Category: Health Care


Employee Benefits – The Humaculture® Perspective

Photos above: Just as different plants thrive in different soils, different people also thrive in different organizations. Aloe vera thrives in thin, rocky, dry soil. Similarly, there are also certain organizations that employ people who may primarily have access to benefits through a spouse or parent and don’t require rich benefits. Other organizations may need moderate benefits (like drip irrigation on grapes) designed and structured to nurture them to thrive properly. Still other organizations may require benefits designed to protect and nourish employees, much like lettuce requires mulch and abundant moisture.

Did any person, or any organization, ever become great by striving to be average? Many business leaders instinctively look at what every other organization in their particular industry is doing, then defensively adopt benefits that make their organization “competitive” with their peers. But, does this approach really make an organization distinctive and magnetic to talented people who will lead to success? Is it really a good idea to attract employees who are concerned primarily about benefits?

Understanding the Nature of the Organization – Vision, Mission, and Strategy

The horticulturist understands that different plants, different production goals, and different climates require soils to be built in specific and intentional ways. Each planting bed is designed with climate, soil texture and drainage, fertility, pH, and other factors in mind based on the types of plants and crops desired. So, the successful horticulturist begins with a vision and mission, then develops a strategy based on the vision and mission while considering climate and available resources. While other inputs may be required (irrigation, support, row covers or other protection), the soil is the key. Without well designed soil one can typically expect mediocre results at best. The most successful gardens “feed the soil, not the plant.” A well-chosen plant in well-designed and prepared soil will naturally thrive and produce the desired fruit.

To be successful and highly effective, organizational leaders must take a similar approach. Each organization has different goals, different purposes, and operates in different business, social and legal environments. All of these factors will have tremendous impact on how the organization is able to attract, engage, grow, retain, sustain, and transition employees or other people who will in some way be a part of, and grow, in the organizational “soil.” Many leaders have at least some idea of their organization’s vision and mission, even if only informally. They also know they need the “right” employees to carry out the strategy to accomplish the vision and mission, so much so that the focus becomes “feeding the plant, not the soil.” But failing to understand the importance of building a good organizational “soil” substantially reduces the effectiveness of recruiting, compensation, benefits, well-being initiatives, engagement, safety, and any other perk or program directed at employees.

Pitfalls of the “We Offer Excellent Benefits” Approach

One large health system sought to have only the “very best” benefits, desiring to be viewed as cutting edge to potential employees and to motivate current employees, which is popular among progressive and innovative organizations. The health system combined the Paid Time Off (PTO) benefits for 7 recently integrated entities by adopting a richest benefit approach. This put the new, larger system above the 75th percentile of its peers. However, the workforce plan and job designs did not allow employees to effectively use those benefits, which led to a lot of frustration and inequitable use. It’s a little like over fertilizing plants, they may be “burned” by the excessive fertilizer. The intent of PTO is to recharge and re-energize people so they can better perform in their job. In this case, the employees felt resentment over a benefit they couldn’t readily access and still meet the patient and business needs of their jobs. There must be an appropriate balance between no time off and full time off. It is important that the PTO be designed for optimal performance. The strategic workforce plan and jobs should then be designed for the level of time off provided (e.g., preparing organizational “soil” to allow the employees to use the PTO benefit to help them thrive).

Similar scenarios are repeated in many organizations, especially as organizations look to benefits and other benchmark surveys to guide their benefit choices. So often, organizations implement or modify benefits programs based on benchmark studies, then struggle with high benefits costs and look for the latest “cost containment” measures, programs, or services. For example, a large utility maintained a traditional sick leave program to remain “competitive” with its industry peers. The 100% pay replacement led to over-utilization, excessive costs, scheduling challenges, and increased time to manage employee relations issues related to absence. It simply became much harder to manage and was not attracting and retaining the employees who would best thrive and contribute to continue to build the organizational “soil.” Yes, “everyone else” was doing it but the choice to be average led to high costs and failed to make this organization distinctive and magnetic to the employees who could best produce the intended “fruit” and nourish the “soil”.

How We Design Benefits from a Humaculture™ Perspective

Humaculture™ recognizes that the organization itself is the key to a thriving, engaged, and contributing workforce that leads to success. Benchmarks are good against which to test designs and cost levels to assure they are distinctive and magnetic, but the designs should first support the vision and mission of the organization. While many advisors may suggest, for example, a healthcare organization should provide rich health care benefits, the Humaculture™ approach would view it a little differently. Humaculture™ would focus on the vision to model healthier behaviors, understand the consumer choices their patients are making, and differentiate the type of talent that may choose their organization (e.g., make the benefits less rich for those who aren’t willing to engage in healthier behaviors).

