ENTRY FROM: 2016 Top Health Promotion Professionals

Nominee: Dan Keith

Common Sense Without the Fairy Dust

It Starts With Me Health
CEO, founder, managing partner
Industry type is Employee Health Promotion
21 years in the field, 26 in healthcare
ISWM has 33 employees

Dan Keith

1. Professional Development

In 1989, Dan earned his baccalaureate in nursing and began his career as a Registered Nurse.  While working he continued to attend college, and in December 1990 he received his Masters Degree in Business Administration. 

Often working 2-3 jobs, Dan spent the first 10 years of his career learning and progressing in the healthcare industry.  These opportunities included:

  • Direct Patient Care Nursing: cardiology, oncology, medical-surgical, inpatient mental health, in patient addiction treatment, pain management, in-home IV therapy for adults and children, and medical detox for homeless individuals outside of the hospital setting. 
  • Case Management: Workers’ Compensation, catastrophic, chronic disease, legal (CCM, LNCC)
  • Insurance:  Utilization review, pre-certification, claims data review 
  • Hospital Management:  oversaw operations and business development of occupational health and case management departments, Employee Assistance Programs, pain clinic, hospital employee wellness programs, client wellness programs
  • Home Health: started and oversaw operations/growth of a Medicare-certified Home Health agency

2. Demonstrated Success

Dan has been involved in hundreds of employee wellness projects.  By far, the ones that have the highest chance of success are those which focus on these aspects: 

1- Employees can easily identify and embrace the value proposition for them personally.  This most usually happens when the wellness efforts are attached in one way or another to:

  • increasing personal finances, personal time, and/or personal health
  • decreasing stressors in their lives (which are many)
  • aren’t viewed as pointless hoops to jump thru that make them needlessly busier (this one will zero out potential gains from “a” above)
  • aren’t viewed as intrusions (real or perceived) into their personal lives (also will zero out potential positive gains from “a” above)
  • are fun or perceived as a nice break from the day

2- Wellness efforts are specifically tailored to the employer and employees.

3- The client realizes that the cost is an investment in people, not an effort to save money or generate ROI.  Those two things are a bonus if they occur, but not the goal.  

4- Wellness efforts cannot be developed or implemented in a vacuum.  Time must be taken to coordinate with the health plan and other benefits offered by the employer before wellness efforts are ever rolled out.

With regard to outcomes of interventions, health status improvements (physical and mental) should almost ALWAYS be the primary goal.  Why?  Because effectively improving those will provide the best chance of effective and organic behavioral and cultural change within the organization.  Employees are smart.  They see successes.  They hear people talking about them.  They begin to see the employer as on their side and not an adversary.  Change & improvement becomes a self-fulfilling prophecy, if done right.  But let’s not overstate it either.  True lasting behavior change is very elusive.  True culture change is as well.  Wellness efforts can be a very important part of those changes.  

Of the WELCOA Benchmarks, numbers 3, 4, 5 & 7 are absolutely the most critical. 

                3. Collecting Data to Drive Health Efforts

                4. Carefully Crafting An Operating Plan

                5. Choosing Appropriate Interventions

                7. Carefully Evaluating Outcomes (this is where most people fail - you can't measure effectively or completely if you don't know before you start EXACTLY what you need to measure, what       reporting you'll need, and when)

Benchmarks 1, 2, & 6 are important and require attention of course, but it is where most wellness efforts focus and is why they are jettisoned when budgets get thin.

3.  Leadership

The wellness company Dan started, It Starts With Me Health (ISWM) has been purchased twice since it was formed in 2001. It has been in the black every single year since it was formed, never borrowing a dime or going into debt for growth. 

