Insuring Alignment of Our Practices and Personal Health Behaviors: An Employee Incentive Plan to Encourage Advance Care Planning (FR414)

Abstract

•Demonstrate ways that advance care planning promotes a healthcare organization’s mission, vision, and core values.•Recognize traditional purposes of employee health incentive plans and how a healthcare company can engage employees in advance care planning as a means of promoting healthy behaviors for the company’s staff as well as the patient population it serves.•Identify key operational components of the Providence advance care planning health incentive option and how this option was received by employees and their insured family members. America’s employer-based approach to health insurance strengthens companies’ stake in their employees’ wellbeing. Corporate health incentive plans have traditionally focused on reducing risks associated with physical illness, through activities related to smoking cessation, dietary modification, increasing exercise, and monitoring BMI. For healthcare companies, such incentive plans carry an additional advantage of encouraging employees to model the healthy behaviors that the corporation seeks to promote. Providence St. Joseph Health is a large (50 hospitals, seven state) healthcare system that seeks to provide goal-aligned care and is committed to the well-being of its over 110,000 employees. The Institute for Human Caring proposed and senior leadership approved an advance care planning (ACP) activity for the 2016 corporate health incentive option. This is one part of a multifaceted plan to establish goal-aligned care as a quality standard across Providence, and make goals of care conversations a common expectation of clinicians, patients and families alike. The Providence 2016 health incentive plan offered insured employees and covered family members the opportunity to view a brief video, complete 8 reflective questions about their own beliefs about ACP, and decide an action to take. A traditional risk reduction activity was also available. Over 51,000 individuals (91% of participating employees and spouses) chose the ACP incentive option and over 80% rated the experience as helpful or very helpful. The organization is extending a focus on advance care planning in the 2018 health incentive. We examine how this health incentive plan fits within a multicomponent, non-incremental change strategy aimed at making goal-aligned, whole person care the new normal care. We present the components of this “health journey” including marketing materials and videos, and the key results, including participant feedback. Early experience suggests that this health incentive plan is contributing to cultural change consistent with organizational values and strategic priorities.