Nearly every successful person I have encountered  has adopted the attribute of "work smarter not harder."

Yet when it comes to the workplace, to many times we succumb to inefficiencies and ineffectiveness.

There are no shortages of authors nor ideas that have been published to help you become a more resilient organization.

Yet ineffectiveness continues to thrive, hiding under a disguise of high-turnover, menial profits, or soaring healthcare costs. 

Recently, I completed a reading of Buy Back Your Time by Dan Martell, an excellent book on creating more space to become a better version of yourself. Martell outlines seven pillars of personal behaviors designed to help an individual operate closer to their true potential.

Unfortunately for most organizations, when ineffectiveness reigns, a strong correlation exists between the effectiveness of the individuals who collectively make up the whole.

As I digested Martell's writing, I couldn't help but wonder what would happen if we sought to apply each of the seven pillars within a professional setting.

Today, we examine how to incorporate the seven pillars of life into your workplace.

As defined by Martell, those pillars are as follows:

1. Health. Health equals wealth. Optimization must be a priority.
2. Hobbies. Ideally, each of us have a way to decompress and find joy.
3. Spirituality. Make time to tap into universal energy.
4. Friends. Cultivate connection both inside and outside of work.
5. Love. Go all in on essential relationships.
6. Finances. Know your numbers.
7. Mission. Live your why.

These Seven Pillars align with and exemplify the idea of flourishing, as thoroughly described in Martin Seligman’s expansive book on the topic.

We often mistakenly believe the responsibility of flourishing falls on the individual. I would challenge you, however, to imagine for a moment how your employees’ lives could be impacted if you incorporated education and encouragement for your people to explore and pursue these Seven Pillars within the context of their work.

While perhaps not specifically aligned with a traditional conversation around employee benefits, all of them could become part of your practice of creating a quality employee experience for your people.

Finance Examples

For example, let’s explore Finances. Have you considered or incorporated financial wellness into your offerings?

We all know our educational systems leave a lot to be desired in helping our young people prepare for the responsibilities of adulthood. Many of your people join the workforce before they have established even a basic level of financial acumen.

A number of your existing partnerships may be able to help. I have clients using programs available through their 401(k) administrator. A number of local banks and credit unions also provide financial education programs. Some employers have brought Dave Ramsey programs into their workplace.

For HUB clients, we also offer FinPath. The FinPath program has been specifically designed to help you better educate your population on the basics of creating a foolproof financial plan — from budgeting to investing, debt management to savings.

What could you doing in your organization to impact this area?

Connection Examples

What about connection? Much of that may happen outside of work, but it doesn’t have to be limited to the employees on their own. Do you facilitate opportunities for your people to connect offsite? Whether it be a picnic or a happy hour, are you doing more than an annual holiday event?

With the growth of DEI (Diversity, Equity, and Inclusion) initiatives prospering across the county, many employers have been able to leverage those DEI initiatives to create opportunities for connection.

Just the other day, I was with a client who had employee-driven groups that meet regularly and have provided a sense of community for sub-sets of their employees. Those cohorts included a yoga group, an LGBT group, and a group for minorities. They even created a group for employees over 50 (but admitted that group mostly just talks about getting together…).

Love Examples

And love. How do you empower loving relationships? That may sound like a stretch for an employer, but you can influence that aspect also.

In Colorado, we now have FAMLI, which in just a couple of short months has already begun a culture change around familial support efforts like access to paternal leave.

But it goes beyond paid leave programs. It can speak directly to your culture. Do you make it easy for employees to volunteer and be a part of their kids activities? Do you offer (and enable) the ability for employees to not only get their kids to practice but never miss the first pitch? Is it realistic for them to consider being the cookie captain for their child’s girl scout troop or the coach of their child’s soccer team?

Do you bring intention to protecting their evening time at home? Or do you operate in an environment that expects them (real or implied) to be available by phone, text, and email around the clock?

How to Move Forward

There is no right way or perfect way for you to do any of this, but it’s worth consideration. You have the power to enhance your employees’ lives. It’s one of the beautiful things about being a job creator, it empowers you to be a life creator.

Think on that for a moment, and don’t forget that when your people connect life and work together, they stay, they produce, and they thrive.

You’ve got this.

