Why GLP-1 Coverage Alone Isn't Enough
Why GLP-1 Coverage Alone Isn't Enough
Publication: Employee Benefit News
HealthNEXT President and CEO Ray Fabius, M.D., shares in Employee Benefit News why simply adding GLP-1 medications to your benefits package is not enough to ensure sustainable results for weight management and health improvement.
Creating an Award-Winning Culture of Health and Wellbeing at DTE Energy
Creating an Award-Winning Culture of Health and Wellbeing at DTE Energy
Authors: Dr. Ray Fabius, MD, and David Kirshenbaum, MBA
A recent article published in Population Health Management highlights how DTE Energy, a Detroit-based energy company with nearly 11,000 employees — 50% of whom are field-based and 49.3% union members—transformed its workplace by fostering an award-winning culture of health and wellbeing. Co-authored by Dr. Ray Fabius and David Kirshenbaum of HealthNEXT, the case study details DTE’s strategic journey to improve employee health outcomes, enhance workplace safety, and strengthen organizational performance. Over a five-year period, DTE achieved a remarkable 75% improvement in their corporate health assessment score, demonstrating significant progress towards becoming a benchmark employer in health and wellbeing.
The Why: A Commitment to People and Purpose
DTE’s vision was rooted in doing “the right thing” for its employees, customers, and community. With a workforce initially burdened by higher-than-average health risks, DTE recognized the need for a comprehensive approach to improve employee health, safety, and engagement.
The company defined wellbeing across four dimensions: physical health, emotional wellness, social connectivity, and financial fitness. By fostering a culture of vitality and care, DTE aimed to empower its workforce and align health initiatives with broader business goals.
The How: A Strategic and Measured Approach
DTE partnered with HealthNEXT to utilize two evidence-based tools—the Employer Health Opportunity Assessment (EHOA) developed by HealthNEXT and Culture Check Site Scans offered through Virgin Pulse. The EHOA provided a top-down comprehensive overview of the organization’s maturity in fostering a culture of health and wellbeing. The Culture Check Site Scan provided a bottom-up view of individual worksites on wellbeing supportive maturity. Together, these tools provided a comprehensive view of organizational strengths and gaps in the existing culture of health and wellbeing.
The initial assessments identified 11 areas of focus to bridge the gaps and achieve best practice over a multiyear strategic plan. These were as follows:
- Embed a best-practice culture of health and wellbeing into DTE’s culture
- Develop and engage an executive committee and champion
- Enhance the workplace environment with a focus on improved nutrition
- Improve population health, including behavioral health
- Market vitality
- Integrate data and analytics
- Train consumers and advocate for them
- Design evidence-based benefits
- Expand on-site services
- Form strategic partnerships and integrate them
- Establish direct provider relationships
Using these focus areas, a comprehensive project plan was developed that included the tasks, milestones, and goals, with a transparent methodology for planning, deploying, improving, and managing over time. Over five years, this roadmap of tactics was refreshed and updated each year, building on successes and ensuring that the correct sequence was followed.
Execution was supported by robust governance structures like the Wellbeing Executive Leadership Committee and a network of 200 local Wellbeing Champions.
The Results: Transformative Impact
DTE achieved significant progress over five years:
- EHOA Score Improvement: The company’s EHOA score rose by 75%, from 386 in 2018 to 675 in 2022—approaching benchmark levels. The EHOA focuses on ten best practice pillars to evaluate a company’s culture of health and wellbeing, producing a score out of 1,000. The benchmark goal is set at 700, indicating a high standard of excellence in health and wellbeing practices. Achieving such a score signifies that DTE is nearing best practice in health and wellbeing, reflecting their significant progress towards becoming a benchmark employer in this area.
- Recognition: DTE received prestigious awards like the C. Everett Koop National Health Award, recognizing their excellence in health and wellbeing initiatives. Since its inception in 1994, only about 70 organizations have received this honor, underscoring its exclusivity and the high standards required for selection.
- Injury Reduction: Musculoskeletal injury rates declined by 36%, while workers’ compensation claims dropped significantly, highlighting improvements in workplace safety.
