The following transcript is from an interview between Brandon Laws and Benjamin Prinzing on the podcast episode entitled: “How to Create Effective Wellness Programs that Stick.”
Brandon: Welcome everybody and thanks for listening today. Our guest today, Benjamin Prinzing, is the founder and one of the partners at Kadalyst. They are a company in Portland, Oregon that specializes in outcomes-based health management strategies. Welcome Benjamin.
Benjamin: Thanks for having me.
Brandon: Today we are going to talk about how to create successful wellness programs, so let’s dive right into the questions. I want to ask you, why do you think wellness programs recently have become so important and what do you think the purpose is behind them?
Benjamin: Quite frankly it will depend on who you ask. For some groups their means are to improve employee morale and increase retention. For others it’s about driving down healthcare costs. Now we are seeing groups wanting to take a look at wellness as a workers comp strategy due to injuries being related back to actual health conditions. The ultimate purpose behind them is to improve employee health but to do that in order to fix a problem. Again as an employer, if I help my team get healthier, they will probably stick around longer. We know they will need to go to the doctor less and studies are now showing that they will get injured less. Unfortunately I see a lot of companies getting into wellness, but not really knowing why. The key is figuring out the “why” behind the wellness program and then design it accordingly versus throwing spaghetti at a wall.
Brandon: Do you feel like the purpose for each company is going to be different? So one company may be implementing a wellness program to reduce premiums, and another may want to reduce absenteeism problems by engaging employees and getting them to feel better so that they will come to work more often. What do you think about that?
Benjamin: Yes, companies definitely have their similar interests in wellness programs, but often there are little differences. We have a group that their average age is 27. Out of 150 employees they only have 50 on the health plan, so healthcare is not even on the radar for them right now as an issue. It’s all about retention and job satisfaction. They have been one of the top 100 companies to work for for five years running. Wellness was a natural fit for them in continuing to make that happen.
Yesterday we met with a group who had a rate increase of 18%. They shifted all that cost onto their employees, and the statement I got was, “We are super embarrassed that we had to do that, that we couldn’t front that bill for them. We need to do something so we can show our employees that we are loyal to them and we are not just trying to throw costs onto them.
Brandon: At the end of this interview I want to make sure that you give out your website address because you have a lot of great information out there. On your website you outline four different wellness programs models – outcome, activity, action and awareness based. What do you think the best way is to determine what kind of wellness program is right for a certain type of company?
Benjamin: The program models should be chosen based on data that supports that model, which is done one step prior to the needs analysis phase. You have to determine the goals of your program – getting back to that “why.” If you know you need to better control healthcare costs, then an awareness program model is not going to be the right fit. Assessments we are used to hearing all about in the industry are Health Risk Assessments, Biometric Screenings, and claims data, but there are many other data sources that an employer can pull from. For example, if you knew the goal of the program was to improve morale and retention, you probably got the information verbally from senior leadership who probably got the information from a report on turnover or perhaps a job satisfaction survey.
The program models are there to create a framework for you. Based on what your goals are, they will guide you to where you need to go. If you are trying to do a health improvement program for your workforce, then an activity-based or action-based program is going to be more appropriate. If you are looking at controlling healthcare costs and you’re looking at a strategy where you would like some responsibility put back on the employee based on health risk, then that outcomes-based, results-based program is going to be the right program model for you.
Brandon: If a company starts with a wellness program that is activity-based, how do you switch from an activity-based program to something like an outcomes-based program? It seems like it would be kind of hard to transition.
Benjamin: The key here is definitely going to be planning. You have to know when you are going to make that transition and what that transition is. If you are going to go from an activity-based program in year one to an outcomes-based program in year two, you have to put a road map together and plan that out. That way you have the ability to communicate what those changes are going to be when they advance. Typically we see program models changing from year-to-year, so there is plenty of time to communicate that to them and rollout the initiatives that are going to be aligned with that new program model.
