How does an employer know if their wellness program is performing at a high level? The answer is that most employers have no idea what the quality of their wellness program is because there are no industry standards to measure against. Best practices emerge almost weekly based on the self-assessment and self-promotion of the employer that initiated a specific “innovation.” Return on investment is calculated using different formulas that nearly always leave out many of the costs involved, as well as many of the difficult to measure benefits. So what is an employer to do when they are asked to make a commitment of time, money and human resources to their wellness program?
A similar dilemma faced employers in the 1980’s, when American companies were trying to figure out how to recapture the economic brass ring that had been stolen from them by the Japanese and the Germans. The answer came in the form of a new set of quality criteria for businesses, called The Baldrige Award. The criteria for this award were developed by a group of progressive business owners, executives and consultants who named the award after Ronald Regan’s Secretary of Commerce, Malcolm Baldrige. There are over ninety quality criteria divided into seven categories, and companies can apply to win this award by agreeing to be evaluated by a group of independent consultants. The award quickly gained popularity, but only a handful of companies could win in any given year. To address this problem, forty-two states have now developed similar awards, which allow hundreds of employers to apply these business principles and standards to their organization, and then be evaluated to see if they have met the demanding standards.
The Baldrige people have continued to refine the quality criteria for businesses, and have even developed completely separate criteria for educational institutions and health care facilities. These criteria have quickly become the benchmark by which hospitals and schools are now evaluated, even though some other quality assessments from the past continue to be used as well.
So why not develop similar quality criteria for wellness programs? That is precisely what has been done by Healthy at Work, Inc., a small wellness education and consulting company operating out of Sarasota, Florida. There are seven categories into which 200 quality criteria have been developed. The seven categories are as follows:
- Preparation Stage
- Wellness Planning
- Program Delivery
- Program Evaluation
- Incentives and Rewards
- Insurance Adjustments1. Preparation Strategic Planning2. Wellness Planning Insurance3. Orientation/Assessment Personal Records Development4. Program Delivery Advocate Recruitment and Training5. Program Evaluation Return on Investment6. Incentives and Rewards Sustainability7. Insurance Adjustment Other Premium Influencing Factors Each of the 200 plus criteria are evaluated using the following five level scoring system:
- Do you utilize on-site health clinics to improve employee health, and are the health improvement statistics from the clinic used to negotiate lower premiums from your health insurance carrier?
- Does your organization provide multiple year incentives (two or three year period) in order to ensure that employees are able to sustain health improvements, such as weight loss, lower blood pressure or smoking cessation?
- Does your organization gather accurate cost and benefit information in order to calculate R.O.I. on an annual basis in order to determine the relative benefit of each program, and where improvements may be possible?
- Does your organization have “wellness advocates,” and are they trained in all aspects of wellness, including marketing, promotion, interpersonal skills, the legal issues of coaching, health issues, wellness programs and program evaluation techniques?
- Does your organization have software in place, which allows all health information and records to be integrated, thus allowing for an accurate assessment of overall employee health and the effectiveness of health improvement efforts?
- Have you put in place a high deductible health insurance plan, combined with a Health Savings Account (or something similar), which encourages, or even rewards, employees for becoming healthier in order to achieve reduced deductibles, reduced co-pays and/or reduced premiums?
- Does the organization’s overall strategic plan have a clear and effective accountability mechanism to ensure that all strategic plan priorities are integrated into management accountability mechanisms?
- Here are a few examples of criteria from each of the seven categories:
|Superior||Good Quality||Acceptable||Unacceptable|| Poor/Not in Place
A weighting system is also applied since some criteria are more important than others. Based on the total number of points available, it is then possible to calculate what percentage of available points were given to the organization’s wellness program. Anything over 70% would be considered good an anything over 90% would be considered excellent.
It must be clearly stated that very few employers would likely be able to score over 50% at this point in time because most wellness programs are simply not very advanced. However, most businesses could not pass the Baldrige evaluation when it was first introduced either. The purpose of these quality assessment tools is to find out what is possible and desirable so that systematic improvements can be made.
When Healthy at Work officially releases this new quality assessment tool, it will be possible for employers to use it as a self-assessment tool or hire a wellness consultant to come in and perform an independent audit. Either way, it should provide the most accurate and comprehensive evaluation of an organization’s wellness efforts that is possible today.