Health Gig EP14: Mark Bertolini (Part 2) - Employee Health

When you see the results of this and the way you feel about others and how they react to you, you say, 'I want other people to do this.' And your organizations are full of stressors and people are working hard. And Mari was in this program in Watsonville, California with Gary Kress. So Mari was in his yoga teacher training class, his yoga therapist class, and I would pop out there and hang out at Watsonville or Mount Madonna, right at the Hanuman Temple wall, and the Sequoias, and vegan food and chanting, and then hang out in the class. And one day he figured out, you know, 'Yes, who is that?' And she told him, and he says, 'Oh my God, he's the guy from Aetna!' And he came over to me and goes, 'Oh, we should build a program together.' And so Gary talks spiritual, and I talk business, and the bridge was really tough to build because he doesn't understand you have to actually prove that it actually matters, the fact that you want to do it, right? Mari became the Rosetta Stone between us. And I finally came to work one day and said, 'You know, I think we should do mindfulness and yoga.' Who do you tell that to? You're like, 'Your team?' My team. I said, 'We should do this,' and they're all looking at me, 'Oh my God, this is... no one actually works.'

And so like a week later, the chief medical officer, Lani Riesman, comes to me and goes, 'You know, this is all fluff, right?' And I'm going, 'Well, what do you mean?' He goes, 'This is just crazy stuff. You're gonna look like an idiot.' So I said, 'Don't you tell me what it would take for you to believe that this was effective.' And so he said, 'We need to do a double-blind study. We need to do a randomized controlled study.' So we did. We invited people to join the program. 795 applied. We created a control group with the East Coast and West Coast people. Interestingly enough, the West Coast people were more stressed. We put these people in groups and we started this program that Gary and Mari put together, and it included journaling, it included in-person, it included online, for me, mindful. And we studied all of this stuff, and we did it for 12 weeks. And then we sent the information to biostatisticians and we said to them, 'Did it work?' And we did pre-testing on heart rate variability and cortisol levels, and then we did post. And the results were dramatic.

Stress levels dropped. We found 69 minutes a month in increased productivity. The healthcare costs of the people before the study that were—we arrayed people in quintiles of stress—the people in the highest quintile of stress were doing $2,500 more a year in healthcare costs than the average. And so we made this investment and we watched people, and it was amazing. The results we had the next year, our healthcare costs as a company went down 7.9 percent—not the trend, the overall costs.

He came in to me and said, 'I don't know what to say. Like, this really works.' We saw stress levels drop in half. But the most important thing were the journals, right? People's personal stories. Like citizen scientists, you know, getting people to actually tell their story and then come together with it, you know, crowdsourcing. Well, and I'm also on the Dalai Lama's Mind & Life Institute, and they invited me to help bring the research to reality because, you know, academics have a hard time reading it over real-world. And so this was one of those sort of live studies. And when we started, Mari was teaching the classes and she's coming back, you know, 'These people are like really stressed out and they don't have enough time and they're not eating well and they can't afford your health insurance.' So I'm reading the journals and all these really interesting stories, and one of them was, 'You know, I was gonna kill myself, but now I found new hope.' And so there was one life saved. The whole program cost $179,000. That's cheap to save one life, for sure.

So then I started saying, like, 'Oh, who are the people?' And also, when I go out in the field, I walk around and I shake everybody's hands on every cubicle and thank them for their work after I do Town Hall. And I was hearing about how hard it was for them. So I came back and said, 'HR department, tell me about the people on the front line of our organization. Why are they—what are their lives like? How did they get along?' And the story that came back was, you know, at the front lines of our organization was pretty tough, and that we had mostly single mothers, 81 percent of them. They're having a hard time. Maybe some of them had their kids on Medicaid. Some of the families are on food stamps. And here we are, this very profitable company, and we're doing really well in the stock market. I'm thinking, 'How can we be this way and let that happen?' So I went to the team and said, 'We need to raise the minimum wage.' And they went, 'Well, how much?' And we got into this whole spreadsheet thing, which is—spreadsheets are words of perpetration, never put on business. They cause us to believe that we actually put truth in them, and it's really just made up. So finally I said, 'Let's take it up to $16 an hour from—the lowest ones are on $12.50, $13.' And one of our benefits people here, Kay, who's still with us today, said, 'You know what? If we raise our wages, they're gonna have a benefit impact. They got to pay more out-of-pocket because we have a scale.' So we said to people, 'If you're under 300 percent of the federal poverty level, we'll have an outside firm evaluate you. We won't know who it is. You can qualify to have all your out-of-pocket costs eliminated if you engage with us in wellness and on disease management.' So we eliminated out-of-pocket costs for those folks, and the result was a 1,200 percent increase in employee engagement in the company. And what that allowed the company to do, those two things, is it allowed the company to think freely about what more could we do for each other, how can we take care of each other.