P.S. One key to these types of initiatives is to know the demographics in and out of your people. We have a cool tool that illustrates your population through generational, financial, and experiential lenses. If I can help, please drop me a note

There have been no lack of words written or spoken describing the pitfalls of the American healthcare system. You’ve likely heard many of them. After working in the employee benefits space for more than 25 years, there are few primary drivers simply not receiving the recognition they deserve for their contributions to our collective challenges. Until we bring light into the darkness, nothing will change. Today, we address five healthcare cost drivers receiving too tittle attention.

In no particular order, these are the special few that we all spend a little more time thinking about, and considering how we can mitigate or temper their negative influences.

• Insurance Companies
• Healthcare Aggregation
• The Pharmaceutical Quagmire
• Brokers and Insurance Agencies
• Human Nature 

Insurance Companies

Many insurance companies have made an effort to improve cost sustainability. In the last couple of years, we have seen some attempts to reduce barriers to care after years and years of increased deductibles and out-of-pocket maximums. Innovation hasn’t died, but it has largely been thwarted by the ever-present need to generate profits.

The Affordable Care Act attempted to temper the profitability of insurance companies by introducing the Medical Loss Ratio (MLR). Basically, this capped how much an insurance company could capture for operational expenses and required a pre-determined ratio to be dedicated to claims payments. (Insurance companies can retain 20% for small-group and 15% for large-group). Effectively, however, the MLR codified the insurance companies profitability. Arguably, service, innovation, and cost containment have suffered as a result.

Perhaps you feel as if your company has no other options but to acquire health insurance from these companies.

You, however, would be wrong.

Most employers have an option to pivot towards self-insuring and unbundling, giving you control, financial transparency, and access to data at a level that does not exist under these traditional arrangements.

Healthcare Aggregation

When it comes to dysfunction, one of the under-cited sources of inflation has to do with the number of aggregators and consolidators constantly at play in the healthcare delivery continuum. Whether it’s insurance companies buying pharmacy benefit managers (or other insurance companies), health systems buying medical practices, insurance companies buying physician practices, the proliferation of new hospitals, or health systems and third-party companies popping up stand-alone emergency rooms, there has been a massive expansion of investment dollars into a smaller pool of players — all created to increase market share and increase profits.

In his book Cheated, Alan Wiederhold shares that the annual value of acquired healthcare services by private entities increased from $42 billion in 2010 to approximately $120 billion in 2019.

He shares a quote attributed to the Private Equity Healthcare report that states, “Private equity funds, by design, are focused on short-term revenue generation and consolidation and not on the care and long-term wellbeing of patients. This, in turn, leads to pressure to prioritize revenue over the quality of care, and overburden health care companies.”

The 30,000-foot view suggests that aggregation reduces competition, increases market share, increases profitability, increases internal referral opportunities, and gives health systems greater clout to negotiate richer contracts while also focusing on quantity over quality.

None of this betters the experience or cost containment.

The Pharmaceutical Quagmire

The number of ways that the pharma industry impacts our healthcare pricing is too long and too complex to fully capture here. And frankly, I’m no expert in this area. However, a few of the primary culprits are the FDA, the manufacturers, and the pharmacy benefit managers.

One of the most helpful resources I recommend to everyone is the book The Price We Pay by Dr. Marty Makary. In the chapter, Pharmacy Hieroglyphics, he details the destructive financial impacts of the pharmacy benefit managers on our prescription pricing.

Makary shared the following anecdote in his book:

Cookie Benefit Manager

“Think about how this PBM game might look if it happens to another important commodity: Girl Scout cookies. Let’s say a dad approaches the CEO of a small company and offers to provide discounted Girl Scout cookies services to the company’s 100 employees. The busy CEO has no idea how much the different boxes of Girl Scout cookies normally cost (who does?) but he likes the simplicity of getting all his cookies from one guy. And he’s intrigued by the promise of bulk discounts the dad claims he can pass along to the company. The CEO agrees to make the dad the exclusive Girl Scout manager for his employees.

“A week later, the dad arranges for a few young Girl Scouts to set up a stand at the company office. One employee walks up and asks for a box of Thin Mints — everybody’s favorite. The girl says it will cost him only $2. He pays the $2 “copay” for his box and gobbles them up. The girls go on to a sell a hundred boxes. The CEO is glad to see his employees enjoying the cookies.

