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Live Life Love | Volume Thirty-Three

Hi Everyone,

It has been an intense, yet immensely rewarding year. I’m looking forward to 2016 where a lot of the work I’ve done on employee well-being, discussed often through these quarterly newsletters, will begin to expand. In the spirit of increasing productivity and well-being — and helping you make 2016 the best year yet — I have asked readers to leave their best productivity tip (in the comment section below). The last time I asked for good tips, the best suggestion I got (in my opinion) was to modify your email signature in a way to give the appearance that all outgoing email sent from you is via your mobile device — making it more socially acceptable to reply with brief messages. A bit sneaky, but extremely effective.

Business, Innovation and Entrepreneurship: This quarter’s business interview is with Kate Matsudaira. Kate has held leadership positions in companies such as Decide (acquired by eBay), Moz and Amazon.com. In 2013, Kate started her own company Popforms, which was acquired by O’Reilly Media in June 2014. My interview with Kate Matsudaira about productivity and work is available here.  

Health and Wellness: This quarter’s health and wellness interview is with Laura Putnam. Laura is a well-respected consultant, trainer and speaker on the topic of workplace wellness. She also writes on the topic for publications such as The New York Times and Entrepreneur, as well as authoring the book “Workplace Wellness That Works.” My interview with Laura Putnam about the topic of employee well-being is available here.

Life Experience: This quarter I went to the Rise Festival in Nevada. The Rise Festival is an artistic gathering attracting over 10,000 people from all over to send lanterns into the sky in unison. Words do not do it justice; got to see the video.

Contribution: My social contribution this quarter was to You Are Super Duper, whose aim is to help kids with serious illnesses and long-term afflictions have some fun through creating amazing and rewarding experiences.

I wish you limitless joy and prosperity throughout 2016. At the risk of sounding repetitive, I would like to thank you again for taking a look at this newsletter each quarter. It’s been really fun so far, and I feel fortunate that it has coalesced into something more meaningful and rewarding than its original design. If I can ever give back, please let me know.

In health,
Michael

P.S. For those of you going to IHRSA next year, please consider attending my session on workplace wellness. I’d love to see you there.

Interview with Kate Matsudaira about Productivity and Work

Kate Matsudaira is a startup founder and technology executive with a passion for productivity. She has extensive experience building and managing high performance teams and has held leadership positions in companies such as Decide (acquired by eBay), Moz and Amazon.com. In 2013, Kate started her own company Popforms with the mission of helping employees excel at work through innovative courseware. Popforns was acquired by O’Reilly Media in June 2014. In November 2014, Kate launched the Spark Notebook on Kickstarter after a decade-long journey trying to find “the perfect notebook.” Her goal was to raise $14,000, and she exceeded this by almost 10X raising almost a half-million dollars. Kate can be found musing about productivity, tech, leadership and life at: katemats.com.


1) Throughout your online authoring on goal setting, you discuss the importance of being mindful of your motive. I like that you move beyond the common Simon Sinek clichés of “start with why” and rather focus on the reality that people are going to be moved to action differently by different motivation. What are the best ways of overcoming being “lazy”?

Have you heard the word akrasia? The term means lacking command over one’s self. When someone acts against their better judgment, they kind of simply have this akrasia.  You know you should be doing something, but you don’t do it. I think most people’s lack of progress comes from this concept. Most people know what they should be doing at some level.

I believe there are two main ways people get stuck. The first way is, you know what you should be doing but you’re not sure how to make progress. For example, you know you really want to be a writer but you don’t know how to get a writing job. You have the skills of a writer, but you do not know how you actually make a living writing — or how to take those steps towards your goal. The challenge here is figuring out how to get started.

The second way people get stuck is, you have the knowledge to move yourself forward… you have the capacity to build a plan… but you cannot establish momentum. Using the writing example, you know that you need to create sample work. You need a few paid opportunities through freelance work so you can build a portfolio. You need to build the needed momentum to reach your goal. So, in this scenario the challenge is not putting a plan into place, but rather actually executing on a plan. This category of being stuck is where my notebook really helps, by turning bigger goals into actionable steps.

To overcome being lazy you need a plan. You need action. I think this is one of the bigger lessons for me in my life. When I first started my career, one of the things I would struggle with was that my boss would give me these huge projects. So, I would always ask, “Where do I start?” The goals were so big, and I was so new at what I was doing, I didn’t even know where to begin. I think that’s something that happens with a lot of people. You have these really big goals and you’re so far from the finish line it becomes tough to continue. One of the biggest lessons I learned during that time was to start with small steps.