- Employee Engagement: By 2023, over 89% of eligible employees and their spouses participated in wellbeing programs, including health risk appraisals, biometric screenings and annual checkups.
- Vendor Management and Strategic Partnerships: There was a remarkable 310% increase in the scoring of vendor management and strategic partnerships from 2018 to 2022. This growth underscores DTE’s commitment to leveraging external expertise to enhance its health initiatives.
- Leadership Support and Management Alignment: The score of this particular pillar increased by 109%, reflecting strong leadership commitment.
Notably, employee satisfaction with wellbeing initiatives has surged, with 83% affirming that “DTE cares about my wellbeing.”
Why a Culture of Health and Wellbeing Matters for Employers
- DTE’s case demonstrates that investing in a culture of health and wellbeing delivers measurable benefits:
- Improved employee health which results in reducing healthcare costs.
- Enhanced safety and wellbeing drive performance and retention.
- Recognition as an employer of choice strengthens brand reputation.
DTE’s journey underscores that building a culture of health and wellbeing is not just an ethical imperative but also a strategic advantage. By committing to long-term planning and leveraging proven frameworks like HealthNEXT’s EHOA assessment, organizations can create sustainable change that benefits employees and the bottom line.
Companies that Promote a Culture of Health, Safety, and Wellbeing Outperform in the Marketplace
Companies that Promote a Culture of Health, Safety, and Wellbeing Outperform in the Marketplace
Author: Dr. Ray Fabius, MD
In our recently published peer-review article in the Journal of Occupational and Environmental Medicine, co-authors Raymond Fabius, MD, President of HealthNEXT, and Sharon Phares, Ph.D., found that companies with a culture of health outperform the stock market by an average of 2% per year. Over ten years, their study analyzed the results of a portfolio of publicly traded companies to test the theory that a commitment to employee health, safety, and wellbeing can lead to more robust returns.
How Companies Were Selected
The portfolio companies were identified by the receipt of various health, safety, and wellbeing awards and criteria established from a decade of research at HealthNEXT, the leader in building corporate cultures of health and wellness. The evaluation process included publicly available information such as an established workplace health clinic, a corporate health officer at the senior leadership level, and demonstrated leadership via presentations at health, wellness, and safety conferences.
Results of the Publication
A focus on employee health and wellness resulted in a high return on investment for the portfolio companies and can positively impact business performance.
Companies with healthier workforces have been proven to experience:
- Lower healthcare costs,
- Less absenteeism,
- Higher productivity,
- Less workforce turnover,
- Better talent,
- Less waste, and
- Higher employee engagement levels.
All of these contribute to a competitive advantage in the marketplace and explain the outperformance.
Employers, fund managers, and fund investors would be well served by including strategies that assess a company’s commitment to their workforce’s health, safety, and wellbeing when evaluating investments in their enterprise and portfolios.
8 Ways to Help Support Workplace Health and Wellbeing
8 Ways to Help Support Workplace Health and Wellbeing
Publication: Employee Benefit News
HealthNEXT President, Dr. Ray Fabius shares valuable insights in a new Employee Benefit News article, highlighting the role of leaders in fostering a culture of health and wellbeing.
The Correlation of a Corporate Culture of Health Assessment Score and Health Care Cost Trend
The Correlation of a Corporate Culture of Health Assessment Score and Health Care Cost Trend
Authors: Dr. Ray Fabius, MD., Dixon Thayer, BS., David Kirshenbaum, MBA, and Dr. Jim Reynolds, MD.
Many corporate leaders who promote a culture of health and wellbeing in their organizations face challenges relating their work to tangible economic outcomes. Fortunately, research shows that as the corporate culture of health assessment scores improves, healthcare cost trends moderate.
HealthNEXT executive leaders Dr. Ray Fabius, Dixon Thayer, David Kirshenbaum, and Jim Reynolds, along with Sharon Glave Frazee, Ph.D., MPH, demonstrated a direct linear relationship between a culture of health assessment score (CHAS) and healthcare cost trends. In fact, using the HealthNEXT scoring system on a 1000-point scale; for every 50 points of improvement, there was a 1% reduction in medical trend. This research suggests that there is an immediate and sustainable impact as a company moves from getting started in this pursuit to the point of reaching a best practice score of between 700 and 750.
