Building Trust, Engaging Employees, and Improving Healthcare

When employers are trying to have successful healthcare programs and get their employees to change behaviors, the top trigger/barrier is whether or not there is trust, explained panelists at the Midwest Business Group on Health (MBGH)’s 39th Annual Conference, held May 8-9 in Chicago, Illinois.

Employees want to know what their employer and health plan will do with their information and whether it’s confidential. And one-fourth of employees have said they don’t participate in employer-sponsored wellness programs because of this uncertainty, said Cheryl Larson, president and chief executive officer (CEO) of MBGH. Other triggers and barriers were time, money, convenience, and stress. While the data she was using were about 7 years old, Larson admitted she didn’t think employers had gotten much better at making their employees feel comfortable.

“And so, when we ask them to do the things that we are asking them to do in terms of being healthy and implementing these great programs…we need to understand what their stressors are,” she said. “What those triggers and barriers are to getting them to engage and change their behaviors.”

Janice Burnham, CEO of ROC Group, which specializes in communicating the nuances of employment value, HR programs, and change management, highlighted 5 aspects of creating trust, which she called the PEERS of trust:

Proximity: the feeling of physical, emotional, or philosophical closeness to the speaker/organization

Ease: how easy it is to trust the speaker/organization

Experience: having a good experience in the past with the speaker/organization

Relatedness: having shared similarities with the speaker/organization

Safety: not feeling under threat by the speaker/organization

Experience is the easiest one to change, because even if they’ve had a bad experience in the past, having good experiences in the future and seeing change can mitigate those past bad experiences. In contrast, safety is the hardest one to change if a person feels uncertainty, unhappiness about changes, or a lack of control.

Employers can help close the distance with a personal story or a local messenger and by making an effort to tell the full story, Burnham said. Demonstrating commonality with shared purpose and motives and making an effort to see others’ point of view can help mitigate feelings of threat, she explained.

Curtis Farmer, director for alliance benefits, Christian and Missionary Alliance (CMA), highlighted how he built a sense of trust among a widespread group of individuals who were not very trusting of the central home office. His organization provides retirement and health plan benefits for employees and pastors across the country, so proximity can be a big issue. He took the time to travel to district events and conferences so he could meet face to face with pastors and understand their pains and what they appreciate about the plan.

Another way CMA has built trust was having less of a focus on sales and more of a role as consultants who are trying to find the plan with the best fit for the pastors. This made the pastors feel like they weren’t being sold something they didn’t want. CMA also implemented a loyalty rewards program that gave pastors a 3% discount on insurance premiums after a few years.

“The overarching theme…is this culture of trust that we’ve been trying to establish,” Farmer said.

Education is also important. This allows CMA to overcome misconceptions, for instance if people don’t understand health savings accounts (HSAs), and this education effort makes the pastors feel like CMA is on their side.

Schneider Electric has also spent a lot of time on educational efforts, explained Christine Goodwin, director of benefits US and Canada, global human resources, Schneider Electric. The company spends a lot on health and wellness, but employers didn’t know about them and how to take advantage of them.

“We’re trying to close this gap,” Goodwin said. “We need to make benefits more approachable and easier to understand….”

One of the tactics the company used was to simplify the message by avoiding industry jargon and not getting too technical. The message, she said, should be about what is in it for the employee and why they should care. Schneider Electric imparted the message through short videos, learning maps to explain complex topics, and created personas that may be going through similar life stages as employees.

Schneider also invested more time in understanding data on employees and using it to develop more targeted communications, including those personas used for communication information. Schneider was able to see who was in the consumer-directed health plan (CDHP), who wasn’t, and the commonalities in those 2 groups.

The third tactic was to assess current communications that were being used for years to see how effective they were. After analyzing those communications, such as the biweekly email campaign, Schneider Electric realized just how ineffective that communication method was. The email only had about 500 clicks a month despite going out to 15,000 users. The company switched to using Yammer, an internal company social media site that was already being used. It set up a company page, which now has 6300 active users and more than 90,000 read messages a month.

After implementing these tactics, the company found that CDHP enrollment was up 12% in 2019, there was a 65% increase in employees contributing to HSAs, and the average amount contributed to HSAs was up 66% in 2019.

“What we’ve found is that when you simplify your message and use the data to drive your decisions… employees make better enrollment elections,” Goodwin said. “They’re more familiar with benefits and they trust the organization most.”

Alvia Siddiqi, MD, FAAFP, vice president of population health, Advocate Aurora Health, is looking to engage its patients, physicians, and employers in the transformation to better access, affordability, and health outcomes. To do so, it implemented high-value care strategies, including a value transformation program, integrated care management, AccountableCare Index Committees, and value-based programs.

Advocate Aurora Health is in the unique experience of delivering health benefits to a group of people who know how to assess what it’s doing. However, Siddiqi has found that healthcare workers can be some of the worst accessors of healthcare—they think they don’t need help, she said. It can be difficult to engage this group of people and get them to trust they need help with care management.

One of the ways Advocate Aurora Health has tried to build trust is to assure employees that there is a firewall and their personal healthcare information is being kept private, and there is also an emphasis on removing low-value care, so the providers who work for them understand being more accountable to total cost of care.

“You can say you’re doing something they would want you to do,” Burnham noted at the end of the session, which is a good way of aligning motives between the employees and the organization.