2) Last year you became a mother. My wife and I just added our second addition to the family. How has parenthood changed the way you approach being productive (now that time is not exclusively your own)?

One obvious change in approach is prioritization. By necessity, I have now learned to say no to a lot more stuff too. When I got pregnant, I became really sick. I had a tough pregnancy. There was simply a lot I could not do during that time. So, at that point in my life, I started taking things off my plate because I physically was not capable of working the way I had in the past. The experience was a good primer for the way I operate now; I was forced to be economical with my time and I became very disciplined.

I have also learned you have got to focus on the task at hand. I talk a lot online about being present. Whether I am on a call, playing with my child or I’m writing an article, that is all I’m doing when I am performing that task. Always quality over quantity (with respect to completing tasks). When I am with my son, I’m not checking my phone. I leave my phone in the kitchen so I am not tempted. I am mindful of maximizing the output from any time spent, whatever the desired outcome might look like of the activity I’m immersed in — if I believe I won’t get positive ROI from time spent on something… I simply don’t do it.

I am up at 5:30 a.m. with my child now. So, time is the thing I don’t have. I have become really disciplined. When I have 15 minutes free, I don’t waste it on things like Facebook, I’m not screwing around with my extra minutes. I’m using all time really effectively nowadays. I have a predetermined plan for those 15 minutes that advantageously pop up. One of the real secrets to time management is knowing what to do with the spare 15 minutes life gives you.

3) Working with Michael Gervais, as well as buying into some of the arguments made by Gary Keller in the book The One Thing, I believe “balance” is a fallacy for high achievers. In my opinion, high achievers find more time than others because there is always more that can be done. You highlight this in your post about making the most of small slices. That said, prevailing science suggests that making time for renewal, and turning down, allows us to be more productive. How does the concept of renewal fit into your productivity paradigm?

You have to schedule it unfortunately. For me, exercise is a release so I try to schedule time to work out regularly. Fortunately, I consider time with my child downtime. I carve out time to spend time with my child and that’s not mentally taxing for me. For me, the time with my family is renewal and I have been really deliberate with how I spend my days. I also make it a point to take vacations every year.

In my car, I listen to good audiobooks, things that make you a better person. I have a pretty long commute, 45 minutes each way, so that’s a good amount of time that I can just kind of unwind if I want. So, I think it just depends on what you need (personally) to unwind. But, for me, I get enough renewal in my life. I’ve built my life around these things because I understand they’re important.  

4) You have an amazing amount of personal systems: for staying on task, organizing yourself and managing incoming information. Personally I feel overwhelmed by the information I have amassed and at times can find it limiting. For example, each year Evernote becomes less useful for me because it contains so much content now. Considering your interests, your proclivity for knowledge and writing, as well as being a continual innovator, what are your strategies to isolate what is important and/or simplify when you need to?

I have this thing I call my Monday Ninja Planning Session and I do it religiously every Sunday night or Monday morning. I start my week with it. I have time on my calendar for it that’s always either 30 or 60 minutes. The sessions are about going over what are the most important priorities and/or things I need to do that week. By engaging in this activity, it really makes sure that I’m not just working on time sucks (e.g. tactical messages in my inbox) or whatever superfluously comes my way. It also means that — by design — I am checking back into my goals every week. I ask myself, “How are my yearly goals going? What is going on with my monthly goals? How does this all fit together?” I make sure that I am actually moving forward with what is important. This method makes you critically look at your productivity and refocuses you to make sure that you’re working on things that matter. Establish this ritual at the beginning of the week, and you find yourself managing your time more effectively.

Also, if you work for someone else, send a status email every week outlining what you are going to do for the week. Make sure what you are working on is mapped with you and your manager’s goals. When I was an employee, this process created an ongoing conversation with my manager and allowed me to track and share my progress in a very tangible and meaningful way.

These are not really ways of simplifying your work I suppose, but rather ways of focusing on what is important which is keystone to being productive.

5) You have now created a movement of people who are going to use your product to aid them in making 2016 their best year yet. What are your plans and goals for evolving the Spark Project and the Spark community in 2016?

