White Paper: The Science of Well-Being

8/3/2019 White Paper: The Science of Well-Being

1/8

The Science o Well-Being


2/8

The Healthways Center for Health Research is a diverse

organization with the mission to constantly rethink how

to best inspire healthy lifestyles and support those living

with chronic conditions. Our studies seek to understand

the importance of personal and population well-being

and to rigorously evaluate the impact of programs aimed

to improve well-being and, in turn, reduce health care

expenditure and enhance productivity. Visit Healthways

Science-Based Outcomes Library for our latest publishedresearch:www.healthways.com/success


3/8

The Science o Well-BeingScience has ueled the evolution o Healthways solutions or more than 30 years. Weve grown rom early programs to improve

diabetes care to solutions that support total populations: keeping healthy people healthy, reducing health-related risks, and

optimizing care or those with chronic conditions. Since the early 1990s, Healthways and external 3rd party investigators have

published numerous peer-reviewed articles and white papers that document the specic impacts o our programs.

Our solutions today look beyond physical health to address other aspects o well-being that afect health care costs and human

perormance. Because innovation at Healthways is driven and validated by research, weve approached the idea o Well-Beingimprovement with ull scientic rigor.

Developingandvalidatingtoolstomeasurewell-being:comprehensive,comparablemeasuresthatreectthebest, research-baseddenitionsofwell-beingandprovideactionableinformationforimprovement.

Determininganddocumentingthevalueofwell-beinganditselements:demonstratinghowwell-beingisrelatedto otherimportantsourcesofvalueincludinghealthcarecosts,risksandperformance.

Creatingacost-eective,congurablesolutiontoimproveindividualwell-beingacrosscustomerpopulations: asolutionthatbuildsonproven,eectiveelementsinallofourpreviouswork.

Measuring Well-BeingHealthways and Gallup launched the Gallup-Healthways Well-Being Index (WBI) in 2008 to provide a denitive national measure

o well-being, helpul to leaders in both public and private sectors working to improve population health.

TheWBImergeddecadesofresearchanddrewonadiverseteamofexpertstotrackandunderstandthekeyelements

andindicatorsofwell-being.

IntheU.S.,thesurveyisadministeredto1,000peopleperday.Ongoinganalysisofthemorethanonemillion completedsurveysarecontributingtoagreaterunderstandingofwell-being.In2011,thesurveylaunchedinthe U.K.andGermany.

WBIquestionsandscoringmethodsareoptimizedtoassesswell-beingforlargepopulationsandenablecomparisons amongpopulations:communities,states,nations,orotherlargegroups.

Healthways developed the Well-Being Assessment (WBA) to help drive individual improvement within customer populationusing a personalized approach. It combines our primary components:

The WBA combines validated instruments

thatmeasurewell-being,productivity,health

risk,andbiometrics.Thisinformationissyn-

thesizedtoidentifyindividualandpopulation

needsforprogramsaimedatimprovingWell-

Beingandtoassesschangeovertime.


4/8

1. WBIquestionsallowHealthwaystobenchmarkthewell-beingofcustomerpopulationsagainstnationalorcommunity

dataandidentifyimprovementopportunitiesinthesepopulations.

2. Aproductivitycomponentassessesanorganization'scultureofhealthandincludesthefollowingvalidatedmeasures ofpresenteeism(onthejobproductivity)andabsenteeism:

- Items measuring absenteeism and presenteeism rom the Health and Productivity Quotient (HPQ), developed

by Ronald C. Kessler and colleagues at Harvard.1

- A presenteeism item rom the Work Productivity and Activity Limitations Questionnaire (WPAI), a tool validated

in research studies to quantiy the eects o health problems on presenteeism.2

- The Well-Being Assessment for Productivity (WBA-P), a specialized measure of on the job productivity loss

11 performance barriers to help diagnose and address the causes of presenteeism. Healthways and Pro-

Change Behavior Systems developed and validated this additional measure to provide a productivity score

that provides actionable information for improving performance. The validation study was published in the

Journal of Occupational and Environmental Medicine.3

3. Specicbiometricinformationiscollectedonhealthriskindicatorssuchascholesterollevelsandbloodpressuretoasses

theoveralllevelofhealthriskandtrackthechangeinthesemeasuresovertimeinresponsetointerventions.