Which led to raising our tuition reimbursement, led to—we now repay student loans up to $10,000 for our employees, which led to pet therapy. We have pet therapy in our buildings.

Yeah, we've—Chloe's been working. I raised a German Shepherd puppy with Mari, and I raised her. She's on your Twitter. Yeah, and she's now working in Stanford, which is a working girl.

But if you go out to AetnaSocialCompact.com on our website, it tells all the companies how to do it. I think about—and we just recently, I just got the number yesterday or the day before, our employees contributed 515,000 hours last year in volunteerism, and we did, I think the number was a $6 million match from our foundation for employee giving. So, so the health—health includes all of these things: the mindfulness, the sleep. You know, if you look at life expectancy in the United States, it has now gone down two years in a row. If you look at the factors that affect life expectancy, 10 percent of it is clinical medical care that you get, 30 percent is your genetic code, and 60 percent is where you live. And so your zip code is now more important than your genetic code as to how long you live and your quality of life.

You know, do I have clean water? Do I have enough food? Am I socialized? Is my neighborhood safe? And so we just this week launched a bigger program called—we launched a program a year ago, but we just with the U.S. News & World Report started a report on it. It's called the Healthy Cities and Counties Challenge, where we gave planning grants to 50 cities and counties—300 applied—to do things like build infrastructure, programs, safety. And they had to apply to us, and then we funded them. So Baltimore is one, Camden, New Jersey's another. We have a whole list, and the results are amazing coming out of these cities. And what we—just by getting the cities focused on improving the quality of life, the impact you can have on health in the community. You know, just we were talking about this paralysis by analysis, but you know, where you put your intention, your attention follows, and then your energy goes there. And so these cities are—that's amazing watching this go on. And what we want to do, if we're gonna pay the winning city a million and a half dollars or a million dollars, something like that at the end, what we want to do is promulgate the findings of all of that. It's a two-year experiment, two cities across America. Because I think what's happened—and this is a sort of a bigger macro issue for me—is I think social media, our economies have now created social ecosystems that are bigger than our government's models can manage. So we used to be able to tell our employees on any issue around our industry what the truth was, quote-unquote, and they would believe it because all they had was the internal communications vehicle of the organization. Now they're connected to the world, and that communication gives them, for good and for bad, quite frankly, as we well know, information that we have to be accountable to in some way, shape, or form. And what usually happens is we try to make the governance model bigger. So we, you know, eliminate access to the internet inside the company, and then people bring their phones in. Or government gets bigger and tries to regulate everything, right? And I think what's happened is that our governance models are no longer adequate, and what we're gonna see is a reversion back to community as a way to govern more effectively. So when you saw the president withdraw from the Paris Accord, 288 cities and counties and companies said, 'No, we aren't. You may be, but we're not, because we're gonna stick with it.' And so this idea of local and community-based governance and support, what the kids are doing around the shooting in Florida and the protests, are creating is really the power of the American democracy, right? Is that we can at any level throughout our society have an impact, and we can gain support. And so I think this reversion to community and the importance of community, which is really the basis of mindfulness, right, is really important. And I think it's gonna be—I think we're gonna get smaller in the way we think about our relationships with others, then global.

