Working Title: Investing in the Health of People, Companies, and Cities
Summary: How might we create a model built upon currently existing employee wellness programs and other initiatives that provide financial incentives for people to improve their health? How might we create healthier communities, companies, and cities by investing in health?
- Employee Wellness Programs:
In the case of diabetes prevention and treatment, improving one’s health could mean losing weight, lowering A1c, or even improving mental health through yoga, meditation, or other efforts. Several programs that could be initiated include:
- Providing additional paid vacation days for employees who reach pre-set health goals.
- Providing a paid bonus for those who can show proof of regular physical activity.
- Providing a bonus for people with every tracked 100 miles they walk.
- Some other cash reward for every percentage point reduction in A1c.
As examples, Aetna’s wellness program currently pays employees $25 for every 20 nights they get at least seven hours of sleep, and IBM offers up to $500 in gift cards for employees and their children to exercise regularly. Piloting these programs in more businesses and scaling them up across the country could be impactful towards building a culture of health and decreasing overall health expenditures. Indeed, tracking outcomes of existing wellness programs has demonstrated a substantial return of interest; Johnson and Johnson leaders estimate that their wellness program saved the company $250 million on health care costs over the past decade.
Another example of how employers could directly influence the health behavior of their employees is UCSF’s campus-wide “ban” on soda, eliminating the sale of sugary beverages on campus to reduce sugar consumption by students and employees. Such efforts to create healthier work and learning environments, encouraging students and employees to reduce sugar consumption, could be replicated and scaled at other universities or companies.
2. Investing in Health: The Way to Wellville and A Culture of Health
How might we shift capital and outcomes to produce health upfront rather than try to recover it after illness occurs? How can we bring Silicon Valley thinking to health to help communities reduce obesity and diabetes, foster a healthy food supply and provide better access to care? Several initiatives are making headway on this front, and scaling up these investible ideas could move the needle on public health.
For example, a nonprofit called the Health Initiative Coordinating Council (HICCup), is leading a collaborative effort titled “The Way to Wellville” a five-year effort giving five small (<100,000 population) communities expert advice on capacity building, development of local leaders and sustainable business and financial models, access to capital and partners, and help with data collection and analysis so that they can meet and measure their goals for health. The “Wellville Accelerator” borrows from startup accelerator models in Silicon Valley, where emerging companies are incubated and mentored by experts. In Wellville, communities are the startups, HICCup is the accelerator, and better health is the return on the investment. Way to Wellville goes beyond pilots and helps communities apply well-known techniques in sustained initiatives and through institutions that are accountable, measurable, and ultimately fundable.
The Robert Wood Johnson Foundation has also partnered with The Reinvestment Fund as part of their Culture of Health program to work closely with cities to use data to better understand the needs of their most at-risk neighborhoods — and then invest in new initiatives that can revitalize housing, health, transportation, education, and other assets that help communities to become stronger and healthier. They’ve launched Invest Health, which will give up to 50 mid-sized cities $60,000 each to work across sectors and start to map out the kinds of changes they want to make.
System Impact: This idea positions health as a return on investment at the level of the workplace or city. For employers, diabetes poses a major economic burden, largely due to medical costs and loss of productivity costs. The incremental cost of diabetes among employees has been estimated at over $4,000 annually per person, with 30% of costs to employers attributed to medically-related work absences and disabilities. While prevention efforts and employee wellness programs may present initial upfront costs to employers, the long-term costs saved could offset them, particularly if there were a financial benefit incentivizing employers to implement these programs. Furthermore, organizations are finding promise in bringing Silicon Valley thinking to health, using data to map out goals based on successful models, working collaboratively across sectors to implement them, and making financial investments in communities and cities. If we can scale up examples of these programs that we know work, this idea presents an impactful, investible, and scalable approach to preventing diabetes.