The Partnership to Improve Patient Care (PIPC) just released a Comparative Effectiveness Research (CER) Inventory on-line.  It can be accessed at www.cerinventory.org.  It will list all research which has full or partial funding through any federal agency including the AHRQ and HHS.  

Physicians and medical directors should find the site helpful as the Inventory ". . provides a single, comprehensive, easy-to-use database of federally supported CER projects." 

Since the inventory is available to the public, patients will find it helpful, as well, when researching what treatment options are under investigation and how they stack up against others for the same health condition.

Towers Watson conducted a survey in September of this year which included more than 450 medium to large employers asking them how they anticipate changing their wellness programs and incentives next year.  The results were interesting and the stakes for employees will be changed (see summary in Los Angeles Times edition).

Of those surveyed, 62% indicated that they will only provide incentives after or upon completion of the activity/behavior change desired.  So getting results is the goal, not just participating, as has been the case for many employers in the early phase of establishing a wellness program.  As LuAnn Heinen (VP of the National Business Group on Health) put it, "It's about doing something, rather than just taking a questionnaire."

Under the recent healthcare reform enacted at the federal level, employers can actually increase incentives to employees for participating in wellness programs from 20% now, to 30% of the total premium cost in 2014.   This should spur employers on in improving programs already in place. 

As employers move forward, however, some experts caution that a reward for results is okay, but rewarding each step along the way may produce even greater results.  Sheri Pruitt (with Permanente Medical Group, Inc.) advises senior management to recognize that human behavior is a science and that waiting for the ". . . outcome without reinforcing all the steps needed to get there isn't likely to be effective."  So, breakdown the behavior you want into its components and divide the reward among those steps to help employees get the reinforcement they need periodically as they work toward the long term goal.  Makes sense; few would prefer one large bonus at year end over several smaller bonuses throughout the year, right?  And the incentive for achieving wellness should probably be handled no differently.

I really couldn't resist featuring this study.  (While it isn't about on-site clinics, per se, you can't do a great job of providing on-site medical care without a really effective wellness program.)  It was comprehensive and was recently published in the Harvard Business Review.  The study was performed by Leonard L. Berry, Ann M. Mirabito and William B. Baun who interviewed top level administrators from ten different corporations with well-established wellness programs in place. 

First, let's give you their definition of Workplace Wellness:  "An organized, employer-sponsored program that is designed to support employees (and, sometimes, their families) as they adopt and sustain behaviors that reduce health risks, improve quality of life, enhance personal effectiveness, and benefit the organization's bottom line."  NOTE:  They left the direct, explicit benefit to the corporation as the last component of the definition. Interesting, but if you find the time to read the article - and I hope you do - you'll know why (if you haven't already figured this out in your own programming). 

Next, we'll tell you that they have also identified what they call the "Six Pillars of an Effective Workplace Wellness Program."  Those are:  Multilevel Leadership; Alignment; Scope, Relevance, and Quality; Accessibility; Partnerships; and Communications.  

The list of companies they surveyed was impressive, too.  They included Johnson & Johnson, MD Anderson Cancer Center, Nelnet, SAS Institute, and Biltmore, among others.   The study included direct interviews with executives, focus groups with users and non-users of the wellness programs in place; and mid-level managers.  All-in-all, more than 300 people were involved at the ten corporations. 

I want to go into the "all" of the findings, but we don't have room for that here.   I promise that you will enjoy and learn from the individual corporate anecdotes and advice given in this report or by implementing the "dashboard."  However, one example I noted which exemplified the Leadership pillar: Dr. Martin Gabica, the CMO of Healthwise said, "Wellness is a viral thing.  When I meet with a new employee, I say, 'Let's go for a walking meeting'." 

Another excerpt: H-E-B (one of the corporations included in the study) has demonstrated that "healthcare claims are about $1,500 higher among non-participants in its workplace wellness program than among participants with a high-risk health status."

These are just two of the wealth of interesting approaches and findings by and of these corporations to make their wellness programs top-of-the-line and worthy of emulation.

Finally, the authors have created a "dashboard for workplace wellness programs" that could help you find solid ways to monitor your progress and the benefit you are creating to everyone.   The dashboard includes reporting on data such as trust in management, presenteeism, voluntary turnover, and disability costs, among others.

We once again encourage you to read the whole report.