Wellness Program Trends

Wellness Programs –What does the future hold?Curt Palmer – MasterCard

Laurie Knutson – FIS Healthcare & Wellness Product Strategygy

Agenda

• Laurie Knutson FIS Healthcare & Wellness Product StrategyLaurie Knutson, FIS Healthcare & Wellness Product Strategy– The business case for wellness

– Wellness program ROI

– Choosing a wellness partner

– Best practices for ensuring wellness program success

• Curt Palmer, Business Leader, Healthcare Solutions; MasterCard– Review of research – wellness program insights

– Role of incentives

2

Wellness Program Trends & Best Practices

Why is Wellness Important?

4

Unsustainable U.S. Healthcare Costs

All Other Healthcare

Medicaid

Medicare

Source: Congressional Budget Office.Note: Amounts for Medicare are net of beneficiaries’ premiums. Amounts for Medicaid are federal spending only.

5

What is Driving Healthcare Costs?

• Chronic disease: resulting from longer life spans and a host of social and cultural “advancements”– The CDC estimates that healthcare costs for chronic disease treatment account for more than

75 percent of national health expenditures.

– The obesity epidemic is estimated to cost private employers $45 billion per year in combined medical expenditures and worker absenteeism 1medical expenditures and worker absenteeism 1

– Total cost of diagnosed diabetes patients in U.S. was $174 billion in 2007, which included $116 billion as direct costs and $58 billion as indirect costs such as disability, work loss and premature mortality. 2

• Technology and prescription drugs

• Aging of the population

• Administrative costs

Some studies suggest at least 50 percent of an organization’s healthcare costs are linked to smoking, poor diet and lack of exercise on the part of employees.

1 Rosen, B. and Barrington, L. “Weights & Measures: What Employers Should Know about Obesity.” New York, NY: The Conference Board, April 2008.

2 National Center for Chronic Disease Prevention and Health Promotion. 2007 National Diabetes Fact Sheet.

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The Challenge

The challenge for companies amidst global competition is to create an organizational culture that promotes a high performing workforce in a high performance workplaceculture that promotes a high‐performing workforce in a high‐performance workplace.

• The total costs of an unhealthy workforce are growing at an unsustainable pace.

• Workforce health and productivity translate into direct and indirect costs for every employer, and both the workplace environment and the lifestyles of employees and their families influence those costs.

• Employer‐sponsored health insurance plays a part, but avoiding conditions is preferable to treating conditionspreferable to treating conditions.

• Employers are looking for creative ways to help employees and their families improve their health—or simply stay healthy.

• Cost shifting is not a sustainable solution and employers do it reluctantly.Cost shifting is not a sustainable solution and employers do it reluctantly.

• A better investment would be to elevate employee health to an integral part of an overall human capital “asset management” strategy.

7

Patient ‘Self‐pay’ Ratios

30%

25%ity

Consumers are now increasingly responsible for the

20%

ent Re

spon

sibilip

cost of their own healthcare.

15%

10%

% Patie

Source: Celent, Effective Solutions, athenahealth, CMS

2007 2008 2009 2010 2011 2012

Population Health

• FIS believes that long‐term wellness and healthier lifestyles are achieved when using ll h b h f l d h l llwellness programs that examine both financial and physical wellness.

• While it is critically important to support the highest risk employees who suffer from chronic disease and represent the highest cost claims, it is equally important to help all employees stay healthy and remain at the low end of the risk spectrum or reverseall employees stay healthy and remain at the low end of the risk spectrum or reverse their trend toward unhealthy behaviors.

• This is what we mean by “population health” – the ability to provide coaching and support to every employee or member, no matter where they are on the health continuum.

• You need to target wellness programs through your healthcare plans to your most costly populations, but not forget about helping the general population from getting i ksicker.

• The focus of this webinar is the Wellness Programs we believe address your employees’ physical health.

