There’s No Growth Without Health: Employee Wellbeing Is Non-Negotiable
What’s incredible to me about this statement is, first, I wholeheartedly agree and have been shouting this from the rafters for years now. Second, it’s that little word that packs so much meaning: “now.”
Workers now expect this.
That’s a telling detail. It’s not that the desire to be viewed as an individual human being is new. It’s the idea that they could actually expect that from an employer that is the powerful idea here. The balance of power has shifted, and employees know that they can raise their level of expectation. And they are.
Here’s more from Gaver: “While standardization has brought the HR industry to where it is today, customization and personalization is how HR will evolve now and in the future.” She quotes Dr. Solange Charas, a human capital expert and adjunct professor at Columbia University and the University of Southern California: “Organizations that aren’t actively embracing an employee-centric business model will soon find that their competitive advantage will erode, along with a diminished employer brand and sub-optimal efficiencies.”
Last year I wrote about how the pandemic is accelerating changes in the way people access care, including the increased acceptance and streamlined accessing of what are known as digital therapeutics or digital care pathways—tools that can be helpful in personalizing care.
Sadly, it took a pandemic for some of these ideas about personalized health and well-being to start to sink in for both employers and their employees. It took a pandemic to drive home the point that the systems and models we built during the age of standardization are no longer relevant in today’s age of personalization. And it took a pandemic for people to understand what I’ve meant all these years when I say that every employer (no matter your industry) is in the business of health.
Case in point: In MetLife’s annual U.S. Employee Benefit Trends Study 2021: “Redesigning the Employee Experience: Preparing the Workforce for a Transformed World,” MetLife identified the top three factors that will affect the workplace of the future. Employee well-being is predicted to have the greatest impact on the workplace of the future (74%), followed by the ability for employees to work remotely (71%), and employee mental health, stress, and burnout (70%). Nearly three-quarters (72%) of employees rank work-life management benefits and programs among their top five desired benefits to improve well-being.
MetLife reports that employers are expanding the range and customization of benefits, improving communications around those benefits, and offering more added value programs.
75% of employers are enabling employees to have greater customization of their benefits (or intend to).
74% of employers are offering more added-value services for employees, such as mental health programs or employee assistance programs (or intend to).
66% of employers are expanding the range of employee-paid benefits (voluntary benefits) offered (or intend to).
“Or intend to.”
I like the optimism in those numbers, but I also know how hard these kinds of changes can be. To achieve greater customization and new value-added services, you have to:
1. Know your people.
But that starts with:
2. Giving people ways to share what they really need.
But the success of that depends on:
3. Helping people feel safe enough with you to be vulnerable to ask for what they really need.
That’s an employer’s biggest obstacle. We don’t know each other as individuals, and we don’t know what’s really going on in each other’s lives. That hampers our ability to provide the level of health and well-being support that employees need and value. The MetLife study found that nearly 3 in 4 employers believe employees are better off than they are, and that disconnect may lead to companies not prioritizing well-being as much as needed.
You don’t just need an updated list of new benefits and programs. You need ways to get to know people, ways to let people know it’s safe to share what they need to share in order for us to know them, and ways to offer flexibility and a range of options in order to be as personalized as possible.
I sought several perspectives for this exploration:
-A large employer: Chico’s FAS, Inc.
Kristin Gwinner, EVP and Chief Human Resources Officer
-An NCI designated comprehensive cancer center, partnering with employers: City of Hope
Harlan Levine, M.D.
-A healthcare system: RWJBarnabas Health in New Jersey
DeAnna Minus-Vincent, MPA, SVP and Chief Social Integration & Health Equity Strategist
-A philanthropist: investing in economic empowerment
Percy “Master P” Miller, Philanthropist, Businessman, Entrepreneur, Music Mogul and Founder of No Limit Records
Their stories combine to show us how we can get to know people in ways that feel authentic and safe, and how to extend what we offer to expand benefits beyond the transactional, cost-center approach.
The Art of Sharing
“We are fortunate that we have people who want to share with us what's important to them.”
Kristin Gwinner said that during our conversation and she was talking about their employees’ openness to share about themselves. I feel the need to push back on one word: “fortunate.” The people who work for Chico’s FAS, Inc. don’t just happen to be people who want to share their lives with their colleagues and bosses. They wouldn’t share if they didn’t feel safe, and if a culture of sharing didn’t exist. That culture is due in large part to the deliberate approach taken by Gwinner, who is EVP and Chief Human Resources Officer.
