Multinational Workforce Health. Building a Sustainable Global Strategy

Transcription

1 Multinational Workforce Health Building a Sustainable Global Strategy

2 2 towerswatson.com

3 Multinational Workforce Health: Building a Sustainable Global Strategy Table of Contents Executive Summary 4 What Is a Global Workforce Health Strategy? 5 About the Survey 6 A Closer Look at the Findings 7 Health Priorities: Mental/Stress Issues, Chronic Diseases, Tobacco Use 11 Different Regions, Different Lifestyle Risks 12 Components of Global Health Programs: Medical Benefits, Wellness Programs 13 Barriers to Development of a Global Health Strategy 16 A View of the Near Future: Control Costs, Address Risks 20 The Way Forward: Start With a Strategy 22 Multinational Workforce Health: Building a Sustainable Global Strategy 3

4 Executive Summary As companies around the world seek to gain competitive advantage, they are stepping up their efforts to improve the health and productivity of their workers. Employer-provided health care benefits have grown significantly around the world and are becoming a vital part of many companies total rewards programs. Even in countries with government-provided health care, employers are offering additional coverage to supplement these provisions or to allow faster access to treatment. Building a sustainable global health strategy, however, has its challenges: Health care costs continue to rise globally while, in some countries, government-sponsored benefits are being scaled back both to address the current fiscal crisis, and longer term, because of the strain placed on them by rapidly aging populations. What s more, population health, globally, continues to be affected by widespread lifestyle risks ranging from stress and mental disorders to obesity and health issues such as heart disease. The Towers Watson second annual global survey on workforce health issues presents insights into the global strategies and local approaches used by today s multinationals. Among the key findings: Employee health is a growing concern; 75% of respondents expect it to be more of a priority for their organization in , while 7% expect it to be more of a priority in While only 32% of all respondents currently have a global workforce health strategy in place (up from 26% last year), 47% plan to adopt one within two years. The reasons for a greater emphasis on workforce health vary significantly by region. In Asia, the focus is the need to compete for top talent, while in the U.S., cost containment continues to be the primary concern. European multinationals are interested in reducing absenteeism and improving employees health and safety. Wellness programs are offered by three-quarters of companies and have been growing in popularity. However, Asian-headquartered companies lag in incorporating wellness into employee benefit and total rewards programs. Companies that have a global health strategy are not communicating it broadly to their local managers and employees. Only 13% of respondents that have or are planning a global health strategy say they ve communicated it to their entire global workforce. 4 towerswatson.com

5 What Is a Global Workforce Health Strategy? A global strategy that offers guidance for local decisions gives multinational organizations flexibility to operate most efficiently in each country. Given the variety of health systems and market practices around the world and the significant differences in costs for employers to sponsor health plans a global workforce health strategy will enable organizations to support workforce health, contribute to overall business objectives and provide benefits efficiently and cost-effectively. Multinational organizations can use a global workforce health strategy to achieve a number of goals, including: Promoting the health and wellness of the entire workforce, regardless of location Demonstrating the organization s interest in employees health and well-being Controlling costs and improving productivity Reducing time lost due to illness Ensuring that health care benefits worldwide play the right role in the organization s talent and rewards program Multinational Workforce Health: Building a Sustainable Global Strategy 5

6 About the Survey Multinationals face ever-growing issues regarding their workforce health and related benefit programs across countries. Towers Watson conducted its second survey in early 2011 to identify the top challenges and understand how multinational employers are responding. The survey had 149 respondents representing a total workforce of 5.2 million people in 37 countries, providing data for some questions by region and for developed and developing countries. Number of employees 15% 10% 49% 49% 10, % 5,000 to 10,000 10% 2,000 to 5,000 15% Less than 2,000 26% Industry groups 1% 5% 5% 36% 22% 17% 3% 11% 5% Energy and utilities 17% Financial services 11% General services 3% Health care 22% IT and telecom 36% Manufacturing 1% Public sector and education 5% Wholesale and retail Headquarters by region 2% 61% 11% 2% Asia Pacific 11% EMEA 61% Americas 6 towerswatson.com