That is a really good question and I wish I had a really good answer for you. I am still consistently surprised by the success of the various Spark projects. Frankly, it is awesome. However, when you have a lot of unplanned success — which has led to not being able to fulfill all the orders in time for the new year — I am just trying to do my best just to make sure everyone is happy.

What the future holds is evolving. I am hoping to expand into some complementary products. We already have launched the meeting notes notepad. I also look forward to building other tools to help people be successful, so stay tuned for that. That’s it in terms of physical products for now. In terms of the Spark community, I am hoping to continue delivering strategies and free worksheets that help people achieve their goals (by way of the Spark email newsletter). We will likely use Kickstarter again next year for the 2017 planner because that platform has really worked well for us so far for launching these projects.

 

Interview with Laura Putnam about Employee Well-Being

Laura Putnam is a well-respected consultant, trainer and speaker on the topic of workplace wellness. She also writes on the topic for publications such as The New York Times and Entrepreneur, as well as authoring the book Workplace Wellness That Works. Laura is the CEO of Motion Infusion, a consulting and training firm that provides workplace wellness solutions to foster positive behavior change as well as improve employee engagement, performance and well-being. Laura has received various accolades for her work including the American Heart Association’s “2020 Impact” award.


1) As the workplace wellness industry tries to shift financial evaluation of wellness programs from ROI (return on investment) to VOI (value of investment), what are some ways you have seen organizations evaluate program success that are removed from these two equations that are still meaningful and measurable?

In the shift from ROI to VOI, we might say that there are three evaluation “buckets” to consider. The first bucket, which is what an ROI approach has primarily focused on, is medical cost-containment and risk reduction. This includes tracking the impact of wellness programming on medical costs, disability costs, workers compensation costs, rates of injuries, types of injuries and recovery time. The second bucket is productivity and performance, which includes effects on absenteeism, productivity, energy levels, team collaboration and customer loyalty. Finally, the third bucket is becoming an employer of choice. Companies now recognize that they cannot be competitive, especially when it comes to retention and attraction, without well-designed wellness programming. The reality is that employees, especially Millennials, expect their employers to care about them as people and to also care about making the world a better place. Data points in this third bucket include measuring rates of retention and attraction, job satisfaction scores, levels of employee and leadership engagement, quality of life for employees and even level of connection with a higher purpose.

In order to address the productivity and performance bucket, companies like Goldman Sachs and Google offer wellness programs that help employees to become more focused, more competitive and ultimately more resilient. In lieu of a potentially stigmatizing “reduce your stress” types of programs, they offer “I can become a more effective employee” types of programs. Goldman Sachs’ resiliency program, which is sold as a means to “sharpen one’s competitive edge,” attracts over 500 employees every quarter. The legendary “Search Inside Yourself” program, launched at Google, trains employees how to become both more mindful and emotionally intelligent. In both cases, the companies are less interested in ROI on medical costs and are more interested in performance enhancement.

This idea of using wellness as a means to better oneself and make the world a better place is something I am personally interested in. I love companies like Patagonia and Eileen Fisher that are going after this third bucket of impact. They are both invested in well-being as a means to not only become an employer of choice, but as a vehicle for protecting the environment. While Patagonia does not have a “wellness program” per se, every aspect of doing business breathes well-being and is deeply connected to its mission to “use business to inspire and implement solutions to the environmental crisis.” Eileen Fisher also connects well-being with environmentalism by encouraging employees to become “sustainability ambassadors,” acting as champions of well-being and advocates for protecting the earth.

Companies like Salesforce.com and Square are using impact on the community as a metric for success. Salesforce just hit 1 million volunteer hours. Square has a clean streets initiative, where employees go out and clean the neighborhood. Leveraging the broken windows theory, the idea is that small changes can have a larger impact. So, something “meaningful and measurable” might be as simple as, “how much trash did we pick up?”

2) Big enterprises have some innate advantages to small and mid-size businesses when it comes to providing workplace wellness solutions: economies of scale, access to insurance brokers that provide various free wellness products as value-added services and better access to aggregate employee health data (to name a few). What are some of the advantages smaller companies have to larger companies when it comes to building a workplace wellness program?

In smaller organizations, there are inherently fewer leaders and fewer people. So, it’s much easier to: a) implement a program; and b) shift the culture. If a leader decides to support well-being, then it is easier for that to actually happen in a smaller organization. If an employee has an idea, it’s usually easier for them to be able to move on it. And, certainly, it’s much easier to shift the culture in a smaller organization.