Here’s how Gwinner describes her priorities: “In addition to benefits, our priority is loving somebody through a difficult time—checking on them, calling them. We're doing many things that don't have anything to do with company benefits. But it's because we literally care about you.”
She gave an example that was close to her heart. A woman on her own team passed away from cancer. They invited her parents to the campus so they could honor their beloved colleague and friend.
“We dedicated a tree to her on campus and the parents came and we had a service for her,” said Gwinner. “Everybody held up signs with words they associated with her: gracious, sensitive, beautiful, thoughtful. Then a couple of people, if they wanted to, could say a few things to the parents. That's what I mean about loving each other. It's those kinds of moments that matter. I have thousands of stories, but they're not all the same because they're personalized to the person. They're all unique. That's just one. We haven’t done that again for someone else, because that wouldn’t have been personalized.”
But how do you personalize for thousands? One way is to create multiple methods for listening at scale: reactive listening, proactive listening, and keeping both on a constant loop. She said you have to pay attention to what's important to your associate base.
Employees say they want convenience, so Chico’s FAS offers health clinics, cancer screenings, gyms and childcare on site. “We do things like biometric screenings, we do health and wellness, we do nutrition, we do mindfulness classes. We help people learn how to meditate. We find it important because it allows people to deal with all of the things that they have going on in their whole life, not just their work life. So, it's those types of things going on that when you look at the whole person you start to think different on your solutions.”
Speaking of whole life: Care.com asked 500 human resource leaders and C-suite decision-makers what employee benefits they plan to keep, get rid of, add, and expand as a result of lessons learned during the pandemic. In a Harvard Business Review article, Care.com CEO said this, which points out the basic humanity at stake here: “Work-life ‘balance’ has always been a lie. Work and life are not independent entities fighting for 50/50 equilibrium. They’re interconnected, and one affects the other. But people — especially women — have been conditioned to design life around the demands of work, and rarely to design work around the demands of life.”
I asked Gwinner for her perspective on work-life balance. In the end, we're still expecting our associates to perform. So when do you know that health and wellness gets in the way of performance?
“I don't think there is balance. Your life will take a journey. You teeter totter up, down, up, down, and when you're lucky and everything's in balanced, terrific. But then there are times when life throws you curve balls. And that's where I think employers need to be understanding that there are many aspects of each of us, not just the title, not just the person you see at work.”
But she said you can't stop the feedback loop. “We listen all the time. We're never done. We continue to get smarter when we pay attention to those who have real stories, because it helps us figure out how we could do something better or more impactful for our people next time.”
There are so many health crises that can impact that work-life balance. “There's a lot of examples where children are born premature, or people who are wanting to start a family or those who are adopting a family—where it’s something that is taxing on a family. That’s where you have to wrap around the whole person. How flexible are you with your organization? What kind of care are you providing to them?”
“Another challenge is how do we help with elder care? A lot of us have parents who are aging and they need care. We have several associates whose parents have been very ill and they've taken them into their house and cared for them. Again, we want to give them the love and understanding and care to be able to care for their loved ones.”
I hope those of you in benefits management see the importance of listening to employees and letting them be the drivers of your health and wellness strategy. Because I’ve had executives tell me that their benefits only change once a C-level executive has personal experience with a health crisis—not necessarily because they don’t care, but because that’s the only way those in charge are made aware of the hardships that affect all aspects of life.
Circling back to Gwinner’s story about the woman with cancer.
“We have associates who have personally been impacted by breast cancer, for example. We have a lot of personal stories of several who have had significant health issues like that. We try to proactively figure out how do we get them the help they need? Not just the insurance, but also the advocacy so they can navigate which specialist they need, how to get the care that they need at the best price, so they can make the right decisions for their own health, not only in preventative, but in this case in crisis mode.”
Democratizing Cancer Care
Harlan Levine, M.D., is with City of Hope, a world leader in the research and treatment of cancer, diabetes, and other life-threatening diseases. He is the organization’s president of strategy and business ventures and serves as the board chair of AccessHope, City of Hope’s wholly-owned subsidiary focused on serving the employer market and making leading-edge cancer care available to all regardless of geography and other demographics.
