Ericsson is one of the world’s leading providers of Information and Communication Technology. Ericsson North America is headquartered in Plano, Texas, and employs nearly 6,300 workers. Ericsson offers a comprehensive and competitive health and welfare benefits package and the E-Health Wellness program to support the physical, financial, emotional and social wellbeing for its employees and their families. The program is well-integrated into the organizational infrastructure and has yielded significant improvements in population health and noteworthy business results over a 4-year period. In 2018, 74% of employees and 47% of spouses registered for the E-Health program and completed at least one activity. A risk migration cohort analysis of 3,626 employees found a positive net improvement of 3-4 percentage points over 4.4 years. Similar results were found when examining medical utilization data with participants having fewer hospital admissions and emergency department visits but higher rates of preventive examinations.
Ericsson offers a comprehensive and competitive health and welfare benefits package (E-Care) for our employees and their families. We invest in our employees, recognize their contributions and ensure that every individual shares in our success. Our benefits strategy and philosophy emphasizes these objectives – creating a culture of wellbeing and highly engaged employees, providing a robust portfolio or programs, ensuring a positive employee benefits experience, increasing inclusion and diversity and strengthening employee perceptions that they work for an employer of choice.
From a health management perspective, Ericsson offers the E-Health Wellness program to support the physical, financial, emotional and social wellbeing of our employees and their families. Since 2012, E-Health has been backed by an innovative wellbeing platform provided though our vendor partner, The Vitality Group. Eligible members use this mobile-enabled platform to complete Health Risk Assessments, review biometric results, track physical activity, set goals, complete goals, and participate in other healthy activities, etc.
At work, employees have access to an onsite gym, walk stations, standing work desks, onsite fitness classes, recreational activities, walking trails and cafeteria with healthy options. E-Health also offers competitive rewards and incentives. Members earn points for engaging in activities which accrue to engagement status levels of Bronze, Silver, Gold or Platinum. Points can be redeemed for gift cards or merchandise.
- Investments in high-performing programs support employee wellbeing
- Strong culture of health has enabled high performance in program engagement, health outcomes and business metrics
- E-Health Wellness program has impacted overall healthcare costs and utilization
Submission Approach and Methodology:
Ericsson and Willis Towers Watson leveraged a two-part approach for this application:
Part I: A review of aggregate program reporting to demonstrate year-over-year increases in program engagement and improvements in health and business metrics
Part II: A 3 year (2016 – 2018) matched cohort analysis of program participants and non- participants to demonstrate how participation in the E-Health program is correlated with lower medical cost and healthier behaviors
Part I – Retrospective Aggregate Program Data Review:
‒ Key E-Health participation and engagement metrics have increased since 2012 over Vitality’s Book of Business
‒ A review of a 3,626 participant cohort revealed transitions to lower health risk levels over a 4 year period
‒ From a Value on Investment (VOI) perspective, engaged E-Health participants also have lower turnover and absence rates, and higher rates of job performance and job satisfaction
Part II – Matched Case Cohort Analysis of Participants and Non-Participants
‒ Financial outcomes:
Per Member Per Year (PMPY) allowed costs for medical and pharmacy were higher for non-participants for all three years
A difference-in-difference calculation also showed that the variance in costs between 2018 and 2016 was higher for non-participants
‒ Health Care Utilization and Consumerism Behaviors:
Participants had higher preventive care rates and fewer office and emergency visits
Participants also had fewer hospital admissions and shorter lengths of inpatient stay
• Multi-year written wellbeing strategic plan aligned with broader benefit and HR objectives
• Holistic approach to encompassing multiple wellness dimensions including financial
• Recognizing and incorporating diversity as an element of wellbeing
• Incorporating employee recognition and other social elements into strategy
• Active management of vendor integration, including Vendor Summit
• Work toward integrating mental and emotional health programs into wellbeing strategy
• Positioning incentives as rewards and offering choice in how they are earned
• Extensive communication strategy incorporating digital, traditional and home reach
• Favorable medical and Rx trend comparisons on a large cohort of the population based on difference-in-difference method, including drilldown to key utilization metrics
• Holistic approach to wellness
• Targets families in some programs
• Matched participants/non-participants
• Easy activity to point to dollar conversion system – with many opportunities to earn points and achieve higher status levels (like a frequent flyer program)
• Fun activities/games to earn points in addition to health-related activities
• No penalties
• Healthy food program – earn rewards to neighborhood groceries for healthy purchases
• Extensive communications strategy
• 74% enrollment of employees and 47% of spouses in 2018 – and 75-80% completing at least one activity
• Participation increasing over time – holding steady at about 50%
• Cohort analysis (N=3,626) – risk migration is positive with a net improvement of 3-4 percentage points over 4.4 years
• Employee satisfaction score (N=648) is high 8.4/10
• Good methods used for medical and health risk analyses – matched cohorts (P vs. NP N’s=4,377/each group) (2016-2018)
• Good results in terms of hospital admissions and ER visits
• Good listing of limitations
Overall assessment: This is a very comprehensive, mature initiative with strong participation rates and excellent health, financial, and business impacts demonstrated.