“A week later, the dad arranges for a few young Girl Scouts to set up a stand at the company office. One employee walks up and asks for a box of Thin Mints — everybody’s favorite. The girl says it will cost him only $2. He pays the $2 “copay” for his box and gobbles them up. The girls go on to a sell a hundred boxes. The CEO is glad to see his employees enjoying the cookies.

”A month later, the dad bills the company’s CEO a whoping $50 per box, and subtracts the “20% discount” bringing the bill to roughly $40 per box. The busy CEO can’t decipher the bill but pays it anyway, comforted by the 20% discount reflected on the bill.

“The dad then gives the Girl Scouts $1 for each box that they sold, so the girls collect a total of $3 per box (the $2 copay from the employee + $1 from the cookie manager). Their wholesol cost is $2.50, so the girls make 50 cents per box. The dad makes $39 per box, or $3,900 for the day for “managing the employee cookie benefit.”

Dr. Mary Makary, The Price We Pay

In this analogy, the dad is the PBM and the girl scouts are the pharmacies. Today, approximately 80% of Americans get their medications through a PBM. The system is a mess, and we can do better.

Brokers and Insurance Agencies

Both authors referenced above, Wiederhold and Makary, blame contingency or bonus programs provided by insurance companies as the driver of the status quo. With massive consolidation in the industry, there are fewer payors available for brokers to represent. In some markets, there may be as few as two or three insurance companies available to offer to employer clients. Every one of those insurance companies incentivizes brokers with both new and renewal bonuses to assure they are maximizing their market position, and those bonuses can add up.

They are not wrong.

But they are not completely right, either.

The real reason brokers and insurance agencies sit on this list isn’t because of the financial mechanics of compensation.

It’s because they are lazy. Complacency is the real contributor.

The reality is that more innovation has been introduced to the marketplace in the last seven to nine years than in the 20 years prior to that. Niche vendors have exploded and point-solutions abound. Each offer a new strategy or methodology to cost containment. Data analytic platforms have proliferated. Third Party Administrators have transformed from check-payers to true advocates. Healthcare navigational resources have become abundant. There are more resources available today to help employers manage claims expenses than ever before.

The innovative stuff takes work. It’s hard to learn. It can be burdensome to quote. Vendor relationship managers change often making it difficult to stay in touch. It’s difficult to know which vendors actually do cool stuff instead of just saying cool stuff. It just takes a lot of work.

Instead of doing that work, a lot of brokers take the safe route. They pick one or two insurance companies, they put nearly all of their clients with them, and they tell their clients that their large blocks of business give them the clout to negotiate better deals.

Human Nature

Maybe it’s you the individual who’s reading this. Maybe it’s the collective you. Maybe it’s the corporate you.

Maybe it’s all of us.

But we are our own worst enemies. It’s human nature.

A quick Google search of “lifestyle impact on health costs” brought up hundreds of articles. Here are a few of the best headlines:

• Changing lifestyle choices could cut $730B in annual health care spending
• Poor diets linked to $50 billion in U.S. health care costs
• Voluntary Health Risks: Who Should Pay?
• Health and Economic Costs of Chronic Diseases
• Unhealthy choices cost company health care plans billions of dollars
• Modifiable Health Risks Linked to more than $730 Billion in US Health Care Costs

Should we go on?

If we would all make a more concerted effort to take care of ourselves, there wouldn’t be a need to be so egregiously offended by the behaviors of the insurance companies, the aggregators, the pharmaceuticals, or the brokers.

Ultimately, you are the problem. I am the problem. We are the problem. The articles above indicated that lifestyle modification could impact up to $730 Billion in annual healthcare spending. Until we get serious about doing everything in our power to not be the problem, I’m not sure any of the rest of it really matters.

Not only should we do a better job taking care of our own health, but we must turn every stone. You have an obligation to yourself, your company, your employees, your customers, and your community to be a part of the solution.

For expanded thoughts on each of these cost drivers, I encourage you to check out the article I wrote on Medium. I’ve provided the link to that article in the comments.

Rest assured, there are solutions. For every bad apple, there are dozens of good apples. It just takes some work to pick through the barrel.

Please let me know if I can help do the picking.

Despite numerous industry advancements designed to simplify access to healthcare, in the moment of diagnose it can be incredibly difficult for your employees to know what may or may not be necessary. In today’s article, I leverage my own health scare to explore how to help your employees become better consumers of healthcare.

