From Lawrence R. Richardson: I am the Executive Director at FOND DU LAC AREA BUSINESSES ON HEALTH (FABOH), and it is my privilege to nominate Jeff Butz, FABOH Wellness Director, for consideration for the DISH Award. Below, in his own words, is his introduction and the compelling rationale for his recognition.
My name is Jeff Butz and I am the Wellness Director at Fond du Lac Area Businesses on Health, also known as FABOH. FABOH is an employer-owned coalition that pools the purchasing power of local businesses by purchasing healthcare directly from local providers. This provides value to members by providing discounts on health care purchased and increasing the specialty care offerings available locally. As Wellness Director, it is my role to support our members with the design, implementation, and evaluation of their respective wellness programs. FABOH’s current membership is comprised of employers with between 15 -350 employees. Former FABOH membership has included employers with greater than 2500 employees.
Prior to my work at FABOH, I served as the Manager of Wellness and Preventive Services for Affinity Health System, Wellness Coordinator for Motorola, and Health and Fitness Instructor for the National Institute for Fitness and Health (NIFS) totaling 14 years in the field.
I earned a B.S. Degree in Exercise Science from the University of Wisconsin Oshkosh in 1999. After working for six years I decided to continue my education. I earned a Graduate Certificate in Health Care Management in 2008 and then completed my Masters of Public Administration degree with a Health Care emphasis in 2012 also at UW-Oshkosh. While doing this course work, I achieved designation as a WELCOA Faculty member in September of 2011. The combination of the theory and practical knowledge provided in these opportunities accelerated my development.
In January of 2013, FABOH rolled out a Self-Care intervention to all members. The Self-Care topic was chosen for three main reasons, universal appeal to membership, the potential measurable impact a Self-Care program could create, and supportive data indicating office visits as the number one cost driver. The appeal of the program stems from the fact that the Self-care program offered employers the opportunity to discuss how wise health care decisions made by their employees benefitted both the employee and the organization. Contributing to the appeal was the fact that many members were working towards their Well Workplace designation in conjunction with the Well City initiative and needed a well-designed self-care intervention program to implement. Additionally, the health care avoidance tied to this intervention would be both easily measured and relevant to key stakeholders.
The components of the turn-key intervention kit included the following:
• A Healthier at Home book for all employees
• Customizable slide deck to train employees on how to use the book, the value provided to employees, and specific examples of how healthcare decisions can directly impact employee costs
• Four 4-question quizzes with evaluation questions added to ensure long term engagement
• An electronic copy of WELCOA’s Personal Health Record (required distribution)
To ensure the best possible outcome, participating employers were required to sign an agreement stating that they would provide training to all employees who received the book, provide incentives to maximize participation in the quizzes, and provide outcome data to FABOH to measure the impact.
The outcomes from this intervention have been impressive. To date, 47.9% of survey respondents reported filling out their Personal Health Record, 62.8% of respondents reported using their book at least once with the average number of uses being 3.21. Of the group that utilized the book, 21.1% reported that the book helped them avoid at least one doctor’s visit and 8.6% reported that the book helped them avoid an emergency room visit. To date 146 doctors’s visits and 32 emergency room visits have been avoided for a cost savings of over $63,300. Satisfaction with the program has also been high (97%) It is anticipated that book utilization and cost savings will continue in the future.
The seven benchmarks as well as WELCOA’s best practices for Self-Care (webinar) were incorporated throughout the design of this intervention. Some examples of this include:
• Inclusion of Senior leadership support occurred at most trainings
• Using data on the front end of this program to determine which program to offer membership
• Evaluation of program required and materials included with the turn key kit meet WELCOA application guidelines
Using WELCOA’s best practices:
• Inclusion of the Personal Health Record (WELCOA’S)
• Provide Medical Self-care materials (Healthier at Home Books (AIPM))
• Build skills through training (Vignettes)
As Wellness Director for FABOH for the last 8 years, I have successfully worked with our membership to develop:
• Training opportunities to increase overall knowledge and understanding of the proven WELCOA model
• Turn-key tools and resources to support the implementation of this model
• Evaluation resources to ensure success
The positive outcomes demonstrated by members through adoption of the WELCOA model made it apparent to FABOH’s Executive Director and Board that FABOH should take a leadership role in the Well City Fond du Lac initiative, expanding the impact community-wide.
The Takeaway: Alignment with proven wellness models = Better outcomes, increased credibility, increased opportunity to lead.
I use proven models for personal wellness too. By following the guidelines set around physical activity and healthy eating I have been able to maintain a healthy weight, and biometric values. This lifestyle provides me with the vitality needed to effectively perform my job and lead others to a healthier lifestyle.
When working with our members, there are two unique things I do to enhance the success of their programming.
1. Incorporate elements of their overall strategy into the programs they offer (example – having the health coach perform the weigh-ins and goal setting for a weight loss program)
2. Manufacture successful recruitment - Tie the kick-off of a wellness program to a large event or an event in which most employees will attend. (Goal setting sessions for weight management challenges done at an HRA follow-up session when BMI is shared)
The impact of making these changes were:
1. An above average utilization of the health coach in 2/3 months of the program resulting in 68% of the participants either losing or maintaining their weight and a total weight loss of 275 pounds.
2. This methodology increased participation percentage in the weight loss program by 27 percentage points over the average attendance.
One of the biggest threats on the horizon for employers is the condition of pre-diabetes. Currently 86 million Americans have this condition and only 7% know it. Through collaboration with our HRA vendor and the CDC’s /YMCA’s Diabetes Prevention Program we are working to increase the awareness and understanding of pre-diabetes and resources available to address the threat. Our strategy will start in 2015 and consist of:
• A professionally designed awareness campaign on what pre-diabetes is and its impact on the employee’s health and finances
• Targeted letters sent to all HRA participants who have a pre-diabetic glucose level at their screening. These letters will direct the employee to employer specific resources available to the employee such as online resources, health coaching, or the Diabetes Prevention Program
• Inclusion of the patient’s PCP and outreach from their office addressing this
• Plan design elements to incentivize participation in programming offered