Read the full study, The Correlation of a Corporate Culture of Health Assessment and Health Care Cost Trend, to learn:
- How corporate health assessments can contribute to lower annual healthcare cost trends
- Examples of corporate health assessment tools
- What is an organizational culture of health
- What specific elements contribute to a healthy corporate culture
Why this study matters
Employers are challenged by what Warren Buffet has called the true corporate tax. For the last few decades, the healthcare costs of their workforce have been trending at an alarming rate of two to three times general inflation, making it difficult to provide salary raises as well as health benefits coverage.
Moreover, according to the Centers for Disease Control, chronic health conditions and unhealthy behaviors reduce worker productivity. Five chronic diseases or risk factors—high blood pressure, diabetes, smoking, physical inactivity, and obesity—cost US employers $36.4 billion a year because of employees missing days of work.
Alternatively, healthy corporate cultures have a workforce with less illness and fewer unhealthy behaviors. As a result, employers with cultures of health and wellbeing spend less on health care without needing to reduce benefit services or shift more costs to their employees.
Purpose of the study
This study aims to determine the relationship between a corporate culture of health assessment score and annual healthcare cost trend by comparing organizations that scored higher versus those scoring lower on the culture of the health continuum.
Methods
HealthNEXT developed, validated, and implemented the Employer Health Opportunity Assessment (EHOA) and the Employer Assessment 50 (EA50) proprietary tools to score a large or mid-sized organization’s culture of health and wellbeing against the benchmark culture of health employers. Benchmark employers have flattened their health cost inflationary trend over many years. Using this score, the team then measured the correlation between CHAS and trends in healthcare expenditures.
EHOA and EA50 are proprietary tools that assess cultural health and wellbeing by analyzing data from a document review, workplace observation, and interviews with senior management, management, and employees to determine elements that contribute to a culture of health.
Study Sample
Data for this study were collected from 21 sets of annual organizational CHAS and healthcare cost trend data points from 12 unique companies.
A total increase year-over-year in total costs was measured for all monies paid to healthcare providers for the organizations’ covered population by both employers and employees. This included medical, prescription drug costs, deductibles, copayments, and coinsurance.
The team identified 21 health score assessments completed between 2011 and 2016 for organizations with available healthcare cost claim data for the same period. Data shows the average score was 459 out of a possible 1000, and the average healthcare cost trend was 5.0%
Analysis
The correlation of CHAS scores with the total healthcare cost trend was strong, and increasing CHAS scores demonstrated lower healthcare cost inflation. In 2015, U.S. healthcare spending for private health insurance increased by 7.2% per person and was projected to increase by 6.8% annually from 2017 to 2025 at the time the article was written. By just modestly improving the culture of health by 50 points out of 1000, the 1% decrease in annual healthcare trends would produce a per-member decrease in healthcare costs of $3999 over a ten-year period.
By implementing best practices, this research implies that it is now possible for employers, large and mid-sized, to control their medical spending and reduce the aggregate health risks and illness burden of their most important asset – their people. Additionally, it is worth noting that other studies referenced in this article calculate that for every dollar saved in direct health care costs, employers save an extra $2.30 in improved performance or productivity.
An Overview of Population Health: Creating Cultures of Wellness
An Overview of Population Health: Creating Cultures of Wellness
Author: Dr. Ray Fabius, MD.
Over the past ten years, population health has gained increased attention, and more organizations are seeking to control healthcare costs while improving health status. Population Health: Creating a Culture of Wellness is a valuable resource for employers, public health professionals, and students looking to understand and lead the charge towards a national culture of health and wellness.
Organizations will benefit from the knowledge shared within the text which outlines the key elements of building a successful culture of health and wellness. Chapter 14 in particular, “Building Cultures of Health and Wellness Within Organizations,” details how to achieve a culture of health and wellness through a vetted seven-step process, including actionable tactics for organizations to adopt.
