Wellness

Post: Self-Care

What do you do afterwork to decompress and recharge your batteries?

It was a ice-breaker question that members of a business group needed to answer as part of their introduction. Almost everyone in the group started with something along the lines of “well I know that I should be exercising” but what I really do is …. guess what they said.

As some of you know, I’ve been trying to get more people working out and living a healthier lifestyle [aka: Hello Workout]. My introduction was last so there was no bias in the responses for what I do or anything that I said.

After hearing everyone’s “confessions”, I almost felt bad introducing myself and sharing a bit about my lifestyle. If you’re wondering, I am a strong believer in regular maintenance whether it’s my car or my body. Both work better when they are cared for properly.

Inspiring, nudging and telling people to workout might not be the right approach. It makes people feel ashamed and it makes people initiating the conversation feel bad. It’s awkward all the way around.

Many in the business group talked about caring for others. There is no shame in caring for others. So maybe the better question is “How do you care for yourself?“.

Words are powerful. Simple changes can make a big impact.

Shame steers people into a life of silence, inactivity, lying and hiding.

~ Harriet Lerner

 

Power of Habits

Your habits are the key to your success in business and life.

A habit is something you do when triggered by something that only you know when you crave the reward.

The Anatomy of a Habit:

A habit has four (4) parts. Once you understand the parts, you can change any habits that is limiting your success.

Cue: The cue is the trigger which can be a feeling, time of day, specific event or anything else that makes you start a specific routine.

Routine: The routine is the action or series of actions you take when triggered. The routine is specific to the trigger and is almost an automatic response.

Reward: The reward is something you get at the end of the routine such as a sense of calm, satisfaction, connection, belonging, completeness, control or whatever you feel from completing the routine.

Craving: The craving is your need for the reward.

 

The Problem:

The routine is the problem. It’s the action or series of actions that you take when you crave the reward that is limiting your ability to achieve your goal. To change the routine and your outcome, you have to identify the cue and the reward so that you can replace the routine with something equally rewarding.

We all have some habits that may not be serving our wellbeing or limiting our success. I have been referring to my need for innovation as a “nasty innovation habit” for the last several years. Like other bad habits, my innovation habit affects my wellbeing in a number of ways and it’s hard for me to break the cycle because it’s so automatic. Let me explain why…

Cue: What drives me to innovate?

It all starts with a problem or at least something that seems harder than it needs to be [cue]. I crave the challenge of adventuring into something new, something that challenges my thinking and the status quo. I’m not as satisfied by the nuance of refining one skill over the lifetime of a career as many others do.

Routine: Develop a solution to solve the problem

I ventured into e-learning during the dot com boom because it seemed like the best way to make a big impact on the industry. I didn’t know anything about the technology or methodologies for developing courses at the time. However, I hired consultants to collaborate with me.

At the time we launched, Health South missed their numbers by more than $2 billion which materially misstated their financials and caused the dissolution of the company. Unlike the other CFOs who had unintentionally misstated their numbers, Health South executives intended to deceive investors and succeeded for a long time. Several of them ended up in jail.

The contractual write-offs are still a big problem for most healthcare companies because the system is fragmented, the contract terms for payment vary from payer to payer, systems lack the needed sophistication to administer the payment permutations and the people doing the day-to-day work and reporting the numbers rarely get the needed training.

Outsourcing only solves part of the problem. Every step of the process and very transaction posted into the billing system makes a difference to the accuracy of the numbers. Rather than fixing the problem, the industry added more solutions to address the consequences and shift the blame. The revenue cycle industry generates more than $52 billion annually and is still not satisfying any of the stakeholders – especially patients.

My first solution addressed the training deficit of the people doing the work and reporting the numbers. I thought it would be kind of like writing a book in that it takes an upfront investment of time and effort but then pays off over time. Like Starbucks, our courses provided professional credits that could be used for college courses. With a 10% initial pass rate, I worked harder than I ever imagined. It wasn’t like a book at all because clients transferred performance expectation to me. I tried to be really inspirational during virtual meetings and relatable in our marketing collateral. Our messaging was on the right track but we missed the need for teaching basic life skills.

