Individuality In Healthcare, Part 4 - The Massive Influence Of Employers

07/09/2018 04:00PM

I recently met with C-level executives at a Fortune 100 company. I shared with them what I’ve learned from experience – that most employers are not as in touch with the healthcare needs of their employee populations as they could be.

I made a bold prediction: “You probably have someone at the executive level who has a chronic disease – or cares for someone with a chronic disease – that is not covered by your insurance. They're probably living in a small apartment, or otherwise struggling to get by – even with an executive salary."

They respectfully disagreed with my prediction. But there was a third person at the table and that person scribbled a note to the executive and the executive said: "Looks like I'm wrong." There was a VP who was living out of his car because he was paying for his mother's cancer treatments and a grandparent’s diabetes

My point is that this is more prevalent than people know. And the stakes are higher than simply wanting to maximize the ROI of a benefit plan. The stakes are people’s lives.

This is the fourth article in a series on individuality and inclusion in healthcare, pulling largely from interviews I conducted and sessions I attended at the HLTH: The Future of Healthcare conference in Las Vegas in May.

The first article dealt with how organizations can turn individuality into better outcomes by operationalizing inclusion. The second article examined how we can embrace individuality without making people feel or be vulnerable. The third article explored some innovations in individuality across the continuum of care.

Throughout this series, I’ve been sharing some of the indicators I use to help companies assess their own readiness to operationalize individuality and inclusion within and throughout their enterprises. As I’ve mentioned before, I do that because I know from experience that without strategy, change is merely substitution, not evolution.

For me, everything comes back to the need to get to know people as individuals, and to structure organizations in a way that is welcoming to every individual at every level.

In this article, I’ll explore that theme from the perspective of employers meeting the health needs of their employee populations. The subject ties directly into knowing your employee community well enough to understand the factors that have the biggest influence on the health of the diverse employee populations you serve. And, once again, having strategies in place to get to know employees as individuals and to pair that individuality with inclusion to achieve better outcomes.

Making Benefits People-Friendly 

One of the questions I ask leaders is: do you actively evaluate the employee benefit plan design on an ongoing basis? How else will you know if there are gaps that might leave people under-covered? Along with that comes a commitment to making benefits easy to understand, easy to navigate, and easy to access.

While at the conference I met with Rob Butler, founder and CEO of Maestro Health. His mission is to make employee benefits “people-friendly” again. Maestro Health and its all-in, tech-meets-service platform is designed to simplify and personalize how people shop, enroll and live with their benefits. Maestro provides employers with a platform of technology and services that provides complete solutions for all aspects of employee health and benefits.

Butler led Maestro Health’s acquisition by AXA earlier this year, choosing to partner because they were both after the same goal: to empower the consumer to make them healthier. From the beginning, Butler’s approach with Maestro was to embrace a level of individuality – acknowledging that every employer is different, and populations of employees are different.

“We see if we can meet the employer where they are, rather than where we want them to be,” said Butler. “Employers want to be able to solve problems for their people, they want individual solutions, and they want to make it noiseless. They don't want people lined up out their door, and they want this to all work. They want to be focused on the stuff they went to school for – conflict management, developing people, developing culture, not dealing with [healthcare] reporting. That's why we started Maestro.”

He predicts even more individuality with employee benefit plans in the next five years: “Employers will be able to let employees all choose differently. Let one vendor have the ability to go to the employer and say, we'll take care of your population."

From Wellness to Wellbeing – a Culture of Caring

Another person at the conference used the same language – “meeting people where they are” – when talking about employer benefits.

Ben Slocum is CEO of WebMD Health Services, and was on a panel in a session titled “Orchestrating Health for Employees.” His comments seemed to go hand-in-hand with another question I ask leaders: How do you show that your organization has a commitment to employee population health that goes beyond legal obligations?

Slocum said they’ve learned that everyone, but especially Millennials, “want to know that the people they work with are in the business of helping them with their lives, what's going on with them on a daily basis, and not just looking at the ROI of their health plan for their employees. You have to create a culture of caring.”

WebMD Health Services empowers individuals to be their best through employer- or health plan-sponsored wellbeing programs, serving 71 million people through a combination of employer group relationships and health client relationships.

According to Slocum, the company will be introducing a new ecosystem called WebMD One, and he described it as a major shift toward a person-first wellbeing journey. “We’ve shifted from wellness to wellbeing,” said Slocum. “We're no longer just trying to track steps and activity. And we're no longer trying to just focus purely on nutrition. We're trying to focus on the entire person.”