One of my favorite examples is The Sioux Empire United Way in Sioux Falls, South Dakota. A single employee, Colleen Thompson, finance director, decided to take up walking as a way to lose weight and support her newfound commitment to a healthy lifestyle. Rather than just doing it on her own, she invited coworkers to join her. To this day, eleven years later, she and her coworkers are still at it. Everyday – rain, shine, sleet or snow – employees walk together, twice a day, a mile each time. To ensure that weather doesn’t get in the way, they’ve mapped out both an indoor route and an outdoor route. This story is proof that one person can really have an impact, especially within a small organization.

Another important element to this story, of course, is the championing of well-being from the president, Jay Powell. In conjunction with this twice-a-day walk, he decided to try out standing desks with a few employees. Once it proved to be an effective, he extended the offer of a standing workstation to every employee. Because of its small size, the initiative was relatively easy to implement across the office.

3) In your book Workplace Wellness that Works you build a lot of your ideas on a wide range of concepts from established thought leaders. What I particularly enjoyed is in the spirit of a true “da Vinci approach” a lot of the concepts were taken from outside the field. Avoiding folks like Dee Edington and BJ Fogg, who are three “outside” thought leaders we in workplace wellness should get to know (and a quick reason why for each)?

  1. a) Barbara Fredrickson: Dr. Fredrickson is a positive psychologist affiliated with the University of North Carolina. She has really done some incredible studies on both positivity and positivity resonance, which is positivity in the context of others. Her work has really inspired my rethinking of the prevailing “identify what’s wrong and then fix-it” model, which I think creates a depleting experience for people. It’s no wonder why so many employees are opting out of wellness at work! The research suggests that over 80% of eligible employees are choosing not to participate in workplace wellness programs. In some programs, the participation rates are as low as 1-2%. I am convinced that these low rates of engagement are largely due to the overly invasive and negatively oriented wellness programs that we’ve developed.
  2. b) Chip Conley: Chip’s work, especially his book Peak, has had a huge influence on my understanding of the role of culture and how to go about building a positive culture. I am more and more convinced that when it comes to the practice of well-being, we are less “creatures of habit” and more “creatures of culture.” Therefore, as wellness practitioners, we must become experts in culture change – and not just experts in behavior change.
    As CEO of Joie de Vivre, Chip modeled a different way of leading. For starters, he dubbed himself the “chief emotions officer.” In addition, he facilitated open, transparent conversations with employees asking questions like, “Is this a job? Is this a career? Or is this your calling?” And, “If it feels like a job, what can we do here so that it feels like it’s more of a calling?”
  3. c) Arianna Huffington: In the field of workplace wellness, we have placed such a premium on science and research and have not paid enough attention to the importance of being able to share our message in a way that resonates for people. This is exactly what Arianna does so well in her most recent book Thrive. While it is not a perfect book, it speaks to people on an emotional level. In both her writing and her speaking, Arianna uses storytelling, humor and even tonality to deliver her message. These are all the kinds of things that I believe we have to do much more of to change behaviors. It is less about reaching people’s rational minds and more about reaching people’s hearts. This is why the first step in my book is titled “Shift your mindset from expert to agent of change” – and I cite Arianna as an example of an “agent of change.”
  4. d) Michael Gervais: I love Dr. Gervais’s message of imagining what’s possible and then planning from there. This approach dovetails well with a detour from a “what’s wrong with you and let’s fix you” approach toward a “what’s right with you and let’s build on it” approach.
  5. e) Firdaus Dhabhar: Finally, I am enthralled with the research of people like Dr. Dhabar, a researcher at Stanford. His research has uncovered many of the benefits of stress – and that it’s less about stress avoidance and more about acknowledging and even embracing stress. His work underscores the fact that stress can be leveraged as energy. He advocates actually intensifying short periods of stress and then offsetting that with proactive restoration, which really is in line with a lot of the stuff that people like Tony Schwartz, CEO and founder of The Energy Project, have been talking about for a long time.

4) Speaking of a “da Vinci approach” to wellness, for those that have not read your book yet, can you explain the essence of this method? And, can you provide an example or two of the most creative ways you have seen “da Vinci” put into action?

I’m more and more convinced that the only way we are going to have real impact is if we start to integrate wellness and well-being holistically, and not have myopic standalone programs. A great way to do that is by channeling Leonardo da Vinci, the Italian polymath, and taking an interdisciplinary approach toward promoting well-being in the workplace.