Starbucks’ program reportedly teaches skills such as “how to live, how to focus, how to get to work on time and how to master emotions”. My sister who is a psychologist identified that her clients at the time were similar to my students. She was just trying to get them through life whereas I was trying to turn them into star performers. I connected the dots, but still couldn’t close the gap.

It was a missed opportunity because we’ve created more problems since then. Offering people a way forward in life empowers them with keystone habits that makes it easier to change other habits to improve their lifestyle and live their best life. In short, education has the power to change lives.

Reward: What do I get for solving the problem?

I often joke with people that I got the whole employment equation all wrong. When you innovate with your own money it often requires significant sacrifice and for some, it seems like unnecessary hardship.

The reward while on the journey are all the “small wins” that reinforce the belief that the goal is achievable. I can actually feel the pleasure center of my brain light up with a win. Another entrepreneur who I met early in my career used to talk to me about progress. The concept of progress stuck but I didn’t fully appreciate the value of it then.

It took experience for the value of progress to really resonate. As with any big goal it takes months or even years to achieve and there are many setbacks that make you question whether you can get through another week or month. I have a sticky note on my monitor with the words “Do whatever it takes”. I move it to eye level on those days when I need a constant reminder to get out of my comfort zone. Of course there are some ethical limits to the “whatever” but I have had to do things and have had conversations that were way beyond my comfort zone. It’s something that needed to be done. Everyone has the power to bust through their self imposed limits.

Carving: What makes me keep going?

My friends and family wonder what drives me to keep innovating. I do well as a consultant and consulting without personal projects provides for a more balanced life. Truth be told, there are times when I crave more balance. Some days I can even hear my subconscious saying “I want my old life back” as though a pouting child. However, the craving to feel the “rush” of solving a bigger problem is more compelling. So I just keep going.

Goals: What are your goals?

I have always wanted to have a “positive impact” on healthcare. Those words alone have served as a guiding force for the type of work that I do as a consultant, the way that I conduct myself within the industry and the types of problems that I tackle on my own. It’s kind of like Google’s “do no evil” mantra.

When Paul O’Neil became CEO of Alcoa, he focused the company on safety. When he spoke about safety at his first annual meeting, investors thought he had lost the typical Republican plot of “synergy, rightsizing and co-opetition”. However, what the investors didn’t understand was that by focusing on safety he united the company around a common goal. As safety improved, productivity and profit improved.

We need a common goal to unit the healthcare industry. The triple aim lacks identity and is hard to remember. I like Patient Wellbeing because it encompasses safety, outcomes, experience, cost and wellness. I’d love to hear your thoughts.

Power of Habit

If you haven’t read the Power of Habit by Charles Duhigg yet, I encourage you to do so. It was enlightening for me on many levels and provided food for thought about how I want to approach my work and life going forward.

If you’re struggling to loose a few pounds, I’ll leave you with the two most important things from the book that you can do everyday:

Eat Breakfast — It will help to keep you full throughout the day and eat less.

Weigh yourself Everyday — It will help inform you which foods make you gain weight and which foods make you loose weight.

Of course, if I was to add a third it would be exercise.

About the Author: Shannon Smith is a healthcare strategist with over fifteen years of experience helping companies achieve greater success. She is also the founder and CEO of Hello Workout.

Join us on Hello Workout for help covering the weekly minimum requirements for good health, advice from professionals and other tips to help you achieve more success in work and life.

Understand your Brand

Whether you know it or not, you have a personal brand.

A new year is right around the corner. You or someone you know may be thinking that they need or want to do something different and need help refining their personal brand.

One of my friends found a mentor earlier this year because she is contemplating the next step in her career and felt that she could benefit from having some guidance. We went for a walk this weekend and when I asked what was new, she told me about her recent meeting with her mentor.

There may have been more said during the meeting but what was relayed to me was that her mentor suggested that she develop her brand attributes and establish a schedule for regular blog posts. It was clear that she didn’t know how to start.

I’ve outlined the plan we talked through during our walk this weekend. It’s designed to be done over the course of a year. You may be able to do it faster.

Establishing a personal brand

If you’ve been hired to do a job, a project, a gig of some sort then you already have a brand. It’s the reason people chose you over all the other people applying, pitching or trying out for the gig. Do you know why they chose you and not someone else?