An Overview of What You’ll Learn
In today’s dynamic healthcare system, Population Health: Creating a Culture of Wellness sheds light on concepts of population health management by exploring strategies for creating a culture of health and wellness and its contribution to true healthcare reform. The reader will gain a thorough understanding of population health from the perspective of practitioners and businesses through various case studies and real-world examples. The textbook is co-authored by HealthNEXT President and Chief Medical Officer Dr. Ray Fabius and is used in medical and graduate programs nationwide.
The reader will gain insights into:
- Implementing organizational culture change
- Population health informatics/analytics
- Health promotion and consumer engagement
- Epidemiology and the impact of social determinants
- Health and wellness vs. healthcare delivery
- The structure and systems of the population health ecosystem
- Value-based payment models
- Policy and advocacy
Dr. Fabius’s Thoughts: Excerpts from Population Health
On the importance of building a culture of health:
“Studying the achievement of companies and organizations who have successfully built a culture of health and wellness can provide great insights for us as a nation. Replicating these best practices on a broader scale can improve the health status of large populations and enhance the quality of life and performance of individuals at work and at home.”
On making the connection between health and wealth:
“Healthier citizens are more productive. The positive outcomes may include more prosperous communities, more involved family members, and more willing civic contributors. As we gradually move toward a national culture of health and wellness, fewer financial resources will be consumed treating illness and more can be directed to keeping well people well.”
Explore the progress towards a national culture of health and how you can help. Order your copy of Population Health today.
Integrating Health and Safety in the Workplace
Integrating Health and Safety in the Workplace
Author: Dr. Ray Fabius, MD.
Historically, many employers have implemented a culture of safety since the concept’s origins in the 1980s. Recognizing the impact that workforce health can have on safety, it is logical to integrate a culture of safety with a culture of health and wellbeing. When employees are healthy, they are less likely to get injured at work, and they are more likely to return to work more quickly when injured.
Employers have traditionally treated health and safety as separate issues. But many expert sources such as NIOSH and the National Academies have proposed a Total Worker’s Health approach. Over time, more enterprises combine work-site health promotions and workforce illness prevention with safety to deliver a more effective Integrated Health and Safety (IHS) program. IHS is a strategic approach that combines health and safety programs and policies to improve overall wellbeing.
To align health and safety strategies, Dr. Ray Fabius, the Chief Medical Officer and President of HealthNEXT, co-authored a whitepaper published in the May 2015 issue of the Journal of Occupational and Environmental Medicine (JOEM). In partnership with the American College of Occupational and Environmental Medicine (ACOEM) and Underwriters Laboratories (UL). This collaborative effort aimed to establish a framework that enables the seamless integration of health and safety strategies, resulting in measurable outcomes.
Read the full whitepaper, Integrating Health and Safety in the Workplace, to discover valuable insights on:
- Aligning health and safety strategies across organizational silos
- Effectively integrating health and safety functions
- Defining Integrated Health and Safety
- Establishing a replicable and scalable framework with a system of health and safety metrics
Why This Matters to Employers
Studies show that worker health is connected to the market performance of companies, suggesting that prioritizing health and safety can bring greater value to companies and their investors. As a result, a universal system of health and safety metrics and reporting will likely emerge as a new standard for valuation.
In addition, a study by the American College of Occupational and Environmental Medicine found that companies with comprehensive IHS programs had a 29% lower absenteeism rate than companies without such programs. Moreover, a study by the National Safety Council found that a 1% improvement in employee health can lead to a 2% increase in productivity.
Institutionalizing health and safety metrics and reporting can push workplace IHS programming into the mainstream business strategy and enable organizations to measure, manage and benchmark the health of their workforce as a strategic asset to the business.
Creating Integration Guidelines
Participants in the 2014 ACOEM/UL summit meeting compared seven leading national and international guidelines that aim to improve workforce health by focusing on health and safety together across operational divisions.
A review of the guidelines suggests that while many share common elements, they lack specific strategies for helping employers unify processes across organizational silos and bring disparate teams together operationally for more effective integration.