Such a design would support the organization’s effort to attract, engage, grow, retain, sustain, and transition employees who will buy-in to the vision and mission, be fruitful, and contribute to the tilth of the organizational “soil.” Well-designed soil requires fewer inputs of fertilizer, pesticides, water, etc. to successfully produce a crop. Likewise, well-designed organizations, including benefits and compensation that are aligned to support the vision and mission of the organization, will have much lower costs and achieve greater results than those organizations who “burn” the employees with rich or misaligned benefits. For example, one health plan had a copay for emergency room (ER) visit but applied the deductible and coinsurance for office visits. After switching the design to copays for office visits and increasing the ER copay, ER utilization dropped by 20% and non-emergent ER costs dropped by 99%. Overall, the broader behavioral redesign rolled back the cost levels 3 years of double digit increases without increasing plan participant costs.

So, what steps should be taken to design and implement benefits that support the organizational vision and mission, as well as reduce costs and support employees who thrive? How should you begin to develop an effective Humaculture™?

  1. Either develop or formalize and articulate the Organization’s vision, mission, and strategic priorities.
  2. Consider and design benefits that support the vision, mission, and strategic priorities.
  3. Optimize benefit design by applying principles of behavioral economics and choice architecture.
  4. Develop metrics that will provide actionable insights into the performance of the benefit designs.
  5. Evaluate benefit effectiveness relative to vision, mission, and strategic priorities and performance.
  6. Modify designs accordingly and continue to measure and evaluate.

Applying these Humaculture™ principles will move your organization toward providing fertile “soil” for employees, reduce benefit costs (even before “cost management” techniques or services are used), and contribute to a much more productive and profitable organization. Please see our real world applications of this approach and the outcomes achieved with time off, health care, and financial well-being benefits. Take the Humaculture™ Benefits Assessment to conduct a high level analysis of how you are doing.

About Humaculture, Inc.
Humaculture, Inc. transforms organizations—the way organizational leaders understand the organization and the relationships among the people in it, and the way people think about their position and role in the organization. Humaculture™ is a philosophy and systematic approach for creating profitable, aligned, and healthy organizations conceptualized as “soil” in which people can thrive. Humaculture™ helps organizations create the right culture in order to naturally attract, engage, retain, sustain, grow, and transition people who enable the business—and each other—to thrive. More information can be found at: Humaculture.co. Learn more about our team at https://humaculture.co/who-are-we/.

Authors:
Wes Rogers, Chief Guidance Officer for Humaculture, Inc. Wes has almost 35 years’ experience in consulting and senior management positions with a variety of organizations, facilitating groups of people with diverse perspectives and objectives to coalesce around a singular vision and marshal resources to achieve the vision. This experience provides exceptional insights into how organizations operate and succeed.  Contact Wes at Wes.Rogers@humaculture.co.

Steve Cyboran, ASA, MAAA, FCA, CEBS, Chief Behavioral Officer, Consulting Actuary for Humaculture, Inc. Over the past 30 years, Steve has worked extensively with leading corporations, higher education institutions, and health systems across the country to articulate a vision for a healthy and effective workplace culture, develop a total rewards strategy to support that vision and brings deep benefits expertise with a behavioral approach and sound analytics to achieve and measure the desired outcomes. Contact Steve at Steve.Cyboran@humaculture.co.


 

Survey: COVID-19 Top 20 Practices for Supporting Students

Humaculture, Inc. invites all institutions of higher education and academic medical centers to participate in a new inventory on the COVID-19 Top 20 Best Practices for Supporting Students. Our organization, Humaculture Inc., wants to equip our institutional colleagues with this quick-check inventory. Once we collect and review institutions’ completed inventories, we will provide all participants with a summary of the responses from other institutions along with actionable insights.

You can access your survey at: COVID-19 Top 20 Practices for Supporting Students

In order to review results as soon as possible, we need to obtain responses by Wednesday, August 5. We made the survey as succinct as possible in an effort to respect the time demands we know everyone faces. We believe, however, that the time you invest in this effort will be well rewarded and will provide valuable insights to all participants seeking to support students this fall.