Brandon: I want to talk about the activity-based program. I think it is interesting because it definitely dovetails into how to develop a great culture within a company . When should you have team activities versus individual activities within a wellness program?
Benjamin: That’s a great question. I will have to answer that question with a couple other questions – What program model was chosen? That obviously reflects what type of activities are going to take place throughout the year. Also, what does the staffing look like? Is there someone internally who is dedicated to running the program? Team-based activities typically require a little more time and effort to manage and run and track versus individual activities. If you’re going to do team-based activities we have to make sure that we have the proper tools to be able to track those programs as well as the proper staffing to make sure that it is being managed efficiently.
Brandon: I want to talk to you about the strategy behind launching a wellness program. How important do you think it is to build a brand around the wellness program? I’m a marketing person myself, so I know that building a brand isn’t just a logo. It’s your communication, the perception of what the wellness program is and the purpose behind it. How do you build that and do think it’s important to have?
Benjamin: Absolutely. It is critical because if you don’t have a brand or even a name, it has no life. What we want to do is create a face for the wellness program so they see it everywhere – on the flyers that go out, the posters, the email communication, everywhere, so it provides life to the program. It takes time to build a brand. You can choose a name and choose a logo, but that’s not necessarily a brand.
You can start developing a brand with maybe a small committee who can come together to decide what that name is going to be and what the program means to the workplace. Often we see people who have a marketing department or a marketing manager like yourself who can come in and help influence that branding initiative. When developing a logo for your program, often times there is probably an artist within the workplace who can help design a graphic. We actually worked with a group recently that didn’t have anyone who was comfortable designing a logo so we went out to Portland State University to the Graphic Design Center. We told them we needed a wellness program logo and asked if their students would be interested in designing one for us, and they did! We had a little over 20 students post their wellness program logos and we picked one of them. The student can then use that in their portfolio and it didn’t cost the employer anything.
Brandon: Talk about a good use of crowdsourcing, that’s amazing! Wow.
Benjamin: It’s getting creative without hiring a marketing company to do this. You can get creative on a budget, even with the branding piece.
Brandon: Time is often an issue for a lot of employers and employees, and it is easy to make a lack of time an excuse not to participate in the wellness program. How do you go about encouraging participation from everybody, including the employers who are the ones launching the program from the very beginning?
Benjamin: Participation from all employees is very much dependent on how the program is designed, how it’s communicated, and even more importantly, the state of the culture has a huge influence on participation. We recently had a health risk assessment launch with a group of ours which had a 90% participation rate on a voluntary program, and these are employees who are spread across 35 locations. That was absolutely amazing. But I’ve seen it hard for groups have 50 employees but only get 50% participation and are all in one location working an 8:00-5:00 job. It gets back to that communication strategy. The goal here is to find out from staff who are participating and ask those who are not participating what you can be doing differently for them to get them to participate. That is exactly where I would start.
In terms of lack of time, we like to make sure that the wellness activities are on paid time. Again, this is supposed to be about the culture and the workplace. This is an initiative that everyone can participate in. If we separate it from paid time to non-paid time, it really creates a mixed message. We want to encourage people to take an active role in their health, and what better way to do that then to have it be on paid time. When they take the health risk assessment, don’t have them clock out. When they do the screening assessment, don’t have them clock out and let them know that it is absolutely free for them to attend and get their blood drawn. If we can get buy-in from management to make sure that these activities are on paid time, I’m talking 10, 15, 20 minutes for different initiatives, it will play a huge role in combating the issue of not having enough time.
Brandon: It seems to me that the peer pressure alone and the social aspect of the wellness program would help encourage participation all across the employee base, but I know a lot of companies are using incentives. What kind of incentives have you seen to help drive participation and is there anything unique that you’ve seen that you want to share with the group?