7 A Closer Look at the Findings Concerns over workforce health are growing Figure 1. Which best describes the global health strategy at your organization? Workforce health is a growing priority for multinational organizations worldwide, regardless of where they are headquartered. Three-quarters of respondents (75%) think that it will be more of a priority in 2011 and 2012, while 7% think that it will be more of a priority from 2013 to 2015 (Figure 3, page ). 21% 13% 19% Despite this view, just under a third (32%) of respondents currently have a global workforce health strategy, and that percentage has risen only marginally (from 26% in our 2009/2010 survey). However, 47% of respondents say their organization plans to adopt a strategy in the next one to two years, indicating a broad recognition that multinational corporations see the lack of a strategy as an issue to be addressed (Figure 1). While 21% of respondents overall say they have no plans to develop a global workforce health strategy, there are some significant differences by region (Figure 2). For instance, multinationals headquartered in Asia are less likely than those in other regions to have a global strategy and are less likely to be contemplating one, while those headquartered in the Americas are most likely to have a strategy in place or are considering adoption of one in the next one to two years. and employers are committed to employee well-being As Figure 4 (page 9) shows, many factors are influencing this growing spotlight on workforce health, and there is significant variation by region. In the Americas, the driving factor is to reduce or contain the organization s health care costs. This is likely driven by U.S.-headquartered companies concerns about health care and medical inflation. Costs have been an ongoing concern, and employers with U.S. operations do not expect relief from health care reform. Recent Towers Watson research shows that only 14% of U.S. employers expect the reforms of the U.S. Patient Protection and Affordable Care Act (PPACA) to help contain their health care 47% A global strategy has been in place for five or more years A global strategy has been in place for less than five years No global strategy, but planning to adopt one in the next one to two years No global strategy and no plans to adopt one Figure 2. Which best describes the global health strategy at your organization? (by region) Asia Pacific 33% Americas 16% 49% 13% 44% 13% 10% 23% EMEA 24% 47% 12% A global strategy has been in place for five or more years A global strategy has been in place for less than five years No global strategy, but planning to adopt one in the next one to two years No global strategy and no plans to adopt one 1% Multinational Workforce Health: Building a Sustainable Global Strategy 7

8 costs. And 90% expect their costs to increase as more provisions of the act are implemented. If that happens, cost containment would become an even greater challenge. Notably, although the desire to demonstrate a commitment to employee well-being, resiliency and stress management was ranked in the top three by 54% of all respondents, it ranks in the top three for 69% of respondents headquartered in the Europe, Middle East and Africa (EMEA) region. While medical cost is not as prominent for European corporations as it is in the Americas, the impact is felt in other areas such as disability, lost productivity and absenteeism. Employers headquartered in EMEA are focusing or planning to focus on using their strategy to directly influence employees health. In addition to improving workforce productivity and reducing absenteeism, this strategy could also help improve an organization s reputation as an employer of choice. Figure 3. Do you expect the health of your global workforce to become more or less of a priority for your organization in the following time periods? 100% 0% 60% 40% 20% % Next one to two years ( ) Next three to five years ( ) Significantly more/more towerswatson.com

9 By contrast, 62% of Asia-headquartered respondents ranked provide competitive reward packages among the top three reasons for their current or planned global health strategy. These results likely reflect the highly competitive labor market in many parts of Asia. Employers in these countries are looking for ways to differentiate their companies as a way to attract and retain top talent. Health programs, as part of a total rewards approach, are tools for doing that. However, costs continue to grow Cost containment was ranked the top objective for organizations health strategies in the Americas and was also the second-highest objective overall. And aside from North America, other countries health care costs are also proving worrisome to multinational companies. More than a third of respondents said that costs in China are a top concern, and nearly a third said they are concerned about costs in the U.K. and Singapore (Figure 5, page 10). Figure 4. Select the top three most important objectives of your organization's current or planned global health strategy 0% 20% 40% 60% 0% 100% Demonstrate interest in employee well-being, employee resiliency/stress management Provide competitive reward packages 45 Retain key talent Increase productivity Increase employee access to health care Supplement public health system Other Contain/reduce the organization's health care costs Reduce the cost of work loss (i.e., absence, disability) Improve on-the-job safety Overall Asia Pacific EMEA Americas respondents respondents respondents respondents Multinational Workforce Health: Building a Sustainable Global Strategy 9

