Value-based design: a new powerful perspective for worksite health promotion.

The growth in recognition of the employee's role in health improvement is driving the development of new perspectives for managing the health of individuals in defined populations, such as a working population. Value-Based Design is one of these newer perspectives and is introduced in this edition of The Art of Health Promotion. The core of this approach uses data to design benefits and incentives that are then implemented effectively and tracked as to their outcome. This perspective helps practitioners focus their interventions and helps move programming more directly to the production of desired outcomes. Behavioral "levers" are identified and integrated across a useful intervention continuum.

Wellness, hard to define, reduces trend up to 4 percent.

The purpose of this qualitative study was to identify a common language for "wellness" and a correlating health cost trend reduction through incentive-driven prevention and wellness. Mapping the results of the survey with the trend lines reported by innovative employers could uncover increased financial value in health investments. A 10-question survey was designed for telephone interviews with 26 businesses (Innovators) from the Board of the Center for Health Value Innovation; a paper-based survey with the same questions was completed by attendees at a seminar. Then, an online trend survey was conducted with members of the Board (Innovators) to track the total health cost trends in their companies over the past 3-4 years. Responses were compared and analysis of alignment and differences were recorded by graphing. The trend survey results were mapped and tracked with weighted averages. Innovators' responses to the phone survey showed broader definitions of "wellness" than other companies, with little difference in the Innovators' responses when subdivided by size of company. The online trend survey showed that companies that provided incentives for wellness averaged a trend of 4% over the past 3-4 years-approximately 50% of the national trends of 8%-10% over the same time frame. Innovators have defined wellness in ways that would accelerate adoption in the broader business community and drive implementation of wellness programs. The bigger win could be the community-level shift to a culture of health as employees carry these health competencies to the next business in the community.

The value of dividends in health: a call to align stakeholders.

OBJECTIVE: The purpose of this paper is to describe the philosophy and utility of value-based designs (VBDs), with an eye toward defining a pathway for a shift to VBDs across US businesses involved in the health care discussion. METHODS: A 12-question survey of 36 companies that had been identified as emerging leaders in health and productivity management was administered by telephone interview and, later, by online interview. Information collected included company size, business sector, prevention, wellness, data accessibility and integration, condition management, C-suite visibility, and culture of health. Answers were scored on a scale from 1 to 10 per category; the maximum score was 50 points. These scores were used to indicate patterns of development and define the pathway to maturity. Experts resurveyed the data to quantify change over time, which was used as a proxy for dividends. A pathway, or continuum, was graphed based on the scoring. RESULTS: Three segments were found to be clearly correlated with the reported experiences from the surveys-patterns of data use, targeted population change, and services and metrics. The movement through the continuum begins with a focus on prevention and wellness across the entire population, next uses data to identify current waste (inefficiencies in specific segments of the population regarding chronic care, accessibility, and quality/reimbursement, and inefficiencies in care delivery), and finally merges the total health and wealth of segments of the population into one coordinated strategy to maximize the total health value of every dollar spent at the individual and system level. CONCLUSIONS: The market for VBDs has grown rapidly. The pathway to success-including the data needed, designs created, services acquired to change behavior, and dividends over time-can be shown to be replicable, scalable, and sustainable.