The first step to developing your brand is to understand why someone chooses you. If you’re not sure — ask your your boss or your client — why they chose you.

The plan

I started living my life in quarters when I started my own consulting business back in 2000. Not many people other than those sales likely think of life in quarters, but for me it helps set my focus for a specific effort and gives me a specific timeframe to evaluate that effort.

Thinking in quarters, we talked through a plan to understand and refine my friend’s personal brand so that she’s ready to start a new consulting business in 2018.

Q1: Discovery:

Collect the information needed to define what and who. During the first quarter of 2017, my friend is tasked with talking to at least three (3) people that she has worked for in the past to learn why they chose her and what she did that they valued most. I know some of her colleagues so we talked through some specific people and what to ask. In general, you want to consider the person that you’re speaking with whether they are or were your manager, client, colleague or co-worker to frame your questions in a way that draws out the answers you need.

Remember, you’re not looking for flattery but rather honest input about the value you bring to the organization, department, project, team or whatever is relevant to your relationship with that person. Your job is to uncover the attributes that they find valuable so that in the future you can identify others like them that will realize similar value.

Q2: Review the feedback

Define what and who. During the second quarter, my friend will be reviewing all of the responses carefully to distill the themes. She needs to identify the cross section of what people value and what she likes to do and wants to do next to uncover the “what”.

Some of the answers may be revealed quickly and others may be harder to distill. People at different stages of their career, different levels and with different backgrounds will likely respond differently which is why you have to look for the common threads or themes. If the answers you need aren’t clear, ask more questions, speak with additional people or do some research about the field to get the needed clarity.

Q3: Test your work

Publish a few blog posts. During the third quarter, my friend will be writing and publishing a few blog posts to test her hypothesis of “what” and “who”. The tone of her posts will also help develop the “personality” of her brand and flush out a manageable publishing schedule.

Blogging is no easy task which is why many companies outsource the work to professional writers. It’s something that I’ve always enjoyed but it requires creativity and discipline. If you haven’t done much writing in a while, start slow and don’t be too critical of your work. It’s a skill that gets better with time. Publishing has never been easier with so many different social networking sites.

Q4: Commit to your Brand

If everything has gone well in Q1 — Q3, my friend will be ready to formalize her “brand attributes” next year at this time. Brand attributes are the foundation of the brand and include the name [if different than her own], logo, personality and pricing.

Knowing your brand attributes is just as important if you’re looking for your next job.

Photo: Your logo may be a professional photo that you can use on a blog and all social sites you choose to share your ideas, case studies and examples of your work.

Posts: Your personality should come through in your posts so that people hiring you or who will be working with you, get a sense of you before you ever step foot through the door.

Pricing: Your pricing should be reflected in the compensation package you negotiate. Understanding the fair market value of your work is the first step in negotiating a fair package.

I was introduced to the idea of a personal brand years ago at a HBA event when Ellen Looyen presented. I hope the process outlined above makes it easier for you or at least gives you some ideas of how to start. Let me know how it goes.

About the Author: Shannon Smith is a healthcare strategist with over fifteen years of experience helping companies achieve greater success. She is also the founder and CEO of Hello Workout.

Join us on Hello Workout for help covering the weekly minimum requirements for good health, advice from professionals and other tips to help you achieve more success in work and life.

Success with Wellness

There is no silver bullet for increasing engagement in wellness programs. However, successful programs with higher than average participation have common elements. 

5 Elements of Successful Wellness Programs:

Offer choice so that you meet people where they are at on their journey for better health.
Working out should simply be time for everyone to do something physical and enjoyable. Offering choice is the easiest way to meet people where they are at on their journey to better health. Many corporate wellness programs make it easier for employees to move throughout the day by implementing walking meetings, standing desks and treadmill desks. Personal trainers, including Harley Pasternak now believe that people can get lean in life just by standing more and walking at least 10,000 steps/day which is about 5 miles/day. 