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The Wellness Incentive Opportunity

Curt Palmer- VP, Healthcare Solutions

ADVANCING PROFITABILITY ADVANCING COMMERCE©2010 MasterCard

Proprietary and Confidential

About This PresentationAbout This Presentation

Confidentiality NoticeConfidentiality NoticeThe information contained in this presentation is the property of MasterCard Worldwide and may not be duplicated or distributed by any third-party without the prior written consent of MasterCard Worldwide. MasterCard Worldwide does not

k t ti ti ith t t th l tmake any representations or warranties with respect to the completeness or accuracy of the research and information contained within this presentation and hereby disclaims any liability with respect to reliance upon the content contained herein.

Third Party Research NoticePlease note that the information provided in the slides in this presentation is based on information obtained from third-party survey responses and other third-party data inputs. MasterCard has not verified the accuracy of this information and disclaims any liability arising from the accuracy or completeness of the information.

©2010 MasterCard.Proprietary and ConfidentialADVANCING PROFITABILITY ADVANCING COMMERCE

Situation Analysis: Increasing Need for Wellness ProgramsIncreasing Need for Wellness Programs

• The cost of insuring employees has increased 54 percent since 1991.

• About two-thirds of U S adults are overweight orAbout two thirds of U.S. adults are overweight or obese. Fifty-five percent do not get enough physical activity, while 26 percent are completely inactive.

If di t d h i l ti it tt ti t• If diet and physical activity patterns continue to worsen at their current rate, they will soon surpass tobacco use as contributors to mortality.


Source: Kaiser/HRET survey of employee sponsored health benefits cited in, “Employee Health Promotion Programs: Supporting Scientific Research and Wellness Statistics,” American Chronicle (September 17, 2008).

Situation Analysis: Financial Incentives are Being OfferedPercentage of companies offering financial incentives in wellness programs

Financial Incentives are Being Offered

40%

66%

P ti i ti i S ki C ti P

Completion of a Health Risk Appraisal

32%

34%

40%

Completion of Biometric Screening

Participation in Weight Management Program

Participation in Smoking Cessation Program

26%

29%

Participation in Disease Management Program

Participation in Health Coaching

7%

15%

Maintenance of a Personal Health Record

Completion of an Adult Health Exam


Sources:”Incentives: Detailed Findings from the 15th Annual Towers Watson/National Business Group on Health Survey on Purchasing Value in Health Care, “Towers Watson (2010).

Research Objectives

• In the fourth quarter of 2009, MasterCard and Harris

Research Objectives

In the fourth quarter of 2009, MasterCard and Harris Interactive conducted a 30-minute online survey to investigate what motivates employees to engage in a wellness program.

Th h bj ti t• The research objectives were to:– Identify wellness program trends

Better understand the wellness incentive market– Better understand the wellness incentive market

– Test a new product concept: a reloadable, prepaid wellness card for employers to offer their employees

– Determine meaningful incentive thresholds

– Identify obstacles to program adoption


Online Surveys: Propensity Weighting

I thi t d lt i ht d th b i f

Online Surveys: Propensity Weighting

• In this study, results were weighted on the basis of:– Age, income, gender

Region race education– Region, race, education

– Propensity to be online

• Harris Interactive uses propensity weighting techniques to a s te act e uses p ope s ty e g t g tec ques toensure that a survey fielded solely online is representative of the entire population (and not just the online portion of the population).population).


We Surveyed Employees from a Variety of Companies

E l d f ll ti t

from a Variety of Companies

• Employed full-time at companies with 250 or more employees

326250 – 999 Employees

• 1,381 respondents

• U.S. adults ages 18 − 64 5261,000 – 9,999 Employees

53210,000 + Employees


Q: Approximately how many employees does the company that you work for have in total?