Benjamin: We’ve seen all kinds of incentive programs developed – some that are great, some that don’t work and some that are just not necessary. Like the group that just had a 90% participation rate with their HRA, there aren’t any incentives. There are no raffle prizes, there are no gift cards going out. It was a very different approach where the CEO wanted to build intrinsic value within his team because they wanted to participate and he wanted them to participate, not by throwing money at them. But this particular CEO has an amazing relationship with his staff and that’s not always the case with other groups that we have worked with, so incentives might be required. I’ve seen groups that throw a ton of money at their health plan to get people to participate because there is no one managing the program. They are just saying “hey if you check these boxes off we will give you an extra $500 a year towards your healthcare premium,” but they are just completing activities, they aren’t necessarily getting healthier.
We have seen groups that give raffle prizes for completing certain activities throughout the year. We created a wellness BINGO game that had 20 squares on it for a group and they had to complete one square per quarter as part of the requirement in getting their health plan 100% paid for. One square a quarter is all they had to do but the great thing was that we one upped it and said “not only are we going to pay 100% of your premiums, but you’ll also be entered into a raffle every single quarter for completing an activity.” Well they only had to do four for the year, but over 50% of that population has completed over 10 squares and some of them have even completed 20 of them. The CEO actually completed all 20 of the squares within the first two weeks of the program.
It really gets back to culture and what makes sense for the group. Are incentives going to be important? Do they actually influence behavior of the group where for other groups that might not be the case. I would start out with a pilot. Maybe do some activities on a voluntary program and see how well that goes and then work on other programs and offer incentives and see what the participation is and how it fluctuates. Then model it there, don’t just throw money at everything but start having a balance so you’re not throwing away money just for the sake of throwing money at it.
Brandon: This isn’t the first time I’ve heard you mention the wellness BINGO. At Xenium we have a formal wellness program and we took that idea and we created a challenge out of it. I just want to give listeners a sense of how successful it was for us. We created a wellness BINGO card with various activities on it, such as “no alcohol for a week,” and “exercise 3 times for 30 minutes for a week.” Then employees tried to cross off things throughout the week. We ran this for about three months over the summer and had a lot of success. I just wanted to mention that it was such a good idea and employees really liked it, so any listeners looking for activity based ideas I would definitely recommend it.
Benjamin: Well that’s great to hear!
Brandon: On the strategy side of things, how do you determine who becomes in charge of the wellness program? You mentioned earlier a committee. How do you go about grouping a committee together and then tracking the results of the wellness program?
Benjamin: That’s a great question. If there isn’t already a committee in place, then advertise that there is a need for one. You can get some volunteers who are interested in volunteering their time to be a part of it. You want people to be excited about being a part of the committee and helping to develop these plans. You also want to make sure you have some key people in there, one in particular being the devil’s advocate, one that is going to be able to influence what actually gets approved and doesn’t get approved from a budgetary standpoint. If you can’t get an executive on the wellness committee who would know whether or not certain things will be approved, get their executive assistant or someone who would know if that’s going to pan out.
In regards to who is actually in charge of the programs you are going to have to get back to who can volunteer their time and get it approved by their manager to donate time towards the wellness program. Making sure that you get that approval in advance is crucial. Too often I see people who have all the ambition in the world and passion to get a wellness program off the ground, especially in an HR function, and then it fizzles because they have their own responsibilities in HR. Get a certain amount of time approved, such as five hours a week or even 10 hours a month, and then come back to management and say, “These are the things I was able to accomplish but I need more time or I need more people to donate 5 hours of their time.” Starting with that is going to be really critical for anyone who is trying to create an internal wellness program. Before you even start thinking about hiring an outside vendor, have someone who is already internal start tracking initiatives. I’d start there and go from there.
Brandon: I imagine one of the most challenging aspects of developing and running a wellness program would be tracking the results. What kinds of tools out there are helpful for tracking results of the program?
Benjamin: Often we see groups working in excel spreadsheets and they are just buried in data. There are tools out there that can simplify life. One tool that we use in particular for just managing everyday tasks and getting things done is a free tool called do.com. You can sign up and have all of your wellness committee members with a login so they can all see the different projects and activities that need to be accomplished throughout the year in terms of what communication plans need to go out and survey tools that are ready to launch. You can put a road map built on to do.com. It’s really lightweight, easy to use; there are not a lot of functions and special features. It’s really a basic tool that is easy to use. It even has an iPhone app so that you can manage your tasks that way.
