How to Become a High-Performing Employer

With Caitlin Rafferty, PhD candidate, CWPC, MSHEP, CHES | Account Executive at Arthur J. Gallagher South Carolina

Arthur J. Gallagher in South Carolina created an industry-leading High Performing Employer program that rewards employers who meet a rigorous set of standards for the wellbeing of their employees. To be a High Performing Employer, clients must achieve:

Clinical Metrics

• 80% of the population engaged in screening and following a minimal care plan
• 70% of the chronic population holding the line or getting better

Financial Metrics

• 50% less than market trend for three years

Engagement and Culture

• Survey results show high engagement and positive company culture

Here, leader of the program Caitlin Rafferty answered our questions about tips for employers looking to improve employee health and lower healthcare costs.

How long have you been offering this program, and what factors encouraged your team implement it?

This program goes back since before I started at AJG, but truthfully it was one of the things that led me to accept the position in South Carolina. Rick Gantt, who is the area president of South Carolina, is risk management and well-being driven. He believed that if you could help people take control of their own health, you could really make a financial impact. He has at least 25 years of experience, and he has been [running the program] since the very beginning. I’ve recently taken it over because I have a background in risk management and population health.

How do you measure and determine a High Performing Employer?

As we’ve evolved as a country and become more health-conscious and wellness-driven, I’ve been able to use the data and see where our clients fit into that trend. I want at least ten years of data, so I am looking at 17 clients that we’ve had since 2012. I take their data from each renewal year, so putting it together, we are looking at 127 years of data. As we add clients and keep renewing, I keep adding this data to see where companies are coming in. One of the things we look at is a comparison of pre-high-performing status and post-high performing status to see what the cost savings are for them.

Do you see a pattern in the types of employers that engage and consistently hit these benchmarks (size, industry, plan design etc.)? If there is a pattern, why do you think that is and can employers with different circumstances achieve similar results?

Yes, we do see somewhat of a pattern. The majority of the groups we have on this list are self-insured, so we’re able to plug-and-play the programs that fit their needs. We also only see success to the extent that there is buy-in from a c-suite level. You have to walk the walk and talk the talk. But from an industry perspective, I don’t think there’s a pattern. We work with religious non-profits, healthcare, manufacturing—all different industries.  

Ultimately, it all comes down to effort. if you put in the time, it can work for you. You don’t wake up one day and become high performing. There has to be a starting point: you have to crawl, walk, run. Regardless of industry, plan design, or size, if you’re willing to put in that work, you can get your employees healthy and be high performing. 

The shift to a strong health and safety focus is interesting. How are you and your clients addressing an improved health and safety effort? 

I think that comes from the overall focus on wellbeing and wellness: addressing it from both a physical perspective (clinical factors) and safety perspective (think Workers’ Comp). You have to manage the whole person to manage their health. For example, you could have a person pass out on floor and hit their head because they aren’t managing their diabetes and need insulin. If you can manage the diabetes on the front end, you’re making safety a priority and managing healthcare costs. Safety is different for every employer. There is a lot of telework happening now, so we have to shift our mindset to what health and safety looks like there. You need to have an integrative, collaborative approach for this to work. 

Engagement and culture are criteria for a high performing employer. Do you find those are more difficult to quantify than the other criteria? How do you evaluate employer culture and why is it important?

It is harder to quantify because you don’t have concrete numbers like you do with clinical and financial metrics. That’s where our employer survey comes in. We have general open-ended questions as well as Yes/No questions about the types of programs they offer. One of the other things I’ve wanted to implement is a confidential focus group where you can really target people within the different demographics (male/female, age, length of time at the company), getting the good, the bad, and the ugly. Once you get down to that level, you can really work to build the employer back up. But culture is really important because employees are more engaged if they are happy.

How do you see the future of the program being affected by Covid-19?

We can still measure the data because we have aggregate claim data and renewal data. But we will have to take into account how Covid-19 impacts the claims that we use for renewals. There have been a lot of deaths and high-cost claims that have come from [the pandemic]. Additionally, there will be a shift toward emotional and mental wellbeing. How are you supporting those people who are teleworking? Keeping that engagement as high as possible will be crucial. 

If someone is looking to implement a program like this, what are the most crucial criteria/processes to get right from the beginning?

I would say that you first need to have the buy-in from the higher-ups in the company. To get that, you need to understand your audience. If you’re talking to a CEO or CFO, get the data. Show them the results of the survey and how you can bring down your overall costs by a significant percentage, and that’s going to resonate. 

Then you need to take the time to establish a 3-5 year strategy and understand it fully. This isn’t something that will happen overnight. It takes time, perseverance, education, and promotion. Sit down and talk about what is financially acceptable to the company with the mindset that you are working toward a bigger goal and a better managed population.

What successful strategies have your employers implemented to create stronger awareness and importance around preventive care?

The go-to campaign would be a Know Your Numbers campaign: emails, flyers, weekly recipes, anything to be really engaging and be an attention grab for employees. We’ve done onsite health fairs that involve the whole family and are really successful. Make it less daunting and humanizing it so people will realize it’s not as scary as it seems.