It’s been a few years now, but in 2017 I was diagnosed with Basal Cell Carcinoma.

This is what they call “good cancer.” I guess it’s called that because it’s unlikely to spread. Personally, however, there was nothing good about it. It was a brutal process, and it resulted in a nasty hole, ghastly stitches and both internal and external scars.

I don’t mean to be dramatic. Several years later, it’s now a nearly forgotten memory. The scars are mostly unnoticeable. And what at the time felt draconian and completely unfair, has largely faded into nothing more than a bad moment in time.

In retrospect, I was lucky.

Furthermore, I look back on the experience with gratitude as it was my first meaningful taste of the difficulty so many of our clients’ employees and family members experience when they too have to seek medical attention.

With that, it feels useful to share some of the lessons I learned in the hope that your employees become better consumers of healthcare.

In my case, the eventual diagnoses of cancer began with an unresolved blemish. The blemish, which seemed to be nothing more than an ordinary pimple made its unwelcome appearance on my right cheek roughly a year and a half before I had it removed.

As so many of us do, I ignored it.

It took me about six months to schedule my first dermatology appointment — partly out of ignorance, partly out of stubbornness. I was in my early 40s, so “I was too young for skin cancer.” My wife was more persistent, and eventually, I conceded to her concerns that this simply wasn’t normal.

I scheduled my first-ever dermatology appointment. That dermatologist, however, gave me a clean bill of health so I went on my way.

The blemish persisted. Eventually, I went to a second dermatologist. This one had the good sense to perform a biopsy. Unfortunately, it came back negative so I again left with a clean bill of health.

I later learned more there are multiple methods of biopsies that can be done, and this doctor chose the wrong one.

After more time passed, the third dermatologist performed the correct biopsy, resulting in an accurate diagnosis.

It took over 18 months from onset to surgery.

You have to learn to listen to yourself (or at least to the people who love you). Had my wife been less vocal, I likely would have brushed it off as an anomaly after two doctors gave me a clean bill of health – at least until it became so overwhelming and obvious that I had no other option but to deal with it.

You know your body better than anyone. When something’s not right, you have to be your loudest and most passionate advocate. Doctors make mistakes, just like the rest of us. If you know, you know. Trust yourself.

Each of us have to give ourselves permission to have the final say on our own wellbeing.

Lesson 2 – Understand Your Options

Unfortunately, Basal Cell Carcinoma grows roots. Over time, those roots grow deeper and wider into your skin. What may look superficial from the exterior can be a mess underneath. Our doctor used the term “aggressive,” which is a nice way of saying, “that bastard has been growing for a while.”

Of course, I didn’t understand any of this at the time.

The common treatment prescribed for Basal Cell Carcinoma (BCC) is called Mohs Surgery. From a layman’s perspective, this is basically the equivalent of using a spoon to scoop out the cancer spot. Then, they look at it under a microscope to see if they got all of it, and if not, they come back and get a bigger scoop. They repeat this process until all the edges are clean.

Approximately 85% of BCCs occur on the head and neck. These are the areas most frequently exposed to the sun. What that means practically is that you are likely to end up with a scar visible to the outside world.

Board Certified Mohs surgeons are common. Many excellent dermatologists have this certification. Much fewer have the skills to stitch you up in a way that will minimize your scarring.

Again, I didn’t understand any of this at the time.

In my case, I could have easily done some research to learn that you can locate a board certified Mohs surgeon who partners with a plastic surgeon.

Instead, I simply trusted my dermatologist. He was, after all, the doctor.

That trust left me with about a four-inch scar that was completely avoidable.

Whatever your situation, know your options THEN act. You’ll feel pressure to act immediately, especially when you have something foreign growing in your body. Take the extra step to understand best practices.

Don’t be afraid to demand a full-explanation of your options. If those are not forthcoming, consider changing doctors if it assures a more positive outcome.

Some doctors will stonewall you, trying to force you to have surgery in their practice. Surgeries make money.

Hopefully, you find a doctor who truly puts your needs first, but approach every conversation with a healthy dose of skepticisim.

Lesson 3 — The Emotions are Real

I was fortunate. People deal with more insidious diagnoses every single day.