10 Figure 5. Other than the United States, in which countries are you most concerned about cost increases in your company-sponsored health care benefits? 0% 10% 20% 30% 40% 50% China United Kingdom Singapore India Canada Brazil Hong Kong Mexico Germany Australia Malaysia Japan Note: Respondents were asked to select their top three priorities. 36 For their U.S. operations, more than half (63%) of employers are depending to a moderate or large extent on preventive services to rein in costs. This U.S. experience highlights that employers understand the vital link between good preventive care, better overall employee health and health costs. Many are also to a moderate or large degree changing plan design (e.g., deductibles, copays, coinsurance) and shifting a greater portion of the cost burden to employees. Cutting administrative costs by consolidating plan vendors is also a key activity for many employers U.S. operations (Figure 6). Towers Watson View: As multinational companies expand their global operations, the need for a formal workforce health strategy grows. Multinationals with a clear strategy can better coordinate local health activities to improve their overall workforce health and increase the efficiency of their total health spend. These outcomes can be achieved through a holistic approach that includes collecting more complete employee population health data, managing the role of health benefits in overall reward programs and responding more effectively to external changes such as decreases in the quality or availability of government-sponsored health programs. Figure 6. To what extent does your organization use the following cost strategies inside and outside the United States? None/slight extent Inside the U.S. Moderate extent Great/ very great extent None/slight extent Outside the U.S. Moderate extent Great/ very great extent Provide coverage for use of preventive services 25% 13% 63% 5% 27% 15% Consolidate plan vendors to reduce administration costs 32% 25% 43% 55% 26% 1% Evaluate employee health programs in the context of total rewards 35% 2% 37% 54% 22% 24% Offer medical savings accounts or other instruments to accumulate funds for health care services 41% 19% 40% 7% 10% 3% Increase deductibles for medical/pharmacy programs 47% 30% 23% 6% 10% 5% Increase copays or coinsurance for medical/pharmacy programs 50% 29% 21% 5% 11% 5% 10 towerswatson.com

11 Health Priorities: Mental/Stress Issues, Chronic Diseases, Tobacco Use There is significant consistency by region about which health conditions cause the greatest concern. Fifty-five percent of respondents said that mental health and stress issues are a priority for their global health strategy in all or most of the countries in which they have operations (Figure 7), followed by chronic diseases such as diabetes, hypertension and asthma. Tobacco use ranked third. Stress and mental disorders rank particularly highly for respondents headquartered in Europe and the Americas. These results mirror a 2009 World Health Organization (WHO) report, Global Health Risks: Mortality and Burden of Disease Attributable to Selected Major Risks, which found that high blood pressure (hypertension) accounts for the greatest number of deaths worldwide each year (at 13%), followed by tobacco use (9%) and high blood glucose (6%). What s more, WHO estimated in a 2001 report that mental health disorders affect one in four people globally and account for 14% of global disease. This number does not include stress and stress-related illnesses. The 2011 Towers Watson Global Medical Trends Survey showed some similar patterns. When asked to choose the three leading causes of medical claims in their client portfolios, 75% of health insurers picked cardiovascular disease as one of the top three, and 63% chose cancer. Respondents also said and they expect these to remain the most prevalent causes of claims over the next five years. Figure 7. In how many countries in which your company operates are the following health risk issues a priority of your organization s current or planned global health strategy? 0% 20% 40% 60% 0% 100% Mental/stress issues Chronic conditions (e.g., diabetes, asthma, hypertension) Tobacco use Lack of physical activity Disability Unplanned absences Obesity Infectious diseases Not at all/few countries Some countries All/most countries Surprisingly, 40% of respondents are seeing obesity as a risk in only a few of their global operations. Multinational Workforce Health: Building a Sustainable Global Strategy 11