Wellness Program Insights

ADVANCING PROFITABILITY ADVANCING COMMERCE

Wellness Programs Are Available to Most Employees in the Survey

In our survey, 1,080 people − 78 percent of those surveyed − worked for a company offering a wellness program.

to Most Employees in the Survey

p y g p g

250 − 999 Employees:

1,000 − 9,999 Employees:

67%

81%

10,000 + Employees: 82%


Q: Does your company currently offer any [of the following types of] wellness programs for employees?Q: Approximately how many employees does the company that you work for have in total?

Poll A

Q Wh t t f l i th U S h

Poll A

• Q: What percentage of employees in the U.S. have participated in at least one employer-offered wellness program in the past year? p g p y– A.14%

– B. 26%

– C. 46%

– D. 61%

– E. Not sure


How Many Employees are Participating?How Many Employees are Participating?

In the past year, 46 percent of those with access to a wellness program have participated.

33%

44%

33%

46%

10%13%

Have Wellness Programs (n=1,080)

Have Never ParticipatedHave Not Participated This YearHave Participated This YearCurrently Participating


Base: Company Offers Wellness ProgramsQ: Have you actively participated in any of the wellness programs offered by your company?

Why aren’t More People Participating in Wellness Programs?Wellness Programs?

Time constraints seen as biggest barrier

24%

29%

46%

Th P A I i i t

I Lack the Necessary Self-Discipline

I Am Too Busy/Don't Have Time

17%

19%

20%

24%

I Am Concerned About Confidentiality

I Don't Have Enough Energy

I Don't Know Enough About the Programs Offered

The Programs Are Inconvienient

10%

12%

15%

17%

My Manager Doesn't Allow Me the Time

The Programs Are Disorganized

I Do Not Have Access To On-Site Programs

I Am Concerned About Confidentiality

7%

10%

I Met My Initial Goals and Am No Longer As Motivated

My Manager Doesn t Allow Me the Time

Have Wellness Programs (n=1,080)


Base: Active and NonparticipantsQ: What barriers, if any, keep you from [signing up for and] sticking with your company’s wellness programs?

Motivating Factors are Both Intrinsic and Extrinsic

Receiving rewards/incentives and the desire to improve health are the most motivating

and Extrinsic

g

25%

25%

Personal Desire to Improve Health and Well-Being

Opportunities to Receive Rewards or Incentives

4%

15%

21%

Opportunity to Do My Share to Help My Company Keep Health Care Affordable

On-Site Access to Health-Related Services and Programs at Work

Free or Reduced-Cost Access to Health-Related Services and Programs at work Programs at work

Affordable

2%

2%

4%

Improved Morale and Camaraderie Among Coworkers

Opportunities to Learn More and Be Encouraged to Stay Healthy and Balanced

An Employee Competition or Challenge

And Balanced

1%

2%

Ability to Track Progress Online

Improved Morale and Camaraderie Among Coworkers

Total (n=1,381)


Base: All Qualified RespondentsQ: How motivating is/would each of the following [be] for you to participate in a wellness program?

Role of Incentives


Participation is Higher when Incentives are Part of the Programare Part of the ProgramCompanies offering rewards/incentives have a significantly higher participation rate

Companies That Don’t OfferRewards/Incentives

Companies That OfferRewards/Incentives

26%

39%

74%

61%

Nonparticipants Active ParticipantsNonparticipants Active Participants

(n=417)(n=511)


Base: Active and NonparticipantsQ: What types of rewards or incentives, if any, are offered for participating in your company’s wellness programs? Please select all that apply.Q: Have you actively participated in any of the wellness programs offered by your company?

Rewards Work Better than PenaltiesRewards Work Better than PenaltiesChange in Perception of Company

if Disincentives Were UsedLikelihood to Participate to Receive Incentives vs. Avoid Disincentives

18%

6%

3%

40%23%

Mean 3.9 3.1

Extremely likely

30%24%30%

19%

%

43%

6%24%5%

11%19%

Receive an Incentive Avoid a DisincentiveNot at all likely

Much More Positive PerceptionMuch More Negative PerceptionSomewhat More Negative PerceptionNo Change in PerceptionSomewhat More Positive PerceptionM h M P iti P ti

Receive an Incentive Avoid a DisincentiveTotal (n=1,381)

No Change in Perception

Somewhat More Negative Perception

Much More Positive Perception

Somewhat More Positive Perception


Much More Positive PerceptionBase: All Qualified RespondentsQ: How likely would you be to participate in a wellness program to…?Q: If your company were to penalize those who do not participate in company wellness programs, how would your perception of your company change?

