BP America

In December 2009, BP initiated their National strategy by consolidating existing local wellness programs into one integrated approach with a broad framework and the ability to tailor locally by business segment. In 2010, they introduced two unique self-insured medical plan options, with a higher-value option tied to their incentive design and worth an estimated $1200 due to lower deductibles, co-pays and co-insurance. In 2013 they introduced a high-deductible health plan with outcome-based incentives with an additional $1000 for the spouse/ domestic partner.

As one indicator of the comprehensiveness of BP’s initial health management strategy, the HERO best practices scorecard placed BP’s program well above the national average (i.e. 169 points out of a max score of 200) in 2010. Since that time the program has continued to expand and innovate, as indicated by a 10% increase in the HERO scorecard best practice score in 2013 (185 points). The increase was driven by expanded programs and increased leadership engagement.

Based on pre-established goals, BP’s Wellness Program has exceeded program targets for engagement, health improvement and savings every year.

BP Wellness program Overview

• Health Assessment- Survey that assesses health risks and invites to programs
• Health Portal- Hub for health related information, tolls and resources and integrated with overall benefit program
• Health Advisor- Call to health professional to review health assessment results and to discuss programs
• Lifestyle management- targeted telephonic and mail- based coaching for back care, BP, cholesterol, nutrition, exercise, stress, tobacco and weight
• Disease management- targeted telephonic and mail- based coaching for asthma, congestive heart failure, coronary artery disease, diabetes, hypertension and chronic obstructive pulmonary disease
• Wellness Classes- Library of live/ recorded seminars on health related topics
• Physical activity Campaigns- Get Fit on Route 66, Run amuck year round global events
• Healthy Living Programs- Online 6 week programs with content, tools and online sessions based on stages of change model
• Biometric screening- Free to employees with option of on-site screenings
• Metabolic Screening- Focused evaluation to identify at risk population and early intervention
• Nurseline- 24/7 service
• Case management- Integrated into incentive design
• Nicotine Replacement therapy- Telephonic lifestyle management participants medication support including NRT or prescription medicines
• Local activities- Local events hosted at all key locations
• EAP- telephonic online and face to face support for family care giving, emotional well being, health and wellness, daily living, adoption, parenting, child or elder care, education, grief, loss etc. two-way referrals between coaching programs and EAP
• Onsite Health and Wellness center- State of the art facility at Westlake corporate campus
• Onsite Fitness facility- Multiple sites
• Access to healthy food choices- Nutritional education, Point of Sale nutritional labeling, healthy vending machines and live cooking demo classes
• Environment that embraces exercise- Creation of safe walking spaces, membership at fitness facilities, sponsorships for walking programs, fitness breaks etc.
• Weight Management- Intensive intervention with wireless scales and actipeds
• Financial Classes- Integration of Wellness and Finances, one-on-one financial coaching, 10 different classes offered to help with financial stress
• Safety- BP starts every meeting with a “safety education moment”

As part of the overall health strategy, BP developed a comprehensive program evaluation plan that encompasses process, impact, and outcome measures. The financial impact analysis is supported by an integrated data warehouse that is maintained by StayWell. Analyses are conducted annually by Mangen Research associates with oversight by Mercer, on behalf of BP. Health outcomes are reported by program supplier, StayWell with report review conducted by Mercer. Health impact measures rely on a variety of data collection strategies including web-based, phone-based and mail-based participant program surveys, health assessment data and biometric screening data. Quarterly Performance Reviews are conducted on each program component to inform our data driven strategy ad ongoing program enhancements.

Health Risk Reduction

For the total 24,893 employees and their dependents, the average number of health risks decreased 10.3% from 2.8 to 2.5 health risks out of the total 8 health risks that were assessed.  Blood Pressure and Cholesterol outcomes improved significantly for the subset of the population that voluntarily reported their biometric results on the health assessments. Individuals, who completed a phone-based or mail-based health coaching program in 2013, experienced a 6% risk reduction, with health risks shifting from 2.9 to 2.7 total risks from 2012 to 2013.

Financial Impact

A quasi- experimental study design with statistical controls for confounders was used to measure the program’s impact on medical and pharmacy costs.  The results showed that the annual ROI results varied over time. The first program evaluation period was based only on wellness program components which yielded a return of $0.63:$1. In the second program year, the program was expanded to include spouses and DM coaching programs with an ROI of $3.00:$1 across both the wellness and the DM program evaluations. In the third program year, the ROI was $2.10:$1. Co-incidentally the cumulative ROI across all three program years was $2.10:$1

No one measure of success fully represents the BP Wellness Program’s strong performance. Rather, it is a combination of high participation rates, effective program components, strong population health risk reduction and demonstrated cost impact based on both a rigorous study design and observed changes n trend that provides convincing compelling evidence of success and captures the full profile of a program that exceeds expectations and best-practice benchmarks.