12 Figure. In how many countries in which your company operates are the following health risk issues a priority of your organization s current or planned global health strategy? 0% 20% 40% 60% 0% Mental/stress issues Chronic conditions (e.g., diabetes, asthma, hypertension) Tobacco use Lack of physical activity 20 Disability Unplanned absences Obesity 12 Infectious diseases Asia Pacific respondents EMEA respondents Americas respondents Note: Percentages indicate responses of most/all countries For European multinationals, a lack of physical activity is the second - leading health risk. More European employers are also seeing obesity-related risks, and they are also facing the greatest problem with unplanned absences. Different regions, different lifestyle risks However, there are notable differences in lifestyle risk by region. For instance, both the Americas and EMEA have the highest level of concern about employee tobacco use (Figure ). In these regions, a number of countries have mandated tobacco-free workplaces and prohibit smoking in most public places. In addition, government intervention has helped identify this as a major health issue, and many employers offer education and smoking cessation programs to support employees who want to stop smoking. Obesity is also a worldwide workforce health issue, particularly among EMEA respondents and those from the Americas. This concern mirrors global statistics: In 200, WHO s report, Obesity and Overweight, estimated that more than one in 10 individuals were obese. While it s surprising that obesity doesn t rank higher among respondents in the Americas and Europe, it may be because they are focused on the causes of obesity (such as lack of physical exercise, which ranked fairly high) or on the diseases caused by obesity, including diabetes and hypertension. In any case, obesity and its diseases are important issues for respondents, who undoubtedly recognize both their human and financial costs. Towers Watson View: Respondents say their greatest challenge lies in managing the mental health and stress issues of their workforce. These concerns are likely to remain as employees continue to feel the pressures of increased workloads, uncertain job security and retirement concerns. However, despite concerns about mental health and stress issues, we will see when we look at the components of multinationals global health strategy in the next section that only 17% of multinationals have a mental health or stress management program in place. 12 towerswatson.com

13 Components of Global Health Programs: Medical Benefits, Wellness Programs Medical benefits and wellness programs form the basis of most respondents global health strategies, although there are some regional differences. Medical benefits of some kind are widely offered by respondents in all regions. Wellness programs (e.g., education, preventive care, screenings) are offered by three-quarters of companies and have been growing in popularity. However, Asia-headquartered companies lag in incorporating wellness into employee benefit and total rewards programs (Figure 9). This may be due to the emerging nature of preventive care in the region. Historically, Asian companies have adopted a piecemeal approach to workforce wellness, in some cases implementing a health risk assessment program but not following up with an overall strategy for assessment or sustainable improvement. Not surprisingly, these efforts have met with sporadic success. As multinationals in the region begin to lead the way by addressing health and well-being more holistically, it can be expected that other Asian companies will follow. Figure 9. Which of the following are core components of the global health strategy at your organization (or in planning such a strategy)? 0% 20% 40% 60% 0% 100% Medical benefits (in addition to or instead of public health care services) Occupational health (e.g., job safety, risk management) Wellness/health promotion programs (e.g., preventive care/screenings, health risk assessments, smoking cessation) 75 Reputational risks/branding (i.e., to build a global reputation as a good place to work, demonstrate interest in employee well-being) Pandemic preparedness (e.g., evacuation processes, communication systems) Overall Asia Pacific EMEA Americas 77 Multinational Workforce Health: Building a Sustainable Global Strategy 13