Much More Negative Perception

Poll B


Poll B

• Q: What percentage of employees in the U.S. who have participated in an employer-offered wellness program in the past year have received a reward p g p yor incentive? – A. 57%

– B. 42%

– C. 32%

– D. 21%

– E. Not sure


A Variety of Rewards and Incentives Are Being OfferedBeing Offered

Over 40 percent of employees with wellness programs are receiving rewards/incentives

Discounts or Reimbursements

Types of wellness rewards/incentives offered to employees already participating in the wellness program

64%or Health Insurance Premium Reduction

16%

Prizes or Merchandise

Monetary Rewards (e.g. Extra Money In Paycheck, Prepaid Card)Paycheck, Prepaid Card) 36%

26%

or Health Insurance Premium Reduction

42%

Perks (e.g. Time Off, Special Events)

Awards or Recognition 17%

12%

9%

42%

Have Wellness Programs (n=1,080)Other

Lottery or Drawing 9%

4%

Respondents (n=511)


Base: Active and NonparticipantsQ: What types of rewards or incentives, if any, are offered for participating in your company’s wellness programs? Please select all that apply.

Money Is the Top MotivatorMoney Is the Top MotivatorMonetary rewards are more motivating than insurance premium reductions

81%24%38% 20%Monetary Rewards

69%20%38% 12%

52%17%8% 27%

45%20%12% 14%

Health Insurance Premium Reduction

Perks (e.g., Time Off, Special Events)

Discounts or Reimbursements 45%20%12% 14%

32%12% 16%

11%6%

Prizes or Merchandise

Awards or Recognition

Ranked Third

Motivated by Incentives (n=1 224)

10%6%Lottery or Drawing

Ranked SecondRanked First Ranked in Top 3


Base: Company Offers IncentivesQ: Thinking specifically of the various types of rewards and incentives that can be offered for participation in a wellness program, what would be the most motivating to you?

Motivated by Incentives (n=1,224)

Money Motivates—But How Much Money Motivates Most?

• The range between

But How Much Money Motivates Most?

• The range between $70 and $100 appears to promote the greatest incremental gains in

50%

40%letio

n

incremental gains in program participation

• The wellness card

30%

20%

tion

and

Com

pldemonstrates diminished return at investment at $150 $25 $50 $75 $100 $125 $150 $175 $200 $225 $250

10%

0%Par

ticip

at

$Total Cash Value of Incentive

Likelihood to enroll in program

Likelihood to complete program


Note: Base case assumes a 6-week program for Exercise, Healthy Eating, and Stress Management, with incentives distributed monthly. Health Risk Assessment is a one-time event.

e ood o co p e e p og a

Poll C


Poll C

• Q: What percentage of employees in the U.S. who have participated in an employer-offered Wellness program would like to receive a prepaid card as p g p ptheir reward for participation? – A. 89%

– B. 73%

– C. 67%

– D. 9%

– E. Not sure


Prepaid Cards Are Well Liked as a Form of Monetary RewardMonetary Reward Most appealing monetary reward is either extra money in paycheck and branded prepaid cards

91%Direct Deposit Into Bank Account or Paycheck

89%Receiving a Branded Prepaid Card

80%Receiving a Paper Check

40%Receiving a Store Brand Gift Card

Total (n=381)


Base: All Qualified RespondentsQ: If you were to earn monetary rewards for participating in your company’s wellness programs, which of the following would be most appealing?

