Oliver Wyman and Altarum Institute, with support from the Robert Wood Johnson Foundation (RWJF), are engaged in a major, multi-disciplinary study of the consumer health-information space. The research is examining the barriers vulnerable consumers may encounter in accessing and using health information, and also how the marketplace views and prioritizes the health information needs of those consumers. Preliminary findings are available here.
Employers are an important participant in the provision of health information. Walmart is one employer that is utilizing new approaches to put health information in the hands of its associates and their families. Here Lisa Woods, Senior Director of Health Care Benefits, and David Hoke, Senior Director of Health & Well-being explains Walmart’s approach and provides details on some of their more successful and innovative initiatives.
Oliver Wyman Health: Can you share some facts and figures about Walmart’s enrolled population?
Lisa Woods: We have about 1.2M plan participants enrolled in one of the Medical Plans we offer.
OWH: What is the range of programs and offerings Walmart is utilizing to put more health information in the hands of its various employee/enrollee segments?
LW: We offer several resources to our associates and their families to provide information about healthcare and their benefits. We have partnered with Castlight to provide information focused on transparency of cost for medical care and prescription drugs, and we have customized the tool to provide information about some of our benefit programs, including our Centers of Excellence, Life with Baby Program, and our Telehealth plan offering with Doctor on Demand. In addition, we have partnered with Castlight to provide information to help associates get the best care on specific health needs utilizing Choosing Wisely as the foundation of that information.
We have also recently started to provide a benefit offered through Castlight focused on helping associates with computerized Cognitive Behavioral Therapy. Associates are asked a few simple questions, and based on their answers they are directed to free, confidential videos focused on their specific need.
It is important to note that we have created a tailored Custom Care Management program available to all associates, but with a focus on supporting the most critically ill. This program has been successful, and associates very much appreciate the direct interaction with a nurse to help them manage through any health concern(s) they have.
OWH: Have you had success with a particular health information program or offering, and in what way did this program utilize new approaches or tactics to reach different employee segments?
David Hoke: We have been very successful in implementing a behaviorally designed well-being program called the ZP Challenge. Our basic approach was to apply some of the key insights from behavior change research to our population. In particular we focused on peer-to-peer influence via story telling.
The basic premise is that many of our associates are doing very well in dealing with the demands of their lives. They have ‘hacked’ their life in a way that allows them to thrive. Others, who are in the same situation, have not yet figured out how to ‘hack’ their behavior. So we work to celebrate the stories of the successful associates and share the inspiration of their experiences with other associates. Using inspiration and aspiration, we can appeal emotionally to someone so they can begin to change their behavior.
The best part of this approach is in the way it brings people together. For example, the ZP Challenge includes questions about inspiring someone else to lead a better life. This makes someone pause and think about the role they play as a leader to the people who are important to them. That thought makes the journey not just about you, but also about others. This is a link to purpose that we know is a key motivator for all of us.
OWH: How did you arrive at these refinements and new approaches? What steps did you take to better understand your different employee/enrollee segments?
DH: For our work in well-being, we spend a lot of time listening and visiting with our associates. Then we combine this information from the ‘real’ world and compare it to both ethnographic and academic research. This usually produces a list of options. It is an iterative process where we actually build the service offering based on associate feedback. We serve not as experts but as facilitators to co-design with associates. This creates a feeling of joint ownership which is really powerful and important. We like to say we are building a movement rather than offering a program.
OWH: How does Walmart view its role in providing health information vis-a-vis its benefits administrators or healthcare providers? How can all parties work together?
LW: We have partnered with both the health plans and the health providers to provide information to our associates. The important part is to ensure that all parties are involved and engaged in delivering a specific message or program. We believe it is very important to coordinate with all of our partners, which in turn provides the best delivery and outcomes of the benefits we provide.
OWH: Looking ahead, how else might you enhance your programs or offerings for employees and enrolled populations?
DH: We are focusing holistically on well-being, and that includes financial well-being. We are preparing to offer solutions that can help our associates and their families attain a greater degree of financial security. Our work will lead us into discussions about cohesion and ‘tribes.’
It is interesting that in a world where we are more connected than ever, we are also more isolated. This isolation manifests itself in a lack of support when things are more difficult. So part of our work is focusing on self-learning skills to increase learned optimism, resilience etc. We are exploring the salutogenic approach to public health where we can understand the intersection between peer influence and access to expert opinions regardless of life circumstance. Finally we are focusing on an understanding of the derivative impacts of improved well-being for the associates, the company and the community.