14 This survey shows that wellness programs are most prevalent in advanced economies. In many emerging economies, these programs are offered only to senior managers, and more than one-third (3%) of employers in emerging economies don t offer wellness programs at all (Figure 10). These programs sometimes incorporate financial incentives (cash and noncash) (Figure 11). Incentives are still a U.S.- dominated concept our survey shows that 12% of multinationals headquartered in the Americas offer significant incentives, compared to only 2% in both Asia Pacific and EMEA but it is starting to grow in other regions such as well. For instance, companies headquartered in Germany and Singapore offer tax incentives for wellness programs. Figure 10. To what extent does your organization offer the following programs?* Employee Health Programs by Economy Not offered Some employees covered Most/all employees covered Medical/health benefits Advanced 4% 6% 90% Emerging % 22% 70% Wellness/health promotion programs Advanced 20% 17% 63% Emerging 3% 32% 30% Pandemic preparedness Advanced 14% % 7% Emerging 1% 19% 63% *Economies are categorized as advanced and emerging as defined by the International Monetary Fund. Figure 11. Do you offer financial incentives in your global wellness programs in the following countries? Use of Wellness Incentives Offer significant incentives Offer some incentives Don t offer incentives Don t offer programs Global All countries 5% 17% 43% 36% Regions Asia Pacific 2% 11% 49% 37% EMEA 2% 12% 4% 3% Americas 12% 2% 29% 31% Economies Advanced 9% 21% 39% 31% Emerging 1% 12% 46% 40% 14 towerswatson.com

15 Figure 12. In the countries in which your company operates, to what extent does your organization offer (or plan to offer) the following health and productivity programs? 0% 10% 20% 30% 40% 50% Health screenings Vaccinations Mental health/stress management Tobacco cessation Health risk assessment Disease management (for those with chronic conditions) Lifestyle coaching Weight management (including counseling) Fitness (either onsite or subsidized gym/fitness subscriptions) Healthy eating (cafeteria or vending machine) Five in 10 Asia Pacific multinationals offer employees health screenings, compared with three in 10 European multinationals and roughly two in 10 in the Americas. Some multinationals also offer targeted health and productivity programs such as health screenings and vaccinations, but aside from Asian companies, 51% of which offer health screenings, the percentages of companies offering any type of preventive or health program is quite low. Globally, the most commonly offered programs are preventive screenings, vaccinations and fitness programs (Figure 12). It is notable that only % of multinationals globally offer (or plan to offer) health risk assessments (HRAs). This is a potential missed opportunity to identify issues early, and it could have important implications for both costs and productivity. Towers Watson View: To get full value from health and wellness programs, multinational employers should clearly define the role wellness, health and productivity programs will play not only in their global health strategy, but also in their overall business strategy. If an organization is in an industry that competes for talent, for example, its approach to health especially in some regions could be a factor in attracting and retaining employees. Overall Asia Pacific EMEA Americas Note: Percentages indicate responses of most/all countries. Multinational Workforce Health: Building a Sustainable Global Strategy 15

16 Figure 13. What have been the three biggest barriers to your organization adopting a global health care and well-being management strategy? 0% 20% 40% 60% 0% Not a business priority at present Lack of internal staffing Lack of budget Organization too decentralized Lack of senior leadership support Desired health care vendors are not present (or don't offer services/products needed) Other Health issues of employees vary too widely to manage globally Lack of evidence to support a business case Unnecessary as most public systems support employees in their health and well-being Separate global health strategy not required as it is part of a broader global benefit structure In particular, this is a concern for threequarters of EMEA multinationals. Barriers to Development of a Global Health Strategy Multinationals without a global strategy say they are impeded by the lack of a strong business case, insufficient staffing, insufficient budget and an inadequate (decentralized) global organizational structure (Figure 13). Overall Asia Pacific EMEA Americas These responses are based on the 99 respondents with no global health strategy today. 16 towerswatson.com

17 In Figure 4 (page 9), we saw that multinationals that have a global health strategy say the top three objectives of their strategy are to (a) demonstrate interest in employee well-being and help workers manage stress, (b) control costs and (c) enhance their total rewards programs. However, they see some barriers to achieving those goals, including insufficient data on employee health risks, insufficient local resources and insufficient budget (Figure 14). Figure 14. To what extent are the following issues barriers to your organization achieving its global health care objectives? 0% 20% 40% 60% 0% 100% Data are not available or reliable to identify employee health risks Limited local support (e.g., resources) 33 Lack of an adequate budget at corporate level 39 Lack of an adequate budget at regional/local level 35 Poorly communicated global strategy Lack of senior leadership support Desired health care vendors are not present (or don't offer services/products needed) Not at all/slight extent Moderate extent Very great/great extent Multinational Workforce Health: Building a Sustainable Global Strategy 17