On an internal level, you need to engage multiple perspectives from multiple departments. As much as possible, break down silos and reach across to as many different departments as possible:  training and development, organizational development, community outreach, IT, marketing, compensation and benefits, health and safety, facilities, etc.

On an external level, I would encourage you to move away from a one-stop-shop vendor to a team of outside partners, which might include brokers, insurance carriers and even community resources. For example, the American Heart Association provides all kinds of support for organizations that are interested in creating cultures of health.

Schindler Elevator Corporation is a great example of a company that has taken a “da Vinci approach” toward promoting health and well-being in the workplace. Rather than delivering a stand alone wellness programs, Schindler has incorporated well-being concepts into non-wellness initiatives, such as leadership development programs and safety training initiatives. These interdisciplinary programs have partnered the OD department with both safety and HR departments, as well as a number of outside wellness, learning and culture vendors.

5) We are seeing some progressive employers move the corporate wellness conversation from concerns regarding employee “wellness” to thinking about workplace wellness in terms of improving employee “well-being”. Trying to improve population health has already proven to be a complex problem for most, could broadening our focus too fast potentially have risks in the sense that complexity can be inherently paralyzing and might lead to further inaction from organizations simply trying to get started?

Yes and no. Yes, the concept of “well-being” can feel amorphous and overwhelming. Certainly, this broader mission, that encompasses dimensions beyond healthy eating, physical activity and smoking cessation, might lead to inaction.

On the other hand, I think a lot of people are tired of the worn out healthy eating, physical activity and smoking cessation wellness programs. The idea that other factors, like social connections or meaningful work, play into our overall level of well-being is really inspiring and is actually catalyzing organizations and people into action. In my experience, “better health” is not that motivating for most, whereas, becoming one’s best self is. “Wellness” is more focused on (and associated with) the former, whereas “well-being” is more linked on the latter.

The truth of the matter is that well-being moves into areas that companies have already been addressing for a long time. Therefore, this shift actually allows for an opportunity to connect with pre-existing programming (like safety training and leadership development). This is certainly what I have seen in cases like Schindler.

I think the key is for each organization to first define what “well-being” means and based on this definition, identify the areas to focus on. For example, HubSpot, a fast-growing technology company based in Cambridge, Massachusetts, organizes its well-being programming around three different areas: physical activity, healthy eating, and mindfulness/stress reduction. The City of Sioux Falls, on the other hand, has organized its programming around five areas of well-being: physical, emotional/social, career, financial, and community.

This broader landscape of well-being provides each organization an opportunity to identify its “signature” program. For example, Treehouse, a technology company based in Portland, Oregon, has designed a four-day workweek for its employees. The CEO insists that people actually take the day off on Fridays to spend time with their families or engage in leisure time activities – not work. What he has found is that employees are more productive – and the program serves as a great recruiting tool. While Treehouse cannot possibly compete with the Google’s of the world in terms of salary, they can say, “Well, if you work at Google, are you going to have a four-day workweek? Probably not. But, here at Treehouse, you will.”

Ultimately, whether we’re talking about wellness or well-being, it comes down to carving out regular practices to be embraced by all levels of employees. Companies like LinkedIn have walking meetings as a regular practice. At Eileen Fisher, employees regularly begin meetings with emotion-boosting activities like a moment of silence. At Campbell’s Soup, former CEO Douglass Conant modeled the practice of saying thank you. It is fabled that during his 10-year tenure, he wrote over 20,000 thank you notes to employees. In his view, this practice played a key role in the company’s turnaround. The company went from having lost 54% of its market value to its stock rising over 30%.

Virgin Pulse

Company: Virgin Pulse
Brand: Virgin Pulse
Website:
Size (by employee): 200 – 500
Description: When it comes to enhancing overall well-being, workers’ goals are unique. To find employee aims Virgin Pulse tries to learn employees, and design well-being programs to support their goals. Virgin Pulse meets employees where they work and helps them change what they want to improve. According to Virgin Pulse this process often improves employee well-being across other areas, also. Personal relationships, activity, nourishment, sleep, tension, focus, cognition, financial wellness, philanthropy – whatever helps make employees become happy human beings, that is what Virgin Pulse cares about. Virgin Pulse also integrates with a lot of today’s latest wearable apparatus, using these devices as tools to help employee’s build better healthy habits.