Among other goals, he wants to help employers make the most of this opportunity identified in the MetLife study: “Employers have an opportunity to help employees better understand what benefits do how they complement each other (particularly with medical insurance), how they can be personalized, and how they apply to real-life situations. When employees understand the full picture, they can identify how benefits work in unison to meet their individual needs.”
When it comes to how employers help people deal with cancer, Dr. Levine explains the urgency: cancer is expensive, the outcomes vary, and it’s a disease that can totally disrupt a person’s ability to live, to enjoy life, and to work productively.
“Cancer is often one of the top three expenses for an employer. While the percentage of people that are actively in cancer treatment is about 1%, cancer comprises somewhere between 12% and 14% of healthcare expenses. In addition, the outcomes are variable. And finally, when someone has cancer, it is so disruptive to the individual, the family, the workplace that there's a significant business win in doing the right thing for the patient, getting them the right care.”
He said cancer care, from the perspective of employee benefits, is ripe for change and disruption.
“Employers need to do something differently because what they're doing today, quite frankly, just isn't working.”
“I think people are beginning to recognize that to scale a solution and pay claims and have benefits and have a network, you need to have a certain element that is one-size-fits-all, but that’s not really sufficient for a cancer patient,” said Dr. Levine. “Cancer is different,” he continued. “I'm a primary care doctor, and taking care of high blood pressure and diabetes is, for the most part, pretty standard. But with cancer, the field is changing so rapidly. Optimal care is changing by the week, and the need for specialization is great. The rapid progress is terrific news in terms of prognosis and outcomes, but it makes it even more important to expand access to expertise and specialty care and to ensure the system realizes the value of getting the right care right away. Receiving care based on an inadequate diagnosis or that is less effective than an alternative choice should be recognized as the antithesis of value-based care.”
He said that it was reported at a recent ASCO meeting that, in California less than half of cancer patients get cancer care that is based on the official guidelines from the National Comprehensive Cancer Network (NCCN).
Enter AccessHope. City of Hope doctors saw the published reports that indicated outcomes were better at National Cancer Institutes, but recognized that most cancer patients weren't able to access that care. So City of Hope created AccessHope to partner with employers, local oncologists, and other leading National Cancer Institute (NCI)-Designated Comprehensive Cancer Centers with the goal of having more cancer patients benefit from the latest cancer care knowledge no matter where they live.
“We want people to have access to the same level of great care, whether you work in the mailroom or the boardroom, or live in Biloxi or Anchorage or New York” said Dr. Levine. “AccessHope brings the cancer expertise of City Hope, Dana-Farber Cancer Institute, and Northwestern Medicine — and we're in discussions with other NCI centers that are like-minded and also want to democratize the way cancer care is delivered across the country. We hope others will copy us because we want to transform the way people receive cancer care.”
On City of Hope’s ceremonial gates is an expression that says: “There is no profit in curing the body if, in the process, we destroy the soul.”
“In creating AccessHope, City of Hope took those words to heart and created a company that would focus on the whole person. We created AccessHope specifically to do something that's never been done before. It's a revolutionary idea: instead of saying patients have to come to City of Hope to get the extraordinary NCI level care, we've created a body that takes that expertise to the patient and their treating oncologist, regardless of geography, or where they live. And our partners in doing that are Dana-Farber and Northwestern Medicine, the health plans, and the employers.” They designed AccessHope so the patient doesn't have to lift a finger, because they know it's so hard for a cancer patient and they don't want to add to the burden.
So far they have partnered with 43 large employers, 19 of which are Fortune 500, and they cover more than 2.3 million people.
Dr. Levine shares the same whole-life view that Gwinner has, when it comes to meeting the individual needs of employees: “You now have three or more generations working in the workforce, often managing four or five generations at home, and that's a particularly compelling statement when it comes to cancer. Unlike many conditions, when someone has cancer, it impacts the entire family and the work place. So now in the workforce you have people with cancer, but you also have people taking care of their parents, their spouses or their children who have cancer. It affects the entire continuum of your workforce.”
Cancer also affects everyone around us.
“Employers tell me all the time that, unlike any other condition, a cancer diagnosis in the workplace affects the entire workforce,” said Dr. Levine. “One of the ways that our cancer support team gets connected to people with cancer is that the supervisors in the workplace are calling us and saying,
‘My employee has cancer and I want to help her take the first step. Can I put her on the phone?’ Wow.