We also welcome the opportunity to meet with you to review a customized summary of the results with insights learned from the survey analysis. If you would like, we can discuss where your institution may be able to take some steps forward to better support your students in the coming months. 

If you have any questions regarding this survey, please contact us.

We are grateful for you and your efforts to care for students.

About Humaculture, Inc.
Humaculture, Inc. transforms organizations—the way organizational leaders understand the organization and the relationships among the people in it, and the way people think about their position and role in the organization. Humaculture® is a philosophy and systematic approach for creating profitable, aligned, and healthy organizations conceptualized as “soil” in which people can thrive. Humaculture® helps organizations create the right culture in order to naturally attract, retain, sustain, grow, and transition people who enable the business—and each other—to thrive. More information can be found at: Humaculture.com. Learn more about our team.

Weathering the Storm: Is Your Organizational “Soil” Healthy Enough to Weather Both Floods and Droughts?

During these unprecedented times with businesses having been shut down due to an outside order by the government in response to COVID-19, many sectors of the economy, labeled as “non-essential,” were ordered to close business for a period. Organizations that are highly leveraged (a significant portion of the revenue is used to pay debt) or in lower margin businesses face an even greater challenge. Organizations need to figure out how to weather the storm. These options may include reduction in force to rolling furloughs, and potentially reorganizing through bankruptcy. What is the right decision for your organization?

If we think about an organization like the soil, the employees like plants growing in the organization, and the fruit they bear as the value or profit of the organization, then horticulture can provide a good analogy from which to view options for addressing the current situation. From a horticultural perspective, the current “storm” is like a drought. The first thing a horticulturist might do, for example, when faced with a drought is add mulch and preserve soil moisture, not jerk plants out of the garden. As another example, during an unexpected late freeze, it may become necessary to cover plants to enable them to maintain their heat.

“It is not nice to garden anywhere. Everywhere there are violent winds, startling once-per-five-centuries floods, unprecedented droughts, record-setting freezes, abusive and blasting heats never known before. There is no place, no garden, where these terrible things do not drive gardeners mad.” Henry Mitchell, author of the Essential Earthman

When weighing options to reduce costs and capacity such as layoffs, furloughs, rolling unpaid time off, treatment of unused PTO, leadership needs to weigh several considerations. For example,

Culture – One of the most important considerations may be how the organization wants to come out of this trying time. The approach may vary depending on the type of culture currently in place. For example:

  • Strong, Productive Culture and Balance Sheet – If an organization has a strong, productive culture, with good talent and is financially strong enough to weather the current challenges (e.g., well prepared, fertile soil, that is more resilient), layoffs can be one of the most detrimental actions an organization can take to the long-term health of the organization and its people. There will be a drain on talent that may later be needed to support a strong recovery for the business, and that talent may wind up joining, or starting, competitors and taking a certain portion of knowledge with them. Layoffs made too hastily, where the remaining jobs aren’t redesigned to accommodate the reduction in staff and pick up the essential tasks of those leaving, may result in the need to rehire many of those positions. Then the organization assumes the cost of the layoff, and training of the new hires for the same positions, without any long-term value gain. In addition to considering the impact of the loss of talent from layoffs, the organization should budget for an increase in health, absence, and disability costs. We have seen 5% to 10% unanticipated increase in these costs depending upon the size and nature of the restructuring. The implications of a layoff may have long term impact that may make the long-term cost not worth the short-term gain. Other considerations may achieve the same goal while preserving the culture and health of the organization and its people.
  • Culture is In Need of a Refresh – On the other hand, if there has been a need to rethink the culture and business structure (remove plants not well-suited for the garden, transplant some to different soil, and prune existing plants to shape them to be more productive), then it may make sense to consider some form of restructuring of the leadership and/or workforce. This can present a great opportunity to accomplish the organizational change that has been desperately needed but deferred. The type and nature of the restructuring may depend upon the suitability of the employees to achieve the business strategy. Organizational leaders should consider aspects of both cultural alignment and cultural health. A few examples (certainly not comprehensive) to consider may include:
  • Working Retired – If there is a segment of the workforce at normal retirement age that may still be employed, but lack the energy and commitment necessary to take the organization where it needs to go. Then the organization may get more energy and innovation from a younger, less costly resource. In this case, an early retirement window may make sense. One client has a location where 70% of the workforce is retirement eligible and has the highest labor costs, but the employees are unprepared and afraid to retire. An early retirement window may be beneficial to those eligible for retirement and the organization.
    • Strategically Misaligned – If there are certain businesses or shared service segments that may not be a good strategic fit (not directly driving the strategic priorities of the organization), then the organization may consider selling off, outsourcing, or co-sourcing those functions. For example, if your business is higher education, an outsourced food services contract affords greater flexibility during periods where the campus is shut down.
    • Re-alignment – If there are opportunities to automate, streamline, or eliminate positions, then the organization may need to restructure. If the organization chooses this route, it is important that jobs are redesigned to ensure important functions don’t fall through the cracks, that you have the right talent in those positions, which may involve “transplanting” employees to other areas of the organization, and retraining or hiring different talent. Some of our clients have worked with a management consulting firm to evaluate staffing ratios to determine how many people should be appropriate. Following those recommendations, the client reduces staffing levels as indicated, but without redesigning the remaining jobs, they must often rehire those positions because critical work isn’t getting done.