Total (n 381)

Incentives Are Typically Given at the Beginning and End of ProgramsBeginning and End of Programs

There may be an opportunity to increase participation through incremental rewards

45%At Program Initiation

25%Upon Program Completion

15%

17%

Based on Specific Milestones

Other

8%Not Sure Averaged Across All Types of Incentives


Base: All Qualified RespondentsQ: How often are the rewards or incentives offered or distributed for participating in wellness programs? Please select all that apply.

Testing the Wellness Card Concept


Wellness Rewards Card

Earn: Burn:

Wellness Rewards Card

Health risk assessmentcompletion

W ll

Intended for use at healthcare providers

and merchants

Health and

Consolidated wellness d

Wellness program participation

Aggregate usage ti f

Health and wellness merchant

discounts

Other rewards rewards

Prepaid reloadable cardIncent behavior change

throughout the year

reporting for employers

or programs

g yCustom messaging

capabilities

Employer funding tool


Employee web portal

34February 18, 2011

Participants and Nonparticipants Like the Wellness Card Conceptthe Wellness Card ConceptEven nonparticipants and employees from companies without wellness programs responded favorably

29% 36%Total (n=1,381) 65%

37% 44%Active Participants (n=503) 81%

26% 32%Nonparticipants (n=577) 58%

%25% 43%No Wellness Programs (n=301)

Like the Concept a Lot Like the Concept Somewhat

68%

Total (n=1,381)


Base: All Qualified RespondentsQ: In general, what is your impression of the wellness card concept?

The Wellness Card Motivates Employees to Sign Up and Stick with a Programto Sign Up and Stick with a ProgramApproximately half of nonparticipants say they would participate if a wellness card is made available

Total (n=1,381)

Sign Up

Stick With 33%

27%

25%

36% 63%

58%

Active Participants

(n=503)

Sign Up

Stick With 33%

28%

40%

50% 78%

73%

Non-participants

(n=577)

Sign Up

Stick With

26%

30%15%

27% 53%

45%

No Wellness Programs

(n=301)

Sign Up

Stick With

29%

38%23%

34% 63%

61%

Extremely Likely Somewhat Likely


Base: All Qualified RespondentsQ: If your company were to provide monetary rewards on a Wellness Card, how likely would you be to sign up for and stick with your company’s wellness programs?

Factors that Encourage Employees to Sign Up and Stick with a Wellness ProgramProgramCard acceptance/rewards encourage participation

27% 47%Monetary Rewards Can be Spent Anywhere Major Credit Cards are Accepted 74%Are Accepted

35%

35%

28%

31%

Opportunity to Earn Additional Monetary Rewards for Using Wellness Card for Health and Wellness-Related Purchases

Card Can be Reloaded by Company When Rewards Have Been Earned 66%

63%

Earned

Wellness Card for Health and Wellness-Related Purchases

31% 19%

Access to Retail Discounts/Special Offers on Health And Wellness-

Ability to Log In to an Employee Website to Monitor Wellness Card Balance 50%

46%

Card Balance

29% 17%Access to Retail Discounts/Special Offers on Health And WellnessRelated Purchases

Extremely Motivating Somewhat Motivating

Total (n=1,381)

46%Related Purchases


Base: All Qualified RespondentsQ: How motivating are each of the following features or benefits of the wellness card to you personally when making a decision about whether to sign up for and stick with your company’s wellness programs?

Conclusions


Offer Incentive Rewards

• Companies that are offering wellness programs have only half of their employees participating.

Offer Incentive Rewards

their employees participating.

• Currently, less than half of employees are offered rewards and incentives for participation.

R d k b h di i i l• Rewards work better than disincentives; target employees are more motivated by incentives than by avoiding a disincentive.

• Approximately half of nonparticipants say they would participate in wellness programs if a wellness card was made available.

• Broad card acceptance and providing rewards throughout the year scored the highest when the card concept was tested.y g p

• The range between $70 and $100 appears to promote the greatest incremental gains in program participation.