• BP America

REVIEWER 1

• Program was offered to all employees (every location, union, non-union, retired, etc) as well as spouses.
• High participation (91%).
• 5 year track record, with an ROI ranging from $.63:$1 to $3.00:$1.
• They have a wellness council and a specific communications team within the council to distribute information.
• They have involvement and participation from leadership and shareholders.
• In 1 year they send over 100 types of communications in 10 modalities.
• They have onsite workout and medical facilities that are available at discounted rates (lower co-lays).
• They offer the medical discounts at the lowest level and offer additional incentives if employees go above and beyond.

REVIEWER 2

• 91% participation.
• HERO scorecard.
• 10% health risk reduction.
• Claims-based ROI analysis, quasi-experimental design.
• Comparison group with propensity score weighting.
• 2:1 ROI.
• Includes spouses/domestic partners.
• Emphasize employee involvement throughout process.
• Comprehensive communications.
• Range of offerings.
• Wellness council.
• Web portal tailored to health status.
• Assess communication efforts.
• Primary-level interventions.
• EAP.
• Targeted biometrics and physical activity.
• Work with quality vendors.
• Multi-method evaluation.
• Quarterly review and refinement.
• Enrollment in preferred benefit plan as incentive.
• Risk improvement for physical activity, nutrition, preventive exams and stress.
• Financial impact – quasi-experimental design controlled for confounding variables.
• 2.1:1 ROI.
• Detailed explanation of methodology.
• JOEM publication.

REVIEWER 3

• Large, diverse, nation-wide program.
• Excellent corporate communications.
• Risk reductions 10 % in two years.
• 25 K participants
• Good appended study abstracts
• Good trend analyses

REVIEWER 4

• Comprehensive program
• Good data analysis
• Positive health and cost results
• Well-organized application
• Began program in 2009
• 91% participation
• N=85,000 – 25,000 in cohort analysis
• Wellness council
• Link safety to health promotion
• Excellent quasi-experimental design
• Good documentation
• Published findings

REVIEWER 5

• Structure: large employer with very challenging population, longevity of program
• Participation- challenging and large population with rates around 60% that had decreased from higher rates in 2010, which might just be related to the challenging population
• Evaluation by Staywell and third party
• Health outcomes- specific risk changes noted for physical activity, nutrition, weight, stress and preventive screens
• Cost- ROI 2.10 to 1

REVIEWER 6

• Comprehensive and integrated health management programs
• Sustained and favorable participation by both employees and spouses
• Expanding health improvement initiatives, e.g. Million Step Challenge
• Favorable population level overall risk improvements (with notation that BMI did not improve)
• Involvement of vendors/consultants able to fully understand and guide the evaluation process and financial analytics
• Favorable ROI

REVIEWER 7

• Proposal components present- yes
• Program structure (integration, rating system)- yes
• Program Longevity (≥ 3 yrs)- yes
• Population Covered (population, subgroups, disparities)- yes
• Participation (rates, inclusion, incentives, benchmarks)- yes
• Financial Outcomes (comparators, years, methods) - Very well documented.

REVIEWER 8

• Progressed to an integrated health management program
• High participation rates
• Exceptional program mix
• Outstanding communication strategy
• Comprehensive evaluation

REVIEWER 9

• The overall program seems have a very strong design. Use of the HERO Scorecard provides a useful tool to confirm this.
• The management structure including the wellness council, communication, health assessments, live and online skill building programs, incentives, onsite facilities, nutritious food and tie in to safety all seem strong.
• Allowing employees to get biometric values through their own physician on onsite screenings increases participation.
• Offering classes during work time is very generous. The cost of this time should be included in the ROI calculation.
• The quasi-experimental design with propensity score matching is a very strong methodology.
• Providing access to all types of employees, as well as spouses and retirees is commendable.
• Participation rates are excellent.
• Health improvements are impressive.
• Medical cost savings are impressive. Reporting results by year is appreciated.

REVIEWER 10

• Innovative program design. For example, wellness requirements to qualify for preferred health plan, and fitness program leveraging biomonitoring devices.
• Good participation, including 66% HRA, and 58% earning enough points for preferred plan.
• 10% aggregate health risk reduction between 2010/2012 and 2013.
• Direct healthcare cost savings for participants vs. non-participants, and positive ROI.

REVIEWER 11

• Broad participation
• Benefit plan based incentives
• Innovative encouragement