Temporary Nature – Organizations will also need to consider if, and to what extent, this challenge will be a short term. If this will only be a temporary set-back and demand is simply deferred (e.g., delayed purchases such as iPhones, or elective procedures), or even if business will rebound to similar levels of activity from prior to the current downturn, then the organization may want to consider more of a shared responsibility approach with rolling unpaid time off or even furloughs. With the right messaging, the organization may be able to enhance its relationship with employees, letting them know the organization doesn’t want to let any of its teammates go during these challenging times, so we all need to consider ways to save money and share in the sacrifice. However, with 40% of the workforce living paycheck to paycheck[1], they may need to consider the potential impact on the financial well-being of the workforce if they are asked to work less (for example, 20% reduction in hours, and a corresponding 20% pay cut).

“My heightened awareness of stewardship to those within my span of care gave me a clear sense of purpose and clarity through which to view the situation.  I thought to myself: We’re a family at Barry-Wehmiller so we need to act like one. What would a responsible family do in this crisis? A loving family would share the burden. Rather than watching a few of our colleagues face devastation, we decided that our reaction would be one of shared sacrifice.” Bob Chapman, CEO of Barry-Wehmiller

Other Cost Saving Opportunities – There are a number of dials in the various reward programs that can be considered. For example, time off programs can be leveraged to save cost and moderate the capacity of the workforce. The time off policies, and other state and local regulations, often drive a number of cost considerations, such as:

  • Do you pay out unused PTO upon termination or at the end of the year?
  • How does time accrue (e.g., front-load, weekly accruals)?
  • To what level and extent should time accrue, or temporarily stop accruing during an economic downturn?
  • What is the right level and balance between scheduled time off (PTO/vacation/holidays) vs. unscheduled time off (sick leave, disability, emergency)?

While there may be pressure to make rash decisions to lay people off for quick cost savings to preserve the profitability of the organization, take a step back and consider alternatives that may be similarly impactful, but preserve the “tilth” of the organization for the future.

Authors:

Steve Cyboran, ASA, MAAA, FCA, CEBS, Chief Behavioral Officer, Consulting Actuary for Humaculture, Inc. Over the past 30 years, Steve has worked extensively with leading corporations, higher education institutions, and health systems across the country to articulate a vision for a healthy and effective workplace culture, develop a total rewards strategy to support that vision and brings deep benefits expertise with a behavioral approach and sound analytics to achieve and measure the desired outcomes. Contact Steve at Steve.Cyboran@humaculture.com.

Wes Rogers, Chief Guidance Officer for Humaculture, Inc. Wes has almost 35 years’ experience in consulting and senior management positions with a variety of organizations, facilitating groups of people with diverse perspectives and objectives to coalesce around a singular vision and marshal resources to achieve the vision. This experience provides exceptional insights into how organizations operate and succeed.  Contact Wes at Wes.Rogers@humaculture.com.

About Humaculture, Inc.

Humaculture, Inc. transforms organizations, the relationship with their people, and how they think about their people. Humaculture® is a philosophy of, and systematic approach to, creating profitable, aligned, and healthy organizations conceptualized as “soil” in which people can thrive. By creating the right culture, the organization naturally attracts, retains, sustains, grows, and transitions people who enable the business to thrive. More information can be found at: Humaculture.com.


[1]Research from the Federal Reserve found that 4 in 10 Americans couldn’t afford a $400 emergency, and 22% say they expect to forgo payments on some of their bills (https://www.marketwatch.com/story/half-of-americans-are-just-one-paycheck-away-from-financial-disaster-2019-05-16).