4. AHealthRiskAssessment(HRA)componentassessesbehavioral,physicalandemotionalhealthrisks,basedonthe

workofDeeEdington,PhD,DirectoroftheUniversityofMichigansHealthManagementResearchCenter. By including each o these components in a single survey instrument, Healthways can leverage the combined inormation to

best guide business leaders on which items are both prevalent and impactul at driving better Well-Being and improved per-

ormance. Additionally, collecting survey data at regular intervals allows or evaluation o how each measure changes over

time as a result o Well-Being programs, individually and in relation to one another.

0.00

0.10

0.20

0.30

0.40

0.50

0.60

0.70

0.80

1.00

0.90

0 0.05 0.15 0.25 0.30.20.1

Areas o Greatest Opportunity

OPPORTUNITY TO IMPROVE PRODUCTIVITY

LACK OF RESOURCES

Workload

Technology Issues

IMPORTANCE OF BARRIER

FREQUENCYOFBARRIER

Financial Stress

CoworkersSupervisor

PERSONAL PROBLEMS/WORRIES

DEPRESSION/ANXIETY

PHYSICAL HEALTH

TRAINING

AnalysisofopportunityusingWBAproductivitydata from

14,274 employees ofa large

manufacturingcompany.


5/8

Valuing Well-BeingRecent Healthways studies within diverse customer populations show and quantiy the relationship o well-being to health

care utilization, health care costs and perormance.

Well-Being is connected to utilization, cost, productivity and employee engagement.

An analysis o over 10,000 employees in a large employer population looked at correlations across multiple sources o data

that were linked at the individual level: WBA inormation, health claims, disability claims, absenteeism and supervisor ratings. Overallwell-beinghadasignicantanddirectrelationshiptosevenoutofsevenmeasuresofhealthcareuseandcost: ERvisits,hospitaladmissions,beddays,pharmaceuticalcosts,medicalcosts,anddisabilitydaysandcosts. Obesitywasassociatedwithhigheraverageannualhealthcarecostsofmorethan$700perperson,indicatinga substantialopportunitytoproducecostsavingsthroughweightmanagementandobesityprevention.

Overallwell-beingshowedasignicantcorrelationwithfouroutoffourmeasuresofproductivity:manager-assessed jobperformance,self-assessedjobperformance,presenteeismandabsenteeism.

Higher well-being is associated with ewer unscheduled absences and better job and team perormance.

Two additional studies within employer populations urther explored well-being and job perormance. One study connectedhigher well-being at the business unit level to higher job engagement and team perormance. Another study ound that hav

ing a 10-point higher overall well-being score,(with well-being scored rom 0 to 100) was associated with:

5%fewerunscheduledabsences

24%lowerpresenteeism(measuredbytheWBA-P)

5%higherreportedjobperformance(recallingthemostrecentperformancereview)and4%higherself-rated jobperformance

6%moredaysofbestworkina28-dayperiod

30

40

50

60

70

80

90

WBA-P PRESENTEEISM SCORE (Productivity loss; 0-100)

R2 = .34, p


6/8

Well-Being predicts quantiable diferences in utilization and health care cost.

A study was conducted within the employees and general population o a large, commercial health plan to determine the

impact o well-being on health care utilization and cost over time.4 Would low well-being be a predictor o high use and cost?

The answer was yes. Results indicated an inverse relationship between individual well-being score and likelihood o utilization

and health care costs the ollowing year. When the population was grouped by well-being levellow, medium, and high

people with high well-being cost 43% less on average than people with moderate well-being, and 59% less than people with

low well-being among individuals who incurred costs the year ater taking the WBA.

Changing Well-BeingHealthways solutions have demonstrated strong impacts on many aspects o well-being. More than 50 published outcomes

reports document our success.