LinkedIn: https://www.linkedin.com/company/virgin-pulse
Twitter: https://twitter.com/VirginPulse
Facebook: https://www.facebook.com/VirginPulse
Blog: http://www.virginpulse.com/blog

Should I avoid PQQ if I have kidney disease?

The answer is that it probably makes little difference, if prudent. The amounts of pyrroloquinoline quinone and its derivatives in the diet are in the milligram range, if that. Most PQQ supplements that are currently sold range in amounts from 5-20 mg to be taken on a daily basis.

On the positive side – PQQ is an activator of the sirtuin family of proteins and other factors important to cell cycling and repair, which seem important to renal protection. For example, these factors when poorly activated may contribute to metabolic kidney disease, such as that this is associated with diabetic nephropathy.

On the potentially negative side is that many so-called antioxidants (PQQ included) under some conditions may act as “pro-oxidants”, particularly at high concentrations. In an acute study using rodents, nephrotoxicity was observed after 3-4 days when rats were given doses above 10 mg per day by intra-peritoneal injection (Hiroshima J Med Sci. 1989; 38:49-51). The most prominent finding was necrotic and degenerative changes of the proximal tubular epithelium of the kidney. As a direct comparison, that would be the equivalent of being injected with 2.0 to 2.5 grams of PQQ on a daily basis or even after various metabolic based corrections, 200-250 mg of PQQ (e.g., a person weighing about 150 pounds). For further perspective, many common vitamins are toxic at this level too, when administered by injection.

In another study, rats were given doses of 0, 100, 200 and 400 mg/kg body weight per day by gavage (the administration of food through a tube into the stomach) for 13 weeks. However, in this case NO toxicologically significant changes were observed based on what was described as “thorough pathological and toxicological examinations”. It is important to mention here that pyrroloquinoline quinone taken orally is subject to a broader range of metabolic modifications, than when injected directly.

Summary: PQQ supplements seem safe when taken orally (e.g. even at 10-20 mg doses daily) by those with normal kidney function. In animal models with kidney disease, PQQ seems to provide some protection for metabolic-related kidney disease. However, there are no human studies that address this point nor studies that speak to kidney diseases of more genetic-based origins, such as polycystic renal disease. To be prudent, as you would be with any substance taken in substantial quantities when there is also qualifiers, such as evidence of renal or liver disease, please consult your physician before making dietary changes.

Guillain-Barré syndrome & PQQ

Guillain–Barré syndrome can occur with rapid onset and result in severe muscle weakness due to damage to the peripheral nervous system.  In some individuals, the symptoms may occur in as little as two to three days.  Physiologic functions can be altered ranging from breathing to muscle weakness (usually beginning in the feet and hands).  The current view is that Guillain–Barré syndrome may be considered an autoimmune disease and represents immune dysfunction caused by an attack on the peripheral nerves and damage to the myelin sheet.

Whether compounds such as PQQ would be of any benefit, unfortunately there is nothing in the current medical literature that would support and/or allow one to make that assertion at this time.  No nutritional supplements per se have been shown to have much value, except for strategies to deal with iatrogenic-related eating behaviors suchas poor food intake (induced inadvertently by standard medical treatments for Guillain-Barre syndrome).  Amantadine (trade name Symmetrel) has been shown to have some benefit, but it has to be administered with a number of caveats and its exact mechanism of action is not clear.  Information found in a recent summaries regarding to approaches to diseases with peripheral neuropathy as a component may be of some additional help (e.g. Interventions for fatigue in peripheral neuropathy, Cochrane Database Syst Rev. 2014; 12: CD008146).

Do the Corporate Wellness PEPM & PMPM Models Support Meaningful Utilization of Corporate Wellness Programs?

Many corporate wellness programs are charged through a per-employee-per-month (PEPM) or per-member-per-month (PMPM) model. These subscription-based business models work by employers paying a set price to get access to a particular workplace wellness service. Critics of PEPM and PMPM models have highlighted that while the arrangement brings predictable and constant revenue to the vendor, it does not necessarily benefit the costumer as employers often pay for services they do not utilize (Cheng, 2015).