Participants concluded that two components most often missing from guidelines today are strategies for better aligning and integrating health and safety efforts across operational activity centers and a universally applicable system of health and safety metrics.
Measuring Integrated Health and Safety
The whitepaper, Integrating Health and Safety in the Workplace, offers a measurement system consistent with the DJSI (Dow Jones Sustainability Index) and meets robust requirements in the three sustainability dimensions – economic, social, and environmental.
The IHS Index should include the following:
- A comprehensive set of standards.
- A carefully calibrated set of metrics.
- A geometric scoring process to help organizations arrive at a consistent measurement of their performance in terms of health and safety integration.
Standards for engagement in prevention and wellness by employers/ employees include:
- Health promotion,
- Lifestyle management,
- Safety engineering programs,
- Biometric testing,
- Active disease management,
- Healthy vending machine and cafeteria selections,
- Effective communication strategies to inform employees of what they can do to reduce illness, disease, and accidents,
- And the organization is aligned with the goals of the community in which it operates, acts as a transparent and trusted partner, and has strong policies to ensure attention to issues of importance.
Companies qualifying for inclusion in the IHS Index would be required to demonstrate adherence to diverse activities aimed at ensuring the engagement of IHS strategies with employees, including reporting relevant environmental inspections by regulatory agencies and being a good corporate citizen of the community.
To fully accomplish this journey, enterprises must evolve from an emphasis on risk management to medical management to population health and ultimately transform the corporation to embrace a culture of health, safety, and wellbeing.
How Employers Can Implement the IHS Index Now
With strong and sustained senior-level buy-in established, the details of health and safety integration can begin using a five-point roadmap developed by the ACOEM/UL task force:
Phase 1 – Developing a Rationale for Why Integration is Important and Needed
The first integration phase involves defining the value of integration, engaging leadership, articulating a vision, and developing an organizational policy statement.
Phase 2 – Evaluate the Current Health and Safety Status of an Organization
Managers should assess how their organization is trending from a health, productivity, and performance perspective and determine what can be done to mitigate the illness burden of their workers. Workforce demographics should be considered when assessing data and metrics.
Phase 3 – Develop and Implement a New Integrated Strategy and Vision
Phase 3 involves implementing the vision and strategies identified in phases 1 and 2 by following the methodologies found in the book Leading Change by John P. Kotter, Ph.D. to:
- Create a sense of urgency
- Create a guiding coalition of key stakeholders
- Develop a change vision communication plan
- Identify goals and remove obstacles to change
- Turn words into action with management participation
- Phase rollout to build momentum with short-term successes
Phase 4 – Create a System for Data Collection, Monitoring, and Evaluation
Integrated health and safety programs should be monitored monthly to evaluate participation and engagement and quantify the investment’s value. The effectiveness of IHS strategies should also be examined once or twice a year.
When establishing an IHS monitoring plan, it is essential to note that significant directional results may take at least 2 to 3 years to be seen. However, for aggressive intervention programs, some results may be evident after the first year.
Phase 5 – Gauge Progress Periodically and Take Corrective Action
The final phase of integrating health and safety activities entails reviewing and adjusting or developing corrective actions as necessary. This is achieved through program evaluation, incorporating lessons learned, and providing rewards and recognition. For example, incentives to promote health and wellbeing include discounts at local health clubs, additional days off, and direct salary/bonus payment incentives.
Key Considerations for Integrated Health and Safety Success
Health and safety teams should be more closely aligned through overarching strategies and integrated organizationally in the workplace.
The creation of a standardized definition for IHS, a new IHS Index, and a roadmap for integration should advance with several guiding principles in place:
- Integrated Health and Safety must be developed with small and medium-sized organizations in mind.
- Programs must be applied in both white-collar and blue-collar workplaces as they are equally concerned about issues such as ergonomics, business continuity, and emergency preparedness and response.
- IHS is successful if well incentivized with favorable tax policies, discounts provided by insurance carriers, or preferred workers’ compensation rates.