Health Assessment & Awareness

Among participants in a Healthways program with a scored risk assessment or three consecutive years, 23.5% o those initially

at risk moved to the not at risk group ater one year. Ater two years, 27.3% had moved rom at risk to not at risk. Risks

included measures o cholesterol, blood pressure and nicotine use.5

Tobacco Cessation

Healthways QuitNet Comprehensive, a tobacco cessation program with web, phone, and medication support, achieved a44.7% quit rate among surveyed enrollees seven months ater program enrollment. The more conservative intent-to-treat qui

rate (counting non-respondents as smokers) exceeded 27%.6

Medication Adherence

Personal reinorcement plans, used to support behavior change within Healthways customer populations, increased medication

adherence by as much as 34.6% within a disease population while reducing the overall incentive budget per participant.7

Physical Activity

Studies o the impact o the SilverSneakers Fitness Program on health and well-being or older adults ound that greater

participation was associated with a decreased risk o depression8 and lower health care costs. One study ound that SilverSneak

ers participants incurred $500 less in total health care costs in the second program year than nonparticants. Among participantthose who averaged two or more visits per week cost at least $1252 less than those who averaged ewer than one visit per

week.9 In a study o seniors with diabetes, compared to nonparticipants, SilverSneakers members generated $1,600 less cos

per member the rst program year and $1,200 less the second program year.10

Gaps in Care & Condition Management

A national study of Healthways diabetes management interventions across 20 health plan populations demonstrated clea

evidence of improved control and testing compliance. Full participants had overall national compliance rates across six

combined measures of 65.6%, compared to 57% among nonparticipants.11 Healthways support of members with coronary

artery disease helped one health plan boost the percentage of members with LDL cholesterol levels below 100 by 30%.12

Hospital Admissions and Readmissions

A study o a telephonic chronic care management program provided by Healthways to a large health plan population inGermany ound that among participants, care calls produced a net improvement in the hospital readmission rate o 21.1% in

one year compared to individuals who did not receive care calls.13 A slightly higher net improvement o 24.1% was seen in a

separate study o the impact o care calls in a senior population with chronic disease.14

Healthways has also proven efective at reducing readmissions by ollowing up with patients ollowing discharge rom the

hospital to ensure understanding and adherence to care plans. In a recent study o members o a large health plan who wer

admitted to the hospital, receipt o a call rom a Healthways nurse within two weeks o hospital discharge was associated with a

23.1% lower likelihood o readmission within 30 days o hospital discharge compared to individuals who did not receive timely

ollow up.15


7/8

Cost Savings

A published analysis o a Healthways phone-based outreach program directed toward Medicare beneciaries with chronic

disease ound that the program:

Measurablyimprovedclinicalmeasures

Achieved94%overallprogramsatisfaction

Deliveredgrosssavingsthatexceededprogramcosts.16Integrated Impact

Healthways Well-Being Improvement Solution integrates our proven strengths in areas like health assessment, behavio

change, admission prevention, and more.

A recent randomized, controlled clinical trial with participants in 39 states evaluated the efects o our combined behavior

change programs or stress and exercise in a six-month period.17 Participants began with a mean number o 4.14 behavior risks

and were divided into three groups:

Control

StressOnline:tailoredinterventionfocusingonstressmanagementasaprimarybehaviorandexerciseasa secondarybehavior.

ExerciseCoach:tailoredtelephoniccoachingprogramfocusingonexerciseasaprimarybehaviorandstress managementasasecondarybehavior.Participation in either intervention group showed clear impact on health risks and well-being compared to the control group

Asignicantlyhigherpercentageofparticipantsinbothtreatmentgroups,comparedtothecontrolgroup,eliminated exercise,stressmanagement,andhealthydietasriskfactorsandhadasignicantlygreaterdecreaseintotalnumber ofhealthrisks.

BothtreatmentgroupsdemonstratedsignicantlygreaterimprovementsonoverallWell-Beingandthedomainsof emotionalhealth,physicalhealth,lifeevaluation,andhealthybehaviorscomparedtocontrolgroupmembers.