We never envisioned that happening, but that's how compelling the offer is. That's how impactful cancer is in the workplace. And that's how good people are.”
According to Dr. Levine, if you can address the social determinants of health in cancer, you can reduce 34% of the mortality.
He said they’re finding that employers are attracted to AccessHope because what it does is acknowledge some harsh realities and tries to address them:
Patients aren't getting evidence-based care
Underserved populations are more likely the ones lacking that level of care
Depending on your geography, your mortality rate is higher
“We want a solution that will close these gaps today, and that's part of what AccessHope does,” said Dr. Levine. “It identifies a high-risk cancer patient, and it proactively intervenes to work with the treating physician to make sure that doctor has all the information they need to have to take the optimal care of that patient. AccessHope is just getting started: we will continue fighting cancer with everything we know, as we say around the office, and we're going to develop partnerships with employers that are highly motivated to help their workforce.”
Screening for Social Determinants
If your approach to health and wellness is limited to those line-item benefits within the narrow scope of your employees’ work lives, then you’re treating a gaping wound with just a Band-Aid. As we’ve seen already, our ability to work at full capacity depends not only on our own health but also on the health of those around us, and our health depends on much more than those things that can be measured in a lab.
DeAnna Minus-Vincent, MPA, is SVP and Chief Social Integration & Health Equity Strategist for New Jersey-based RWJBarnabas Health. In that role, she’s part of a team working to reach beyond the walls of their facilities, use their assets and resources to more equitably improve their communities’ long term well-being and quality of life.
I share her belief, as stated in her bio, that “we can make the most impact and create sustainable change when we tackle and re-engineer systems.”
She said we need to re-engineer how health, social service, government and business sectors work together.
“For instance, we can’t just provide medication for diabetes that says, ‘take with food’ without also asking them: ‘Are you able to afford the prescription? Do you know how to prepare healthy food? Is there a grocery store in your neighborhood? Can you access it?’”
Otherwise, patients won’t be able to follow the directions and they’ll end up back in the emergency room, being accused of not adhering—as if they’re purposely not following the rules.
Minus-Vincent said they’ve made a commitment to ask those questions related to the social determinants of health—but not only to those patients who have low incomes or fall into other “at-risk” categories. They ask those questions of everyone who comes through the door. Why? To avoid bias, and to remove the decision about whom to ask, because the fact is we really don’t know what someone is going through unless we ask.
“We did not want our clinicians to have to decide who to ask, nor did we want anyone to feel stigmatized if they got the questions and someone else didn’t,” she said. “To alleviate all of that, we're asking everyone.”
In asking everyone, they are also creating a preventative strategy.
“I used to be 120 pounds heavier,” she said. “I have a father who's a diabetic, my grandfather died of diabetes, my mother has heart disease and her mother died of heart disease. And I'm an asthmatic. And I was in the emergency room probably four times a year and admitted at least once. I had every resource. My husband and I have the best insurance. I just did not understand the correlation between lack of sleep, stress, and how that allowed me to hold on to weight. But none of my doctors ever asked about my weight or my lifestyle choices.”
If the policy was to only pose those questions to people who fall into particular demographic categories, no one would ever pose those questions to Minus-Vincent—yet, as she points out, she needed to think through those issues just as much as anyone else.
She also pointed out the importance of understanding barriers, and whether those barriers are real or artificial.
“For instance, food policy is a big issue for us. So many disease states are dependent on food. So we've been working with our state government partners to think about how can we ensure that those who are eligible for government benefits for food, get them. For example, we know nationally only about 50% of seniors who are eligible for food assistance are enrolled.”
As she put it: Through the use of data-matching and the appropriate consents, it is easy to determine who is enrolled in the benefit and compare that to social security data or income tax data to determine eligibility. Let’s just make it easier for eligible seniors to get SNAP. Why should they have to jump through hoops to sign up for it themselves?
“Let's give them SNAP. It's going to provide better health outcomes. It's going to allow them to age in place with dignity. So why don't we just take that artificial barrier down? Why should seniors have to go in person to a place with all these documents, when we have the documents sitting here? So those are artificial barriers. Let's take those down.”