Lean is not enough. People also need to be strong [and flexible]. Some companies are encouraging employees to workout at their desks or wherever they feel like it because just 5 minutes of resistance training each day improves health over time. Others are offering on-site classes, access to company gyms or contributing to workout related expenses by adding a fitness benefit

Make the healthy choice the default choice.
Subtle changes in what you offer and how you offer it can have a big impact on choice and waistlines without causing mutiny. Target makes the healthy choice the easy choice [aka default choice] by giving employees an extra discount on healthy food and workout clothing purchased from their stores. Other companies such as IDEO are finding success simply by putting the water on the top shelf and soda on the bottom shelf in company fridges. Employees are now drinking more water than soda. 

Reflect your cultural values in your program
Think about what your company does, who your company serves and what the company values for ways to link your wellness program to the core mission. Target successfully aligned their business with their social mission to reinforce their cultural values of wellness in the communities where their employees live and work.

Engage people who can inspire healthy changes and support the program
Dayton, Ohio RTP [Fat Bus Drivers] took a risk by adding a health coach and it paid off over time by reducing healthcare costs. The “secret” to their success is that they truly care for their people and it’s reflected in everything they do from privacy to celebrating milestones. Having a boss that has walked a day in your shoes probably helps too. Mark Donaghy, CEO of RTP shared at the recent FitBit Captivate conference that he started as a bus driver and to this day still identifies as being a bus driver. Can you imagine having a boss that not only relates to where you are now but also shows you the path to a more successful life? That’s powerful.

Reward Healthy Behaviors
Share the healthcare savings with employees who participate and meet their goals. The Dayton Ohio RTP program rewarded employees who participated with enough money to cover the increase in premiums each year. Doing so reinforced the fact that healthy behavior lowers healthcare costs for all.

Successful wellness programs do more than lower healthcare costs. Publicly traded companies with wellness programs are outperforming their competitors with better recruitment, retention and productivity.

About the Author: Shannon Smith is a healthcare strategist with over 15 years of helping companies achieve greater success and the founder and CEO of Hello Workout, Inc.

Keep it Simple

Einstein was famously quoted saying “Make everything as simple as possible…”.

Keep it Simple may sound like common sense for some however, making a product or process simple takes a lot of work.  For large companies it is the latest transformative concept being used to recruit and retain good employees. Technology is now enabling large companies to offer employees more control over their work life. How you ask? It starts by giving people more flexibility over when and where they work. For instance:

Virtual office environments and collaboration tools are enabling people to work from where they feel most comfortable whether it’s at home, in a coffee shop or at the office. Large employers are realizing that people don’t need to be in the same physical location or even in an office to collaborate effectively and that employees are more productive when they can choose where they work.

Employee portals provide access to information and people on demand and now guide employees through essential processes so that they get the right information tailored to them at the right time. Employees can complete their on boarding paperwork, quickly build their internal network by connecting with coworkers, managers and other colleagues, find courses and training programs and manage their benefits from one place. 

Sounds good but like with all technology the effectiveness depends largely on how it is implemented and embraced by the organization. For example virtual offices can be plagued by the same types of biases as physical offices if the focus is still on presence [people logged in] rather than performance.

Transparency is a key ingredient for an initiative like Keep It Simple to be truly transformative.  Companies need to be transparent about the things that matter most to employees like pay and performance measures.

Compensation: Pay is still a problem for most companies largely because salary history is still a function of the compensation formula or at least a benchmark used to set future pay. What people were paid in the past or at another company has nothing to do with the value of their contribution in a new role.  Replacing salary history with a base pay for everyone would eliminate past inequities especially for women and minorities and properly value the work being done.

Performance measures: Job descriptions rarely make the priorities of a job clear. Often they contain a long list of duties but rarely spell out how success on the job will be measured. Think about it….what is the elevator pitch for your job?  If you can’t articulate what you do, your job description is likely too vague and it’s time for a chat with your manager. If you have a pitch, try it out on your manager. It’s probably the fastest way to find out whether you’re in sync or if there is a gap in understanding that needs to be closed.

We all have lists of things that we’d like to do and then there are things that we have to do whether we like it or not. If we want people to focus on things that they have to do for the company to succeed, the nice to dos have to eliminated from the job description. In fact it may be time to replace “job descriptions” with job summaries that highlight the top 3-5 responsibilities and personal qualities needed to succeed in the role. Make them real so that employees can see into the job [be transparent about a day in the life] and decide whether it’s right for them now or not.

