Sustain Change and Encourage Progress Using Short-Term Wins

Part 5 of a series on Change Management in Health Benefits

At this point, company leaders will have already gotten an alliance of employees on board with rolling out their vision for an improved health benefits transformation. Here, it’s important to keep the momentum going, fueling the fire for change and propelling people forward. 

The best way to do that is by identifying, sharing and celebrating short-term wins, which, as Dr. John Kotter points out, should be: visible and tangible; unambiguous; and clearly related to the change effort.

Dr. Kotter’s work has informed a lot of my thinking in this area and this series. His 8-Step Process for Leading Change is an excellent framework, one that I’ve drawn on and tweaked to fit the way in which I believe business leaders can best execute a health benefits transition.

For example, as it applies here, a short-term win could be either qualitative in the form of an employee success story, or quantitative in the form of black-and-white cost savings. 

The following are qualitative examples of short-term wins celebrated after implementing Health Rosetta-type plans:

• More people enrolling in, and taking advantage of, direct primary care (DPC). Despite the relative lack of understanding by the average employee about the value of primary care, we've seen multiple organizations get over 50% enrollment in direct primary care models that provide an immediate accessibility advantage compared to old, hard-to-access primary care. 
• Praise for care (often nurse) navigators. Typically, navigators aren’t well received when there isn't proper primary care available. But when navigators help families with guidance on treatment, finding a center of excellence, or obtaining diabetes supplies in a more affordable and convenient way, word will get around. 
• Tyler, Texas has countless qualitative examples of short-term wins due to a wise onboarding program with a local DPC organization. Men, who had previously avoided the doctor because they viewed visits as going to the vice principal's office to be berated about health habits, were astonished to see they had a mobile app where they could easily reach their DPC doctor. And starting with small steps, these formerly at-risk patients – many already on multiple medications – were able to turn things around on issues like blood pressure, diabetes and back pain. They were able to get off medications that were costing them financially and physically, and now consider the doctors their friends and allies. (Many of their healthcare costs also dropped.) 

The following are quantitative examples of short-term wins celebrated after implementing Health Rosetta-type plans:

• Despite budget constraints, one municipality was able to put $500 into everyone's HRA-VEBA accounts – the public-sector equivalent of a health savings account (HSA).
• A private sector employer uncovered significant pharmacy rebates that hadn't been returned to the plan sponsor, so they changed it. This turned what would have been an OK year into a great year for the employer and its employees.
• A Texas employer had an employee who had been costing the plan $16,000 every month following gastric bypass surgery because the employee’s health wasn’t being well managed. As a result, the employee was facing large out-of-pocket costs, until they went to a DPC doctor who got that spend down to zero. 
• An employee who had previously walked into a CEO's office in tears because she was taking a $40,000/year medication her employer didn’t cover was able to get it for free under the new plan. Half of her income had been paying for this medication, exhausting her savings, until the new plan was able to navigate the opportunities to source this medication at no cost to the member and at a fraction of the cost for the health plan. 
• Many Health Rosetta type plans remove all co-pays and deductibles if individuals make wise choices such as calling the concierge line to find high-value care. 

Wins like these meet Dr. Kotter’s three criteria. They are benefits that employees can see, cannot deny, and can easily relate back to the change effort. They perfectly position the vision against the realities of the dysfunctional healthcare system that triggered their current benefits change in the first place, and effectively validate everyone’s patience and hard work. 

They can also, when correctly leveraged, be used to drive even greater change. They can be used to strike down disbelievers; provide feedback to leaders on what’s working well, what isn’t and what can be done even better; and keep everyone on track and moving forward. 

However, leaders can’t just hope for short-term wins to pop up. Leaders must actively look for ways to obtain clear health improvements and reward the people involved via recognition, and even money. I know of one organization that rewarded employees for finding billing errors by passing along 20% of the savings. Early on, one employee found a six-figure billing error which they prevented the employer from paying and allowed the individual’s annual income to increase by over 50% that year. The employer called a company meeting and presented the individual with a giant novelty check, unleashing a small army of people reviewing hospital bills that are often riddled with errors and duplicate charges.

At the end of the day, short-term wins have a gigantic impact on long-term success, and the leaders that realize this will be glad that they did. 

Part 1: I Think I’ve Figured Out Why It’s So Hard to Really Treat Employees Like They’re Your Most Valuable Asset

Part 2: Creating a Sense of Urgency — Why Change Now?

Part 3: How Great Leaders Inspire Action: Developing a Vision for Better Benefits

Part 4: To Ensure Benefits Success, Grassroots Support is Vital

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Dave Chase is the co-founder of the Health Rosetta (a LEED-like organization for healthcare), and author of the book, “The Opioid Crisis Wake-up Call: Health Care is Stealing the American Dream. Here's How We Take it Back.” Follow the link to the book for a free download of the book. Chase's TEDx talk was entitled "Healthcare stole the American Dream -- here's how we take it back." See the Health Rosetta website for how to get involved, resources and how to join others to support its mission.

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