18 Figure 15. To what extent are the following issues barriers to your organization achieving its global health care objectives? (by region) 0% 10% 20% 30% 40% 50% Data are not available or reliable to identify employee health risks 3 Limited local support (e.g., resources) 13 Lack of an adequate budget at corporate level Desired health care vendors are not present (or don't offer services/products needed) Poorly communicated global strategy Lack of senior leadership support Lack of an adequate budget at regional/local level Companies that have a health strategy are not sharing it broadly with employees. Only 13% of respondents say they ve explained their strategy to their entire global workforce, and fewer than half say they ve explained the strategy to the regional and local leaders (Figure 16). EMEA corporate leaders were the least involved in health strategy, possibly because of the high rates of government-sponsored health care in those countries (Figure 17). This has far-reaching governance implications, and is surprising given that EMEA-headquartered multinationals cited factors such as reducing the cost of work loss and increasing productivity, for instance, as leading objectives for their global health strategy. Without senior leader involvement, these objectives will be difficult to achieve. Asia Pacific EMEA Americas Note: Percentages indicate responses of to a very great/great extent. Figure 16. To what extent is the global health care and well-being management strategy communicated across your organization? 0% 20% 40% 60% 0% 100% The strategy is communicated to regional/local leads The strategy is communicated broadly to the global workforce Not at all/slight extent Moderate extent Very great/great extent These responses are based on the 46 respondents who have or are planning a global health strategy. 1 towerswatson.com

19 Furthermore, senior leaders visibly support the importance of a healthy work environment in only 23% of companies (Figure 1). And only 12% of companies include employee health as part of the organization s objectives or value statement. Towers Watson View: Without senior managers involvement in the overall health strategy, companies miss an opportunity to use their leadership to help cultivate improved employee health throughout the organization. Not involving senior leaders may also engender a vicious cycle that starts with a lack of a clear understanding of why employee wellness is key to business growth and sustainability, which then further restricts access to the resources and budget required. This puts local operations at the risk of navigating an uncoordinated and reactive health strategy. Figure 17. To what extent is the global health care and well-being management strategy communicated to regional/local leads across your organization? 0% 20% 40% 60% 0% 100% Asia Pacific EMEA Americas Not at all/slight extent Moderate extent Very great/great extent 0 20 These responses are based on the 46 respondents who have or are planning a global health strategy. Figure 1. To what extent are senior leaders and other managers involved in the global health care strategy and/or health care decisions at your organization? 0% 20% 40% 60% 0% 100% Senior leadership visibly supports the importance of a healthy work environment Senior leadership allocates adequate budget for health and productivity programs Senior leadership includes employee health and productivity in our organizational goals or value statement Managers and/or senior leaders receive regular reports with health and productivity program utilization metrics Not at all/slight extent Moderate extent Very great/great extent Multinational Workforce Health: Building a Sustainable Global Strategy 19

20 Figure 19. What are your organization s top priorities inside and outside the United States for improving employee health and well-being over the next three years? 0% 20% 40% 60% 0% Control costs of employee health programs Address emerging health risks (e.g., obesity, heart disease) 4 54 Use health programs as a tool to help attract and retain top talent Provide incentive programs to improve employee health/wellness Increase quality of health care Reduce lost time (scheduled and unscheduled) Expand health coverage to more/all employees Improve pandemic preparedness 11 5 Consolidate vendors 11 6 Other 2 3 None of the above A View of the Near Future: Control Costs, Address Risks Over the next three years, employers say they expect the top four health and well-being priorities to be controlling health-related costs, addressing major health risks, using health programs to boost attraction/retention and motivating workers to improve their health (Figure 19). However, there are some regional differences. Most significantly, U.S.- headquartered companies are less concerned than others about using health programs for attraction and retention. This may be because many American workers consider good health benefits a needed to play benefit that is, employees won t consider the employer unless benefits are adequate or better. Alternatively, it may be that because of the high rate of U.S. unemployment, employers don t believe that the quality of their health benefits currently have an impact on their ability to attract top talent. Multinationals with U.S. operations report more use of incentives to encourage employees use of wellness programs in their U.S. operations than elsewhere. Conversely, employers headquartered in the U.S. are less likely than others to want to increase the quality of health care or expand coverage to more employees. Outside the U.S. Inside the U.S. Note: Respondents were asked to select their top three priorities. 20 towerswatson.com