About the Author: Shannon Smith is a strategist with over fifteen years of experience helping companies achieve greater success.

Let’s Change the Game

Medical risk is like the hot potato that keeps getting passed around between the government, employers, insurers and providers.  Similar to the hot potato game, whoever ends up holding the medical risk usually looses the game.

The responsibility for managing medical risk includes the responsibility for managing a big pot of money to administer claims. Medical billing and collections, as described by Jonathan Bush, founder and CEO of Athena Health, is one of the stinkiest parts of healthcare that few providers do well. So basically by transferring risk to providers they end up with more of the stinky stuff that they haven’t been able to manage well. That alone give me heartburn because the stinky part is critical for monitoring the overall health of the risk pool and their organization.  However, there is even more to the story.

Risk + Money = the Risk Pool:

Healthcare trends like the aging population and the number of obese and overweight people are the risks that suggest a need for a very large pot of money to pay for healthcare. Unfortunately for providers, all the other players in the hot potato game are basically saying they’re tapped out. So healthcare providers somehow have to figure out a way to do more with less. In other words, they are getting less money than they need to pay all the expected claims. 

Do More with Less:

Many providers are accepting the challenge to do more with less even though it’s never been their strong game. Most have been focused on delivering the care patients want regardless of cost because historically, they have been able to make enough from some patients to cover all the bills for everyone. So at this point no one really knows how to do more with less successfully.

Building regulations, staffing regulations and lack of pricing transparency for medical supplies make it challenging to cut costs that companies in other industries routinely cut. Some savings will be realized if providers share records and reduce the amount of duplicate tests but the bigger savings come from not delivering care at all. Providers have yet to figure out how to say “No” to patients who want medically unnecessary care without getting a bad review and how to get people covered by their risk pool to live healthier lives.

Medically Unnecessary Care:

People who are really sick rarely think care is unnecessary even if a treatment has a very slim chance of working. Who doesn’t like to think they will be the exception to the rule? Isn’t that part of positive thinking? That’s what makes coming up with care guidelines so difficult and hard for providers to adhere to. Saying No or No unless you pay for it upfront is hard for all the players. Insurers did a better job of playing the bad cop because they didn’t have to face their member and tell them the bad news or work with them day-to-day.

What healthcare consumers need to understand is that healthcare insurance doesn’t mean covered for everything and anything. Few healthcare consumers read the fine print of their policies before they need to access the benefits – and unfortunately, that’s when the frustration begins for everyone.

Live Healthier:

There are a lot of people in this country carrying too much fat. Providers tippy toe around the issue by telling patients they are at risk for disease and/or by letting them know their BMI measurement is beyond the healthy range. You can only imagine that some patients don’t really see the problem with a point or two beyond normal and why some patients are not connecting the dots or getting the right message about fat. Fat causes a lot of health problem that are costly to treat and makes it hard for providers to do more with less.

Wearables may help connect the dots for some healthcare consumers. The latest technologies measuring our motivation, movement, sleep and food consumption can help us develop awareness, establish a baseline and monitor metrics during periods of physical change.

The problem with wearables now is that they are not sticky enough without a financial incentive to motivate the healthcare consumers who needs to loose weight and they are addictive for people who are already extremely active. Both groups are problems for healthcare providers trying to do more with less.

The Point:

There are a lot of questions left to be answered about how to make it all work so that providers can do more with less and patients get the care they need and want. It’s going to take some more honest conversations and fresher thinking to change the game.

The one thing we know now is that everyone can help by eating a healthy diet, exercising and living an active life.

About the Author: Shannon Smith is a healthcare strategist with over fifteen years of experience helping companies achieve greater success.

Workplace Wellness

Leading edge companies are coaxing their employees into the last frontier of the culture change underway in the healthcare industry – wellness.

For many the thought of employers accessing their health information seems invasive and worrisome because the use of their information may seem like more of a motive or agenda to rid the company of people with negative health habits.  Most people know that the obesity rate is on the rise, smoking causes some serious health issues and the stress of balancing the demands of life is growing as more people become caregivers for children and/or aging parents. 