- Integrated Health and Safety will succeed if it has the formal buy-in and public backing of organizations from both the health and safety communities. This means outreach to potential partners, awareness building, co-sponsorship of special events, and educational activities.
- Education models must convey IHS concepts in a way that makes them relevant and accessible to employees.
- Data collected must follow regulatory compliance.
How HealthNEXT Can Help
Through advanced measurement tools and on-demand Chief Medical Officers, HealthNEXT provides multi-year, strategic roadmaps to build a culture of health, safety, and wellbeing for corporations, resulting in reduced healthcare costs, enhanced productivity, and long-term competitive advantage. The HealthNEXT portal and methodology incorporate the many important recommendations of this seminal whitepaper. With our help, your organization can establish a sustainable benchmark culture of health, safety, and wellbeing.
Developing Two Cultures of Health Measurement Tools
Developing Two Cultures of Health Measurement Tools
Author: Dr. Ray Fabius, MD.
Is there a correlation between a company’s investment in community health and employee health and wellness and their stock market performance? In the study, “Developing Two Culture of Health Measurement Tools,” HealthNEXT President and Chief Medical Officer Dr. Ray Fabius and other experts in the population health management and informatics fields developed tools to quantify employer investment in building internal and external cultures of health. An internal culture of health includes programs and policies that support an employee’s health, whereas an external culture of health includes initiatives that support a community’s health and wellbeing.
While many studies are available to support the financial benefits of investing in an internal culture of health, the business case for corporate investments in community health is less clear. This study was conducted to better determine whether companies that invest more in employee and community health outperform companies that invest less, as shown by trends in their employees’ health risk profile, medical expenditures, and company stock price.
The Benefits of Investing in an Internal and External Culture of Health
Businesses have the ability and incentive to improve the health and wellbeing of their workers. By building a workplace culture of health (COH) with strong leadership commitment, a variety of evidence-based programs, and a physical and social environment that supports and encourages healthy behaviors, employers may increase employee engagement and productivity, improve physical and mental health, and in many cases, reduce healthcare spending that can affect the company’s bottom-line performance.
Alternatively, corporate investment in community health may enhance an organization’s reputation and strengthen its brand. The investment can also solve significant social and economic problems resulting in healthy, vibrant communities that draw talent to the enterprise and retain experienced staff.
The Results
Results of the study show little correlation between the internal culture of health survey scores and the external culture of health surveys. This may result from the initiatives being performed by different company divisions with different goals, objectives, and interests.
Although the current study could not draw a definitive conclusion on the correlation between investment in an internal culture of health and external culture of health scores, it provides evidence that building an internal COH may more quickly impact organizational performance. Companies that scored high in their pursuit of an internal culture of health outpaced the stock market standard indices. This was not the case for companies focus on supporting their communities’ health.
Dr. Fabius remarks, “The study suggests, to use an airline example, you have to put your mask on before you can help others, and I believe this strongly. The best way to help the health and wellbeing of a community is to build cultures of health within the community’s largest companies. The magnitude of that work will ultimately have an influence on the communities at large.”
Key Takeaways
The study reinforces the merits of building an internal culture of health, as suggested in previous studies conducted by Dr. Ray Fabius and others, while also raising the potential benefits of simultaneously investing in community initiatives. The authors of the study reflect, “Not only does volunteerism provide direct benefit to the community, but it has also been shown to improve the psychological wellbeing of the volunteers (employees) themselves.”
While investing in the health and wellbeing of employees can provide immediate benefits in terms of lower healthcare medical trends, higher employee retention, and lower absentee rates, investing in the health of the surrounding community can offer longer-term benefits of a healthier future talent pool.
Indirectly, an investment in an internal culture of health benefits the community through the employees that live and work locally. Dr. Ray Fabius states, “The study suggests that you can impact a population of employees more quickly and perhaps more efficiently than trying to address a huge community of citizens less well known or connected to employers.”
HealthNEXT supports the internal culture of health initiatives through a two-part Culture of Health program that assists organizations in developing a strategy to improve workforce health, resulting in a stronger and healthier workforce that benefits the organization and the local communities.