The Best Source for Best Practices in Health Management 

A few weeks ago I mentioned the launch of the latest version of the HERO Employee Health Management (EHM) Best Practices Scorecard in Collaboration with Mercer. This online tool, which covers all aspects of workforce health— from keeping healthy people healthy to managing chronic diseases — and allows employers to assess their use of best practices in program strategy and design, is available free of charge on Mercer's website. Upon completing the Scorecard, employers receive an instant score that lets them see how their program compares to national norms.

The information they provide also becomes part of a research database. More than 1,200 employers completed the prior version of the Scorecard, and Version 4 is off to a great start with nearly 100 employers completing it in just three months. While it’s clearly too soon to draw conclusions about the state of EHM programs based on this relatively small sample, we can provide some early results that suggest how far the industry has moved in the past few years* — with the caveat that any numbers cited here will likely change as the database grows.

• Past analyses of Scorecard data have shown that employers with a formal, written strategic plan for EHM in place were more likely to report that their program had helped to reduce health risks and lower medical plan cost. Just over half of the new Version 4 respondents (53%) have a formal strategic plan in place, compared to 44% of the Version 3 respondents.

• Version 4 includes a new question to gauge whether leaders understand the strategic importance of EHM: “To what extent is your EHM program viewed by senior leadership as connected to broader business results?” About a third of respondents said “To a great extent,” while 17% reported that it is not seen as connected at all to results.

• Version 4 emphasizes critical organizational and cultural support strategies for EHM. Best practices in this area include policies allowing employees to use work time for physical activities (36% of respondents) or stress management (28% of respondents).

• Leading by example is a key best practice. Analyses of Scorecard Version 3 data have shown that when leaders participate in EHM programs, participation rates are higher and outcomes are better. However, there was no improvement in this best practice from Version 3 (53% of respondents said leaders actively participate) to Version 4 (51%). And only 32% of Version 4 respondents say that leaders are role models for prioritizing health and work/life balance (for example, by taking activity breaks during the work day or not sending email while on vacation).

• Fully three-quarters of respondents offer health behavior change programs open to all individuals eligible for EHM, regardless of health status, and 44% of these programs incorporates social connection by allowing individuals to communicate with, support, and/or challenge other individuals or to form teams. Many are mobile-supported (39%) or include tracking devices such as pedometers, glucometers, or automated scales (46%).

• Participation strategies, which include communication and incentive design, significantly affect participation rates and program outcomes. Our past research had shown that financial incentives help drive participation rates, but communication efforts are even more strongly related to positive health and financial outcomes. Branding the EHM program with a unique name and logo was found to be especially helpful in earlier analyses, but only 59% of Version 4 respondents use this tactic, little changed from 56% of Version 3 respondents.

• Looking at incentive design, nearly three-fourths of Version 4 respondents use some type of financial reward or penalty in connection with the program, with most of these incentives (nine out of 10) communicated as rewards. While incentives for participating are the most common, a third of respondents that use incentives say that employees have a financial incentive to achieve, maintain, or show progress toward specific health status targets.

• While financial incentives are widely used, 33% of respondents say that their engagement strategy intentionally includes a focus on increasing employees’ intrinsic motivation to improve or maintain their health.

To continually improve an EHM program, an employer needs to measure its performance. Deciding on what metrics to use is the first challenge. Participation data, health care utilization, and cost data are the most common, but we were pleased to see that 20% also use productivity data to evaluate EHM performance. This is an important step toward broadening the view that the success of a health management program is measured solely based on its impact on medical plan cost. The best practices included in Version 4 point to a program that designed to support an organization’s long-term success by helping to sustain a healthy, engaged, productive workforce.

* The Version 4 data represent programs in 2014. For comparative purposes, the Version 3 data shown includes only Scorecards submitted in 2009 and 2010.