It’s the same type of action that needs to happen within our companies and throughout our communities: identifying the obstacles and removing them. But it requires a shift in mindset: from seeing these types of benefits as a cost center, to seeing them as an engine for growth.
The cost-center mindset would look at something like that and think: why would we just automatically put money in people’s hands if they haven’t asked for it? But a growth-engine mindset asks: why wouldn’t we want to invest in individuals in every way possible?
The work she and her team are doing creates the systemic change that we need so that all communities can be better served.
“If we serve the whole person,” said Minus-Vincent, “you're not just going to see positive health outcomes, you're going to see positive health, social, economic, educational outcomes. And not just for me, but for my child and for my grandchildren. If we get someone housed, we know they do better in school. We know that they can go to work. We know that it stops incarceration. We know that will create healthier communities. Those outcomes have been proven. That is our mission in a nutshell, to create healthier communities. And we can't do that without doing all the things I just talked about.”
Investing in Your Community
So far we’ve covered employers investing in their employees, cancer experts investing in employers, and health systems investing in their communities. The next logical step in this progression: people making investments back into their own communities to promote education and financial health. Why? Because we know that everything is connected.
One of our biggest problems, in my opinion, is that we usually talk about everything separately. I’m anticipating some people thinking that including this conversation about investing in education is a bit off-topic for this article. But it’s not. We’ve already heard from the experts who say that under-represented communities get the short end of every stick: more chances of developing health issues, less access to care, and worse outcomes overall.
On that note, an announcement caught my eye. Iconic hip hop artist, Percy “Master P” Miller, launched a new initiative focused on improving racial equity within Black, Indigenous, and People of Color (“BIPOC”) communities. His aim is to connect with individuals and business owners to increase economic empowerment in BIPOC communities and advance corporate racial equity.
Miller owns and runs P. Miller Enterprises. He is a philanthropist, businessman, entrepreneur, music mogul and founder of No Limit Records. Miller has launched several successful worldwide companies including fashion and footwear lines, consumer packaged goods and film and television production companies. He also played for two NBA teams—the Charlotte Hornets and Toronto Raptors. He recently received an honorary doctorate degree from Lincoln University.
Miller dedicated $10 million to launch the initiative and is calling for corporations, private equity firms and investors to join him in changing the narrative. He will invest in a wide spectrum of opportunities, including seeking equal representation at the senior leader and board level at large, national corporations, and supporting small businesses and start-up companies, that are owned or operated in BIPOC communities. He will focus on the following sectors: healthcare, education technology, financial technology, access to healthy food, and broadband to help bridge the wealth gap.
“I think the most important thing we provide is education and economic empowerment, to a culture that's underserved,” said Miller. “The education part is so big. Everybody thinks it's about the money, but health is wealth. And I feel like the first step is the education. It's about leaving an imprint and also being able to fund other small business that are going to put money back into the community and the culture. That's what's exciting for me.”
In my conversation with him, he shared a story that made this news more personal. His son, Hercy Miller, is one of the top high school basketball players in the country. He had the chance to play college ball for Vanderbilt, LSU, USC, UCLA—but he turned all of them down to play instead for Tennessee State, a Historically Black College and University (HBCU).
“He looked at their engineering program, and it's also a great basketball program, but he really wanted it because it's an HBCU,” said Miller. “He said something that made me, as a grown man, say, ‘now I need to think even bigger about the future.’ He said he wanted to make a difference and it needed to start somewhere. Somebody needed to actually do something. Even though they don't have the big jumbotrons and the arenas. He said he wanted to be the spark plug to economic empowerment, to show that we can get corporations to come and invest in arenas, to do things for the school. So the school could make money, so you could put it back into the educational system. And that's what I love. He’s not just thinking about himself. He's thinking about educating the next generation and that's what we need to be.”
Full Circle
Another finding from the MetLife study ties these seemingly disconnected stories and examples together.
According to MetLife: “Holistic well-being is a reflection of financial, physical, mental, and social health—more than half of workers say they’re worried about at least one of those categories. Because these aspects are interconnected and equally important, initiatives that address the full spectrum of employee wellness are likely to have the most impact.”
This is a conversation that should go well beyond HR and benefits management. There's opportunity for people in corporate social responsibility; diversity, equity and inclusion; strategy; marketing and more. Every aspect of your business should be involved in the quest for better health and well-being.
We’re all human, after all. And we now expect to be seen and treated that way.