Workplace Well-Being Factors That Predict Employee Participation, Health and Medical Cost Impact, and Perceived Support.

PURPOSE: This study tested relationships between health and well-being best practices and 3 types of outcomes. DESIGN: A cross-sectional design used data from the HERO Scorecard Benchmark Database. SETTING: Data were voluntarily provided by employers who submitted web-based survey responses. SAMPLE: Analyses were limited to 812 organizations that completed the HERO Scorecard between January 12, 2015 and October 2, 2017. MEASURES: Independent variables included organizational and leadership support, program comprehensiveness, program integration, and incentives. Dependent variables included participation rates, health and medical cost impact, and perceptions of organizational support. ANALYSIS: Three structural equation models were developed to investigate the relationships among study variables. RESULTS: Model sample size varied based on organizationally reported outcomes. All models fit the data well (comparative fit index > 0.96). Organizational and leadership support was the strongest predictor (P < .05) of participation (n = 276 organizations), impact (n = 160 organizations), and perceived organizational support (n = 143 organizations). Incentives predicted participation in health assessment and biometric screening (P < .05). Program comprehensiveness and program integration were not significant predictors (P > .05) in any of the models. CONCLUSION: Organizational and leadership support practices are essential to produce participation, health and medical cost impact, and perceptions of organizational support. While incentives influence participation, they are likely insufficient to yield downstream outcomes. The overall study design limits the ability to make causal inferences from the data.

Development and Validity of a Workplace Health Promotion Best Practices Assessment.

OBJECTIVE: To explore the factor structure of the HERO Health and Well-being Best Practices Scorecard in Collaboration with Mercer (HERO Scorecard) to develop a reduced version and examine the reliability and validity of that version. METHODS: A reduced version of the HERO Scorecard was developed through formal statistical analyses on data collected from 845 organizations that completed the original HERO Scorecard. RESULTS: The final factors in the reduced Scorecard represented content pertaining to organizational and leadership support, program comprehensiveness, program integration, and incentives. All four implemented practices were found to have a strong, statistically significant effect on perceived effectiveness. Organizational and leadership support had the strongest effect (ß = 0.56), followed by incentives (ß = 0.23). CONCLUSION: The condensed version of the HERO Scorecard has the potential to be a promising tool for future research on the extent to which employers are adopting best practices in their health and well-being (HWB) initiatives.

Linking Workplace Health Promotion Best Practices and Organizational Financial Performance: Tracking Market Performance of Companies With Highest Scores on the HERO Scorecard.

OBJECTIVE: The aim of the study was to evaluate the stock performance of publicly traded companies that received high scores on the HERO Employee Health Management Best Practices Scorecard in Collaboration with Mercer© based on their implementation of evidence-based workplace health promotion practices. METHODS: A portfolio of companies that received high scores in a corporate health and wellness self-assessment was simulated based on past market performance and compared with past performance of companies represented on the Standard and Poor's (S&P) 500 Index. RESULTS: Stock values for a portfolio of companies that received high scores in a corporate health and wellness self-assessment appreciated by 235% compared with the S&P 500 Index appreciation of 159% over a 6-year simulation period. CONCLUSIONS: Robust investment in workforce health and well-being appears to be one of multiple practices pursued by high-performing, well-managed companies.

The predictive validity of the HERO Scorecard in determining future health care cost and risk trends.

OBJECTIVE: To determine the ability of the Health Enhancement Research Organization (HERO) Scorecard to predict changes in health care expenditures. METHODS: Individual employee health care insurance claims data for 33 organizations completing the HERO Scorecard from 2009 to 2011 were linked to employer responses to the Scorecard. Organizations were dichotomized into "high" versus "low" scoring groups and health care cost trends were compared. A secondary analysis examined the tool's ability to predict health risk trends. RESULTS: "High" scorers experienced significant reductions in inflation-adjusted health care costs (averaging an annual trend of -1.6% over 3 years) compared with "low" scorers whose cost trend remained stable. The risk analysis was inconclusive because of the small number of employers scoring "low." CONCLUSIONS: The HERO Scorecard predicts health care cost trends among employers. More research is needed to determine how well it predicts health risk trends for employees.

Best practices for an integrated population health management (PHM) program.

Large employers are beginning to create much more robust and potentially effective systems of integrated health management interventions. This organization-wide activity is referred to as a "Population Health Management" (PHM) approach. Best practices are also beginning to emerge in this area, and a number of technical developments are helping shape the patterns of response from innovative employers. This initiative is rapidly emerging as a critical part of overall business and health care strategy.