Even with such a favorable diagnosis, four inches and 20+ stitches across my cheek left me feeling shattered. At no point did the doctor, his nurses or his staff ever indicate this was anything more than a simple procedure. I felt like Frankenstein and immediately mourned my unwelcome and unwanted facial modification.

I don’t consider myself a vain person, but I was disfigured. It hurt my soul. I was angry, embarrassed, sad, and deeply disappointed that I had joined a club I never wanted to be a part of. I was convinced no one would ever meet with me again professionally, let alone choose to be my friend. It threw me into a downward spiral unlike anything else I had experienced.

Maybe that sounds dramatic, but my face was jacked up.

The experience helped me understand the gravity of and challenges that arise when the unexpected happens.

If you have an employee or a loved one who experiences a health scare, don’t dismiss what they are going through. It’s real. It’s rough. It’s raw. Please don’t minimize them by telling them it’s a good kind of (insert illness here).

As well, continue to promote those behavioral health resources, employee advocacy and concierge programs, nurse lines, or whatever tools you have in your arsenal. Often we dismiss the value of those programs because of low utilization, but when they are needed they can be a lifesaver.

Lesson 4 – Promote Self Care

Don’t be as stupid as I was.

You get one body for the entire duration of the trip, however long it may be. Take good care of it.

In many ways, I do this well. I exercise daily. I generally eat well. I try to get good sleep. I consciously try to be a good example and practice what I preach.

But until receiving a cancer diagnosis, I never thought about something as simple as a daily face lotion with SPF. I was a child of the 80s. Not only did we not use sunscreen, we thought it was cool to coat ourselves with the tan accelerator stuff when we were kids.

Maybe for you, it’s also SPF lotion or wearing hats and sun-protection shirts.

But I’m guessing it’s a hundred other micro-failures. You skip that workout. You finished the whole bottle of wine on a Tuesday. You stare at your television or phone long past when you should have just gone to bed. You begin your morning by checking your email. You constantly amplify the cortisol running throughout your body because you haven’t figured out how to quiet your mind.

At some point, we each come to the realization that our every day choices directly correlate into our everyday outcomes. If you don’t like those outcomes, it’s up to you to change the habits that create those outcomes.

And yes, we now have a magic pill available to help you lose that dad-bod, but that comes with its own complications.

It’s something we don’t talk about, and if we do we likely don’t do it at work.

Why is that? Why is self-care not a regular topic in every professional environment.

We spend a majority of our waking hours each week at work. How we approach and promote self-care becomes very much a part of who we are as an organization.

Promoting self care equates to promoting culture.

It’s fundamental to creating a quality employee experience.

And, it’s a critical part of any effort to help you your employees become better consumers of healthcare.

Lesson 5 – People Are Both Amazing and Resilient

When the proverbial hits the fan, we literally put our lives in the hands of others to fix what ails us. It’s kind of crazy when you step back from it, but it’s also awesome.

It’s awesome that certain men and women have been uniquely created to remove the bad that happens to their fellow humans.

When I pause and think about it, I love that humans take care of humans. We are fortunate to live in a time where our medical professionals have the knowledge to solve real problems, and to live in a place where their availability is relatively abundant.

It’s easy to bash the healthcare industry, and it happens all around us. Whether it’s big pharma, the insurance companies, the lack of access to quality primary care, or a hundred other challenges, we hear about healthcare’s failings all the time.

But let’s not forget that most people are inherently good. And a heck of a lot of those good people chose healthcare as their calling.

We have to continue to collectively work to remove barriers, encourage positive healthcare consumerism, and help our people feel safe and comfortable going to see their healthcare providers. They’re good people and they exist to help.

Let us also remind our people that they are resilient.

Unfortunately, we don’t recover from every healthcare scare that occurs. However, most of the time, the scars and memories fade and we end up stronger for having overcome that obstacle.

We have the ability to use it as a catalyst to become a better version of ourselves.

Sometimes, it’s hard to remember that this too shall pass. Help remind your people that they too are resilient.

Part of creating a quality employee experience exists in those deeply personal situations. Be there for your people when things get difficult. Remind them of their own resiliency.

Final Thoughts

Nothing ever gets fixed by ignoring the issue.

Whether it’s a health issue, a relationship issue, or a confidence issue – take action. Go talk to that person. Start. Go see a doctor.

Do.

Taking action on life makes life more livable.

So go live fully.