• Comprehensive approach focuses on physical, financial, emotional and social well-being. Elements include HRA, biometric screenings, physical activity tracking, goal setting and completion, healthy activities. Strong documentation of offerings targeted to each area.
• Built environmental supports promote physical activity
• Strong offerings to support mental health and engage highly male population.
• Specific mentions of diversity and inclusion efforts focused on increasing women in leadership and offering transgender benefits.
• Provides zero funded health plan option with high deductible and funding for HSA.
• Robust incentive design with many different ways to earn incentive. Unique approach provides rewards for healthy food purchases at grocery stores.
• Application addresses program integration across vendors and across benefits offerings.
• 74% of all employees, and 47% of all spouses, registered for the E-Health program and completed at least 1 E-Health activity. Detailed participation by program element indicates participation increased over time and exposure to behavior change activities exceeds Vendor benchmark.
• Relied on cohort analysis of health risks. Demonstrated net risk improvement among cohort.
• Another analysis compared highly engaged to low engaged participants and demonstrated risk improvement for most highly engaged.
• Medical cost impact relied on propensity matched controls and a differences-in-differences savings calculation, demonstrating significant cost impact over a 3-year period.
• Sub-analyses indicate better hospital admissions rates, length of hospital stay, ER visits, avoidable ER visits, office visits, and preventive exam compliance. Demonstrated impacts in absence, turnover, job performance, work satisfaction when comparing most highly engaged with lower engaged participants.
• Data dashboards the organization is using to track overall performance of initiative are impressive.
• Very complete design.
• Amazing that they do not link wellness incentives to premiums in this day and age.
• Appreciated the risk migration analysis.
• Good tie-in to key business indicators!
• Showed reduction in claims cost
• Exhibit G, integrated scorecard, provides multiple risk and outcome measures where data were available (sample size should be reported for all charts so the denominators and numerators can be ascertained).
• Exhibit J provides a participation cascade chart.
• The Artemis Data warehouse was recently added in 2018, a potentially promising addition but not enough time to be determined.
• Matched cohort based on age, gender and risk and difference-in-difference method used in series of charts in exhibit S. Where biometrics were available, participants were generally healthier than non-participants.
• While there was a demonstrated cost reduction, it is unclear if costs to employees were assessed in addition to traditional PMPY measures.
• Application is nicely organized and clearly describes the diverse population of Ericsson.
• Comprehensive and clear health and well-being strategy to include wellness initiatives based on needs and best practices (onsite screenings, teledoc®, CBT, medical reviews for musculoskeletal and cancer; financial well-being; low or no deductible for health care), along with a comprehensive communication strategy.
• Significant measures and reports presented – not all connected to the overall intention of the application, but many are helpful in observing general trends.
• Health risk reduction noted among wellness participants.
• Health care cost reduction noted in among the wellness participation cohort (n=4377) as compared to the non-participants/bronze categories (n=4377).
• Longstanding program
• Zero contribution health plan (exceptional)
• Good mix of programs
• Seemed to have good outcome results but poorly displayed and interpreted
• The program scope seems comprehensive and uses a good combination of motivational, skill building and environmental strategies. The communication strategy seems comprehensive. Participation rates are excellent for the HRA and very good to reasonable for other offerings. Satisfaction rates are also strong.
• Health improvement from a risk level are good. It is not clear from the description if the biometric risk is self-report or actual measurement.
• It is encouraging that changes in most PMPY costs and utilization were in the desired direction from participants compared to non-participants but disappointing that preventive exam compliance got worse for participants.
• Comprehensive program
• Written multi-year strategy
• Vendors include Vitality, Quest, Aetna, BCBS TX, Express Scripts, AbleTo, Grand Rounds
• Addresses the full wellbeing continuum
• Many on-site and environmental features, programs and services
• Incentive points design with gift card rewards and no premium costs
• Multiple measurement approaches
• Demonstrated impact on health risks, costs, health service utilization
• Vitality portal and rewards, along with health assessment, screening, environmental supports, DM/CM, telehealth, well-being, and other resources
• Integrated data and dashboards
• Good participation: 74% ees (47% sps) on portal, 51% assessment, 41% screening
• Engagement increased consistently from 2012 to 2018
• Good overall risk improvement over time (7.4% risk profile improvement, average 4.4 years between T1 and T2, n=3626)
• Matched cohort analysis showed lower medical/Rx costs and trend 2016-2018 for engaged participants vs non/low engaged (n=4377) $75 difference in difference
• Highly engaged also had better metrics related to absence, turnover, job satisfaction, and job performance
• Positive employee satisfaction and perceived value scores
• Participation improvement
• Positive survey results
• Good improvement in risk categories
• Spouse participation