We also use a tool called incenteev.com. It’s an online platform that allows you to track your different incentive based programs or challenges. It’s a portal where you can have ongoing communication throughout your organization, especially if you have a diverse workgroup that is in multiple locations. It creates a central hub where you can communicate information about wellness and the activities that they are doing. You can create quizzes, you can create challenges that are due based on time and everyone can login and track everything and it even has backend reporting for management. It’s really affordable and it’s customizable so you can put your wellness program logo on there as well. It’s another simple and easy tool to use without a lot of bells and whistles.
Brandon: Assuming that most employers choose to have a wellness program run on a calendar year, or just for a twelve month period, once you’ve collected the data from the previous year, what do you think is the best way to determine what changes need to be made for the next program year?
Benjamin: Obviously looking at the data is the important thing – looking from year one to year two. Whatever you are going to be assessing in year one, whether it be a health risk assessment or biometric screening, make sure you are doing that the following year so that you can take a look at that data and determine how you need to adjust your program.
For example, we were trying to decrease our smoking population by 20%, did we meet that goal? If not, what can we do differently this year to make that happen? Can we have a different smoking cessation program in place? Do we need to include new webinars throughout the year about the effects of smoking or do we need to create some kind of incentive plan to encourage people to get off of that?
What policies are you putting into place to make sure these goals are being met and that the data is being shifted to more positive numbers? If we are looking at reducing our smoking population but we still have a smoking area outside our building, it really creates a conflict of interest that makes it harder to make that happen. We can put it on our road map and communicate that it is our goal down the road to be smoke free. Until then we will provide resources to help people quit smoking because by year two or year three, this will be a smoke free campus.
Being able to look at that data can really guide you to the specific activities, initiatives or specific health risks you can focus on throughout the year.
Brandon: You mentioned a lot of great resources. I want to make sure for listeners who are interested that they get the links to those resources and your website which has a lot of really good information that supports what we talked about today. Any parting thoughts before you leave? How can people get started? What are their next steps?
Benjamin: What I would do, whenever you start any kind of initiative, is start with a plan. Don’t go into wellness just throwing spaghetti at a wall and hoping to see what sticks. Go into it with the “why,” with the purpose, and get a committee together to start talking about what a wellness program means to the company. If you already have one, what can be done differently to make it more impactful?
Really start building that business case to senior management to get that funding or continue getting that funding or the budget for that wellness program. One of the things that we lack here in the wellness space is the business case. We know the intangibles, that we are going to improve health and people are going to be more productive and be sick less, but we forget to provide any kind of data or reports back to senior leadership to show the progression of what we did in the previous year.
Even if you are just starting out with a basic program and doing challenges throughout the year that you have made up on your own without any budget, track participation and build satisfaction reports. That’s a great way to show that people enjoy doing this – people want to do this. Throw out the employee interest survey from year-to-year or job satisfaction survey and show some of that data to see if job satisfaction is really improving. Even if you can’t do a health risk assessment or biometric screening, you want to be able to show some data over time, even if it’s for your own records to show that you have actually done a good job and that you’ve improved whatever area it is you need to improve.
Those are the ending thoughts I have for anyone who is starting a wellness or wanting to get to the next level. Have those reports and really get senior leadership on board and make sure they understand where you are at so they can help you get to the next level.
Brandon: You mentioned just a second ago the Biometric screening. We did ours for the first time last year and it is a huge undertaking and it is something that employers definitely want to offer a lot more of. I’d like to have you back in the future just to talk about that subject alone because I think it’s worth discussing. So I will leave you with that. For listeners that want to learn more about you and Kadalyst and what you do, where can they learn more?
Brandon: Our guest today has been Benjamin Prinzing, founder of Kadalyst. Thanks for being a part of the program.
Benjamin: Thanks for having me!