Dan "walks the walk" on exercise by hitting the gym at least 3 times a week, even when he travels (which is much of the time).  But that's not all.  While he expects a lot from employees, he has made it a point to offer special benefits to them to help make their lives easier. Of all of the health issues that can affect productivity & presence at work, Dan believes that lack of sleep, stress, depression/anxiety, and overwhelming personal obligations need significantly more attention, because the detrimental health effects from each are enormous.  So in addition to a standard benefit package that is very generous,  including a 401(k), ISWM provides the following benefits:  2 paid days off per year for employees to volunteer at a local nonprofit of the employee's choosing;  1 paid day off per year for whatever reason the employee wants, called a "Me Day"; $2500 toward funeral expense of a direct family member; financial programs that start with making sure employees have a will and at least a small emergency savings account; occasional onsite massages; and expert assistance for employees who are taking care of elderly parents or a special needs family member. Needless to say, the company has very little turnover and a strong group of employees who are proud of the work they do. 

Advice for others: 

1. Don’t be a follower.  Question everything you hear that seems too easy or is a platitude.  You’re smart.  You’ll know it when you hear.

2. Get some clinical experience and get around clinical people so you are more rounded in your knowledge base.

3. Don’t try to sell wellness products because they are the next new concept or next new thing.  Just try to help someone, or help a business owner.  If you can, do if for free for a while to prove the value. If there’s value there, the sale will happen on its own.  And you’ll be much more valued long term for doing so.      

4. Innovation

See section 2 in its entirety. 

5. Compelling Vision

Dan believes that the single biggest threat to the health promotion/wellness industry in the next 5 years is the industry itself - if it doesn't change fast.  The wellness industry has become primarily a marketing machine with too many people focused on being known as “experts".  This has resulted in most industry change or advancements being in terms of changing concepts, not changing delivery.  And even though ROI claims made by wellness experts have been panned outside of the industry for years, the wellness industry has been oblivious - even defiant, as if it was immune to intense scrutiny because their ROI claims and formulas were indisputable.  If the industry's leaders said it...well then it had to be so. 

Dan is a huge believer in health promotion/wellness and what it can do for the health of an organization.  But the deliverable is what’s important, not the concepts and promises.  And that’s where he believes wellness has lost its way.  What he sees is that fewer people in wellness want to do the hard, one-on-one, boots-on-the-ground work. Instead too many are focused on being “consultants” far before they have the experience necessary.  The problem is that when most of what you do is "coordinate services” and consult, then by default someone else is doing all the heavy lifting.  And that formula does not an expert make.    

Dan says that the proof is very easy to point out.  Here is what he says:  "When an employer has to cut costs, what is almost always one of the first programs on the chopping block?  We all know the answer.  It's wellness.  Why?  Because when it comes right down to it, wellness "experts" have not put programs in place that are a good fit for the employer and/or they don't show clear value.  They know neither how to completely explain the value proposition, how to completely and accurately assess a program's financial impact, or how to even gather the data necessary to evaluate the program.  For that, you need some financial background and some clinical background, and most wellness experts have neither.  So they make promises of cost savings in the beginning that they have no business making.  Their own program is inadvertently set up to fail, all the while with the best of intentions. 

The fact of the matter is that most wellness programs are an expense - a potentially valuable expense, but an expense nonetheless.  I hear wellness people and health plan brokers saying all the time 'If I had said that it was going to cost the client money and not talked about ROI then the client might not have bought the program in the first place'.  Dan says "Bingo.  And that is a perfect example of where marketing has taken first chair over substance in the wellness industry."

What does Dan plan to do to advance the industry?  See Section 2.  He's focused on merging the separated tracks of clinical practice and wellness.  The wellness industry can be extremely helpful to clinicians and has a definite role in the improvement of health.   And clinical information can be of great help in establishing effective wellness programs.   But they MUST work together.    

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Dan Keith
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Bret R.
Ascend Strategies works with health, wellness and insurance companies to develop and execute business strategies and plans. View Bret R.'s Profile.
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This guy sounds like he has it figured out. What a great combination of clinical and business experience. I'm a believer that those two views need to be synced more often.

Bret R. on 1/25/2017

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