The Impact of Successful W ll PWellness Programs

Wellness Programs = Real Change

• Wellness programs are defined as programs designed to maintain or improve employee health before problems ariseemployee health before problems arise.

• Beginning in 2014, small businesses can apply for grants to implement comprehensive workplace wellness programs through a $200 billion, five‐year federal program designed to address underlying poor health habits and promote disease p g g y g p pprevention through:– Smoking cessation

– Stress management

– Weight loss

– Reduced intake of fatty, high‐calorie foods

– Other ways of healthier living

• PPACA’s provisions all demonstrate an interest in supporting wellness programs as a• PPACA s provisions all demonstrate an interest in supporting wellness programs as a means to find cost savings through encouraging healthy behavior.

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Wellness – An Opportunity to Bend the Cost Curve

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Wellness – An Opportunity to Bend the Cost Curve

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Wellness ROI

• Companies frequently fail to make wellness programs work financially.

T i f ll i l d l k f i f i l d ( h• Two common pitfalls include a lack of commitment from senior leaders (who must function as role models) and the failure to integrate the health promotion program with the delivery of benefits and incentives.

• The most effective tools bring the financial and health elements together to helpThe most effective tools bring the financial and health elements together to help employees understand the impact of health on wealth

• FIS has integrated a full suite of Wellness programs into our Consumer Directed Healthcare Solutions to meet the needs of employees when managing their health and their wealth

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FIS Wellness/Consumer Engagement

Personal Health Record

WealthCare Portal

Personal Health Record

Mobile Wellness

Wellness tools and Health Risk Assessments

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Choosing a Wellness Partner

• Wellness programs range from turn‐key content rich to personalized coachingWellness programs range from turn key, content rich to personalized coaching.

• The program should reflect your organization’s values, style and budget.

• FIS researched a number of companies to partner with for integrated wellness solutions as part of our WealthCare Product Portfolio.p

• Key elements:– Proven results to effectively change behavior

– Ease of use and integration with our product suite

– Scalable, with durable results for individuals

– Ability to offer mobile solutions to improve participation and results

• FIS has chosen HealthMedia because they offer Digital Health Coaching programs for th t l t d i tf l b h i d th b t l f i t h lthe most prevalent and impactful behaviors and the best value for companies to help their employees better manage their health.

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Start with the High Impact Programs

The most impactful programs with respect to improving employee health and productivity include:p y• Weight Management => HealthMedia® Balance™ Program Results:

– 55 percent of participants lost weight after 180 days– Productivity Improvements: Estimated productivity savings of $905/year* per participant with a BMI of 30+

• Smoking Cessation => HealthMedia® BreatheTM Program Results:• Smoking Cessation => HealthMedia® BreatheTM Program Results:– 52 percent reported they still were not smoking six months after completing the program– 92 percent of participants who quit smoking indicated they were confident, very confident or extremely

confident they could remain smoke‐free 180 days after completing the program

• St M t > H lthM di ® R l TM P R lt• Stress Managements => HealthMedia® RelaxTM Program Results:– More than 58 percent of participants reported a decrease in personal symptoms of excess stress 180 days

after taking Relax™– Productivity improvements: Estimated productivity savings of $590/year* per participant, based on a

$50 000 annual salary$50,000 annual salary

• Nutrition Management => HealthMedia® NourishTM Program Results:– 91 percent reported an improvement in their nutrition efforts at 180 days

• Physical Activity Management => HealthMedia® MoveTM

• Sleep Improvement => evidence‐based techniques to help individuals recover from insomnia

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Whose Responsibility is Wellness?

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Questions and Answers

Thank You L i K t FIS H lth & W ll P d t St tLaurie Knutson, FIS Healthcare & Wellness Product Strategy

[email protected]

Curt Palmer, Business Leader, Healthcare; MasterCardCurt Palmer, Business Leader, Healthcare; MasterCard

[email protected]

Wellness Program Trends

Health & Medicine

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