How to Care Without Being Creepy

Another question I ask leaders when we are assessing their organization’s readiness for individuality and inclusion: Does the organization know its employee community well enough to understand the factors that have the biggest influence on the health of the populations it serves? This is important but can also be tricky, especially if the employees don’t feel that the organization is a safe place to be open and vulnerable.

This topic was addressed at the HLTH conference in a panel discussion called “Evolving Role of Employers.” There was an interesting conversation among the panelists about the importance of getting to know employees at the individual level – to understand where they’re coming from and to know how to motivate them to live healthier – while also acknowledging the challenge of doing that in a way that isn’t manipulative.

Panelist Rob Andrews is CEO of the Health Transformation Alliance, which includes more than 40 U.S. employers who collectively are responsible for more than 7 million employees, dependents and retirees and an annual health care spend of $26 billion.

“We believe that the key to a lot of these behavioral questions – whether it's diabetes, or weight control or smoking – is not going to be found in claims data and electronic medical records,” Andrews shared in the panel discussion. “This is very much about what makes people tick. And we are interested in an ethically appropriate, HIPAA-compliant, data-secure way to answer questions like: Do people live alone or not? What motivates them to get a physical exam or not? Who influences their life decisions and who does not?”

Another panelist was Glenn Steele, MD, Ph.D., and chairman of xG Health Solutions, an independent venture launched by Geisinger Health System (you probably recognize Geisinger from my first article in this series).

Steele brought up the next thought many of us have: “As I'm sure all of you know, there's an initial paranoia if a company starts to get a little too paternalistic with employees. So what we have to do is convince employees that it is worth their while – both in terms of ease as well as outcome. So there's a big effort in our understanding what the human being, the employee, values.”

A third panelist was Jon Kessler, president and CEO of HealthEquity, Inc., a health savings trustee that helps members build health savings by providing health account administration. He mentioned the importance of motivation when it comes to employees choosing their own path to health.

“My first response would be to say, yes it is extremely difficult to modify behavior – and thank God for that,” said Kessler. “Consumers want to be healthy, and most of them already know what they need to do. It is not a question of lack of information.”

He mentioned that the role that we can play collectively as a system, is in motivation – both financial motivation and also social motivations.

“That's really where the opportunity is with the consumers,” said Kessler. “To understand that these are, quite literally, real people.”

Our Individual Capabilities Are Not Tied to Age 

If we’re striving to see and treat people as individuals, then we have to consider people’s lives from a few different perspectives – from outside the workplace in their communities, and encompassing the spectrum of their lives as they age.

I had a great conversation on this subject with Paul Irving, chairman of the Milken Institute Center for the Future of Aging. He wants to accelerate the conversation about the impacts of aging, and catalyze innovation at the leadership level to make our cities and our companies more accommodating for an aging population.

“Soon there will be more older adults than teenagers and kids,” said Irving. “Just think about the impacts of that on the fabric of society and the way our cities and streets look, on the way our homes look.”

His work reminds me of another indicator I use to assess a company’s approach to individuality: whether or not the organization is active in the community to address wellbeing-related features like walkability or food insecurity. Irving’s work of mayors to pay more attention to how the design of their cities can affect the lives of older people is certainly relevant. But he also talked about the opportunity for companies that take older employees into account when designing workspaces and also designing the strategic direction of the company.

“About a third of people over 85 will have dementia, but that means two thirds won't, right?” said Irving. “I argue that older adults are an underutilized human capital asset with the opportunity to add to workplaces, to volunteer, to strengthen our communities, to improve the lives of young people.”

Irving said he talks to corporate leaders about the importance of having a longevity strategy focused on two things. One, the creation of products, services and innovations for this rapidly growing cohort of older adults – not just health products, but all products. Two, the human capital factors – how to encourage and enable people to remain in the workforce, so we don't lose their wisdom and knowledge.

“What we really should do is we should stop valuing people based on chronological age,” said Irving. “There are people who are healthier at 70 than others at 50. What we should be doing is thinking about the individual. We should be evaluating people based on who they actually are.”

And there it is. As always, it comes back to the individual. Our capabilities, our health, our wellbeing – so much of that is tied to our individuality. To turn all of these health innovations into better outcomes for employees, organizations need:

  • Individuality – which requires a concerted effort to know and account for the realities and the values of individual employees.
  • Inclusion – a system for making sure the organization is welcoming at every level to every individual.

Employers have a great deal of influence when it comes to healthcare in general and the wellbeing of their employee populations. That means there is an abundance of opportunities for those who take that role seriously.

Are you ready to lead inclusion and individuality as a growth strategy?  Take this assessment to find out.

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