Clear Outcomes or Every Customer

Whether driving results in a highly ocused area or infuencing multiple aspects o well-being over time, every Healthways

solution is designed to deliver dened outcomes. For customers using our comprehensive Well-Being Improvement Solutionwe are measuring and valuing impacts on claims, health-related behavior, and productivity.

Innovation and experience continually shape the science o our solutions. Visit Healthways Science-Based Outcomes Library

or our latest published research. Contact Healthways or more inormation.

Reerences

1 Kessler RC, Barber C, Beck A, et al. The World Health Organization Health and Work Perormance Questionnaire (HPQ). J Occup Environ Med. 2003; 45(2):156-74.2 Reilly MC, Zbrozek AS, Dukes EM. The validity and reproducibility o a work productivity and activity impairment instrument. Pharmacoeconomics. 1993; 4(5):353-65.3 Prochaska JO, Evers KE, Johnson JL, et al. The Well-Being Assessment or Productivity: A Well-Being Approach to Presenteeism. J Occup Environ Med. 2011; 53(7): 735-42.4 Harrison PL, Pope JE, Coberley CR, Rula EY. Evaluation o the Relationship between Individual Well-Being and Future Health Care Utilization and Cost. In submission.5 Sustained Improvements in Health Risk Among myHealthIQ Participants, Healthways Center or Health Research, 2008.6 Severtson L, Haas J, Netzger A, Purvis J, Rula E, Tobacco Cessation through Participation in a Comprehensive Multi-Media Program. Outcomes & Insights In Health Management, Vol. 1;Issue 1 April 2009.7 Kalayoglu MV, Reppucci M, Blaschke, et al. An Intermittent Reinorcement Platorm to Increase Adherence to Medications. Am J Pharm Benets, 2009; 4(5): 91-4.8 Nguyen HQ, Koepsell T, Untzer J, et al. Depression and use o a health plan-sponsored physical activity program by older adults. Am J Prev Med. 2008;35(2):111-7.9 Nguyen HQ, Ackermann RT, Maciejewski M, et al. Managed-Medicare health club benet and reduced health care costs among older adults. Prev Chronic Dis. 2008; 5(1).10 Nguyen HQ, Maciejewski ML, Gao S, et al. Health Care Use and Costs Associated with Use o a Health Club Membership Benet in Older Adults with Diabetes. Diabetes Care. 2008;31(8): 1562-7.11 Espinet LM, Osmick MJ, Ahmed T, Villagra VG. A cohort study o the impact o a national disease management program on HEDIS diabetes outcomes, Disease Management. 2005; 8(2)86-92.12 Health plan report to CMS by a Healthways customer, September 2008.13 Hamar B, Wells A, Gandy W, et al. The Impact o a Proactive Chronic Care Management Program on Hospital Admission Rates in a German Health Insurance Society. Popul HealthManag. 20101; 13(6): 339-45.14 Hamar B, Wells A, Gandy W, et al. The Impact o Proactive Chronic Care Management on Hospital Admissions in a German Senior Population. Popul Health Manag. 2011: 14(Suppl 1):s29-33.15 Harrison PL, Hara PA, Pope JE, et al. The Impact o Postdischarge Telephonic Follow-Up on Hospital Readmissions. Popul Health Manag. 2011; 14(1):27-32.16 Rula E, Pope J, Stone R. A Review o Healthways Medicare Health Support Program and Final Results or Two Cohorts. Popul Health Manag. 2011; 14(Suppl 1):3-10.17 Prochaska JO, Evers KE, Castle PH, et al. Enhancing Multiple Domains o Well-being by Decreasing Multiple Health Risk Behaviors: A Randomized Clinical Trial. In submission.


8/8

Connect with us:

800-327-3822

WWW.HEALTHWAYS.COM

[email protected]

701 Cool Springs Blvd.

Franklin, TN 37067

Stay in touch.

White Paper: The Science of Well-Being

Documents

Transcript of White Paper: The Science of Well-Being