
Andrew Liveris DVD
•
Q&A
What Some Leading by
Example Companies are Doing
The Dow Chemical Company
•
Company
“In 2004, we
health
launched
strategya simple yet
dynamic Health Strategy that took our
• Preventive
benefit
business
caseemphasis
for healthininvestment
to the
nextplan
level. This strategy is sharply focused
on improving Dow’s financial position by
• promoting
Relevant workplace
health
policy
better health,
and
features
and
clear
metrics to ensure
•tough
Overgoals
85% of
North
American
forward
progress.
Our top
two priorities
employees
voluntarily
participate
andservices
quality and
in are
one prevention
or more health
effectiveness
of health care.”
each
year
-- Andrew N. Liveris, Chairman and CEO
Outline
•
About Partnership for Prevention
•
Understanding Management Support: The importance of
leading by example and setting priorities
•
Health Management Initiative Assessment Discussion
•
Andrew Liveris DVD
•
Q&A
Questions
•
Garry M. Lindsay, MPH, CHES
Managing Senior Fellow & Senior
Program Officer
Partnership for Prevention
1015 18th St., NW, Suite 300
Washington, DC 20036
(202) 833-0009
glindsay@prevent.org