Shortcomings of the PEPM Model in Corporate Wellness

When employers pay PEPM fees, they are essentially paying for services that will almost never be fully utilized or found valuable by the entirety of their workforce. This is because PEPM fees are collected regardless of how many employees use the service. James Powell (2014) articulated this situation well when he compared it to inviting 250 people to a party just to get one to attend. In other words, employers assume much of the engagement risk — which is neither in their interest, nor compels the vendor charged with fostering employee well-being to have a vested interest in program engagement.

Furthermore, subscription fees make it harder to generate positive return-on-investment (ROI). Many companies are now looking for a return on their corporate wellness programs to justify their existence (“Doctors on Demand,” 2015). In Powell’s post cited above, the author presents an example of a client with 40,000 employees who had access to a second opinion program. Out of all employees, only 140 used the service in one year, which means the utilization rate was less than 0.4 percent. Services with low utilization are not cost-effective, so it is somewhat startling they are not questioned more rigorously by our industry.

Alternative to the PEPM Model

An alternative to the PEPM model has been suggested by those who argue that a non-subscription model is better suited to the health and wellness needs of businesses. They propose a pay-as-you-go model, which places the financial risk upon the vendor. This suggests the vendor needs to take initiatives and offer services the client will actually use.

Furthermore, a no-PEPM model will likely offer better ROI that can be realized from Day 1 of usage. With this model, a consistent utilization rate of 1.5 to 3 percent has been reported; and in some complex cases it increased to up to 20 percent (Powell, 2014).

Overall, the non-subscription model probably offers a more meaningful utilization of wellness initiatives and ensures that employee wellness services represent the client, which should be considered a major goal for a progressive vendor that is truly interested in providing quality workplace wellness programs.

Examples of a no-PEPM Model in Corporate Wellness

Fortunately there are progressive providers that are starting to successfully implement a pay-as-you-go model of business. A shining example is Doctor on Demand, the country’s leading video telemedicine company. Its unique business model supports the next-generation telemedicine services, which are becoming a very popular benefit as showed by a survey among U.S. employers (Towers Watson, 2014).

Doctor on Demand regards its model of work as a no-risk model that allows for the employer to offer its services to everyone, including non-benefit-eligible and non-benefit-enrolled employees (Cheng, 2015). In this way, access to high-quality, low-cost health care is becoming a reality, which resonates with the values of the wellness industry.

Live Life Love | Volume Thirty-Two

Hello Everyone,

I hope you had an amazing, healthy summer. It was a whirlwind for me — working hard and playing hard — and I am always grateful that this project forces me to pause and reflect. It serves as a reminder that experiencing fulfillment is sometimes better served by remembering to relax and relish in moments, rather than trying to race to the next goal. Although the rewards of delayed gratification are undeniable, it is a myth that this approach is mutually exclusive with immediate gratification (note: in psychology there is a distinction between gratification and “easy pleasures”). I struggle personally with the inherent tension between the merits of a “Well-Planned Life” in contrast to a “Summoned Life” — although as I move along in life I find myself more aligned with the latter. The research around flow certainly suggests that happiness and well-being favor those who find engagement in the present.

Business, Innovation and Entrepreneurship: This quarter’s business interview is with Al Lewis. Al is an outspoken voice in health care and workplace wellness. He is the author of several books and held several senior positions at different health-related organizations. Al’s latest endeavor Quizzify guarantees health-care savings for the organizations it serves. My interview with Al Lewis about the return on investment of corporate wellness programs is available here.

Health and Wellness: This quarter’s health and wellness interview is with Drew Schiller. Drew is the co-founder and Chief Technology Officer at Validic, a health and wellness technology company that operates as digital health’s Rosetta Stone for disparate health data. He is a true digital-health thought leader. My interview with Drew Schiller about the future of digital health is available here.

Life Experience: As I referenced earlier, a lot of life experience took place this summer. One of the highlights, and an experience I recommend, was a visit to Boston’s Institute of Contemporary Art. Boston is a beautiful city, so this is only one of many reasons to visit.

Boston’s Institute of Contemporary Art

Contribution: To give back this quarter, I contributed (as part of a group) to get a friend a new wheelchair. I also donated to Team Rubicon, which is an organization that matches the skills of military veterans with emergency first responders to enhance the capabilities of response teams, and I donated a pair of eyeglasses to the Lions Clubs International.

I really appreciate all the positive feedback regarding the new format, and as always I appreciate you allowing me to share with you this quarter. My hope is you find the rest of your year prosperous.

In health,
Michael