The problem is that the majority of people cannot see their own health risks.  People often rely on friends and family to help them with other decisions and see issues in their life, but relying on friends and family to help with their health issues is not working.  Let’s face it – talking with friends and family about how you feel about your body or life invites comments and judgements that can be destructive to the relationship.  No one wants to hurt the feelings of someone they love or care about which is why it is so difficult.  So the question then is who should provide and/or hold the mirror to help us see our issues?  

Employers are stepping into the role to provide the mirror and in some cases, are holding it for us.   Why the employers?  We all have a relationship with our employer and there is a mutual benefit if we are healthy and happy on the job and in our individual lives. Several companies on the leading edge of wellness recently spoke at the Silicon Valley Leadership Forum Wellness Summit about their journey into wellness and the success of their programs.

Progress is being made but there is still a long way to go to ignite the wellness revolution in America.  So let’s revisit the culture change framework to get a better understanding of where things are now and what still needs to be done.

Getting Started

Change starts with establishing new behaviors.  The way we work, what we eat and how we live has changed since employers started providing healthcare insurance.  The system that served us well way back then is not working for many people now or the companies competing in the global market.  

To get a competitive advantage or to just level the playing field, some companies are shifting more of the financial burden onto employees to help reduce their labor costs.  However, the leading edge companies are showing us that there are better ways to go about it.  They are providing the mirror in the form of biometric screenings so that employees learn their numbers and know where they stand on health.  Many are starting to change workplace policies, implement benefits to promote healthy living and model healthy behavior in the workplace.  How you ask?  

The programs are as different from company to company as the people they serve.  There is no “silver bullet”.  However, there are some common elements such as discounts on programs such as Weight Watchers to promote diet modification, company gyms or discounts to clubs and gyms to promote regular exercise, standing and treadmill desks to promote movement throughout the day, the use of yoga and meditation practices to promote mindfulness and stress reduction and individual support whether in the form of concierge services, health coaching or on demand solutions.  

If there is one “silver bullet” common to all programs, it is the use of financial incentives to gain participation and engagement.  The promise of better health is simply not enough at this point.

Making Progress

Progress makes people happy. There are glimmers of happiness with the wellness programs in place now.  The leading companies have figured out the right elements of the program needed and have the leadership and financial support to fully implement the initiatives for a successful program.  Other companies are struggling to develop a meaningful program because the Return On Investment (ROI) is not clear to the leadership and is generally not immediate or certain over the long term.

A study was done of the Johnson and Johnson wellness program in  2010 that showed a 3.7% lower average annual growth in medical costs and a return of $1.88 – $3.92 for every dollar spent on wellness.  The Johnson and Johnson program is notable because it has been in place the longest of any program and is routinely evaluated and modified to meet the changing needs of their employees.  Other studies done by Johnson & Johnson since the 1980’s report improved employee health, reduced inpatient healthcare spending and decreased employee absenteeism – all indications of happier employees.

Health is part of the DNA of Johnson and Johnson.  The company’s Credo from 1943 reflects their commitment to healthcare providers and the health, wellness and safety of their employees.

Earning Support

When you tell people your goal and they can see your commitment you will get the support needed to achieve it. Getting people to tell employers their issues and goals can be a little tricky even though there is a mutual benefit. 

Employers can do a lot with the the relationship that exists with employees but like with any relationship there are limits as to how far the relationship can go.  Depression is a bigger issue than diabetes and an issue that often goes unreported because of the stigma around mental health.  

Google reported a rate of 6% but suspects that depression is more prevalent in their workforce.  There was discussion at the summit around ideas and initiatives to support people with depression but most panelists acknowledged the challenge of getting help to the right people at the right time.  So who’s in the best position to help with this kind of issue?

Who is the question that remains to be answered.  It may be the employer, it may be friends and family as health and wellness initiates make it into the home, it may be healthcare providers or it may take the entire village to pitch in, help out and provided the needed support.

Progress is being made to promote health and wellness but conversations are just starting about work life balance and/or work life integration in terms of what makes people happy and more productive.  

About the Author: Shannon Smith is a strategist with over fifteen years of experience helping companies achieve greater success.