21 Finally, in the next three years, multinationals will rely increasingly on more global governance of their health care benefit programs. Data management, selection of insurers and third-party administrators, the use of health risk appraisals and the offering of prevention or wellness programs are the areas most likely to come under some type of global governance at respondent organizations (Figure 20). There will also likely be changes in the worldwide health landscape that will affect employers and their global health strategies. In 2009, WHO predicted that, within 20 years, more people will be affected by depression than any other health problem. This would put more employees at risk and add additional cost to employer health plans in addition to affecting lost-time rates and, possibly, disability claims. These figures highlight even more sharply the focus employers will need to place on wellness programs and programs that manage employee mental and stress issues. The aging population in many regions will also put additional stress on employer health costs and challenge employers to continue to provide adequate care. Diseases of aging, including heart disease, arthritis and dementia, will further add to the burden. Finally, in many countries, the degree of support from public health systems for workforce health programs will come under increasing strain to provide the required treatment. The role of the private sector, and that of the employer, will be crucial to providing interventions and influencing workforce health outcomes. Figure 20. At what level have decisions been made for the following issues related to health care benefits over the last three years? How do you expect decisions to be made in the next three years? 0% 10% 20% 30% 40% 50% Data management and program evaluation 20 Selection of insurers or third-party administrators 22 Health risk appraisals 12 Prevention/wellness program offerings 19 Selection of brokers/consultants Plan offerings Plan design changes Funding decisions Employee cost sharing Eligibility decisions Plan communication Change Last three years Next three years Multinational Workforce Health: Building a Sustainable Global Strategy 21

22 The Way Forward: Start With a Strategy Around the world, employers are facing a litany of challenges relating to their employee benefits, from workers delaying retirement, to growing health risks such as stress and chronic diseases, to the rising cost of medical benefits. For multinational employers, managing these challenges takes on a greater level of complexity. A global workforce health strategy can give multinational employers a greater level of consistency, flexibility and control over their local operations, and generally promote the health and wellness of the entire workforce. Ultimately, it can help manage spiraling medical costs, improve productivity and thereby have a positive impact on an organization s bottom line. A sound evaluation framework is the foundation of a strong workforce health strategy. Organizations with good data and proven practices can measure outcomes and demonstrate the business case behind their strategy, which is important to attain senior leadership buy-in. Senior leadership buy-in in turn ensures that the health strategy plays the right role in the organization s overall talent and rewards program, is communicated consistently and is sustainable. The barriers identified by the multinational companies in our survey which included lack of data, lack of resources and poor communication are difficult to overcome without this broader strategic perspective. A strong evaluation framework can also help identify practices that are most effective in managing costs and boosting overall workforce effectiveness. The challenges multinational employers face, both strategic and workforce-related, are likely to grow over the coming years as changes loom in the competitive global landscape. Putting a global workforce health strategy in place now can ensure that multinationals have the foundation to make the most of existing resources, attract and retain the needed talent, and optimize their benefits spend. 22 towerswatson.com

23 Multinational Workforce Health: Building a Sustainable Global Strategy 23

24 About Towers Watson Towers Watson is a leading global professional services company that helps organizations improve performance through effective people, risk and financial management. With 14,000 associates around the world, we offer solutions in the areas of employee benefits, talent management, rewards, and risk and capital management. Copyright 2011 Towers Watson. All rights reserved. TW-NA towerswatson.com