Well, the ambition's personal. It's not collective anymore. And so we've managed our systems in healthcare to look at the best average. So if we improve our averages, right—hand washing in America for clinicians touching patients is in the high 60s before they touch a patient. So the most important thing you can say when you're in a hospital bed, and it could have you, 'Washed your hands? Please wash your hands,' right? And it should be 100 percent, don't you think? Yes. So when we average to the averages and we move the average up and go, 'Hey, we won!' No, we didn't win. It's still not 100 percent, right? What do we do to have that impact? And so we got to stop looking at averages and start talking to people. So people define their health as an impediment or barrier to the life they want to lead. I don't talk about myself as a spinal cord injury survivor. I talk about my neuropathy is getting in the way of my golf game and riding my bicycle and fly-fishing, right? And I want those things. And so if you can help me accomplish those things, which I love to do, then you've got me engaged. But if I'm a diabetic with peripheral neuropathy, you tell me, 'If we get your diabetes under control, you'll be able to run the 5K next year,' and you've never run an inch, right? And so you've got to spend this time with individuals understanding three issues: What's your problem? And people will define that as the life they want to lead. That's their ambition. It's not their injury or their illness. Second, what are your alternatives to solving that problem? And third, what are the barriers for you pursuing those alternatives? So you take a company like Peloton that's created these bikes. Why do people buy these bikes? So you don't have to go to a gym, right? And are all the people that buy Pelotons look like the people that ride them on the ad? And so have you think of how—what is the barrier for people going to a gym? I don't want to go to a gym looking like this. And so, you know, and so what are you—so if you're looking at everything at me, the need is me. Well, what is this for me, and how do you help me live the life I want to lead? Those are my ambitions. And if you help me solve for my ambitions, then you've got me engaged, and I'm a partner with you making that happen. And that's why our whole campaign here is, you know, 'You don't join us, we join you.' Mind, body.

My daily routine? Well, there is no really daily routine, but there are things I try and fit into the day, would be the way I talk about it. So people always say to me, 'What is your work-life balance?' And I always tell people there is no such thing as work-life balance. It's just all life. At the end of the movie Tombstone, with Val Kilmer and Kurt Russell, Holiday's laying in a bed dying of consumption. He's got TV, and Kurt Russell sitting there with him as Wyatt Earp, and he says, 'No, what are you gonna do, Wyatt?' And he goes, 'All I want is a normal life.' And he goes, 'I'm a lawman and all this sort of stuff.' And Doc Holiday looks at him just before he dies and says, 'Wyatt, there is no such thing as a normal life. It's all life.' And so if you think about this as your day as a way of fitting your life in, how do you best spend it? The two most important decisions you can make every day is what I'm going to do with my time and who am I gonna spend it with. And so I always encourage people to have a personal practice that allows them to present their best selves to the rest of the world. And so what I try to do every day, and did this morning, is get up and do my yoga. Get on my mat. I try to roll it out the night before so when I get out of bed, it's there. I can't walk past it without feeling guilty. And then get on my bike, and you know, and on the jet if I'm traveling. And so if I do that, I'm in a much better place than if I don't. And there are days that I don't get it all in because I have to start too early. So I get up around 6:00, 6:30, get my routine in, and then get into the office. Or if I can ride at the end of the day, I'll ride at the end. They tried desperately to get back here yesterday in enough time to ride. So it was 72 degrees.

Mari. Mari sounds amazing. She's had a great influence. I mean, she came to our—Arthur Ashe was on our board when he passed away, and we have an African-American calendar event. And six years ago, we had one on urban farmers, and she came with me to St. Louis because she likes urban farming. And all of a sudden, she's in the corner with all the urban farmers, and 'What are you doing?' And she said, 'Well, you know, they know how to do this, and they could create a book on how to build an urban farm, and you've got money.' And so since then, we've done 3,300 urban farm beds across America as a company to eliminate food deserts. Mari is now on the board of Harlem Grown, up in Harlem, which is building farms across middle schools through Harlem. And Tony Hilary's a good friend of ours, and actually Mari's with him this morning. And we've supported him buying property and supporting program development. But not only do they teach kids about urban farming, it's to supply food to the school across the street, but they're also helping them with their schooling while they're in the farm. They do teaching, and they get them college applications, get them into school. So Mari—so, you know, that would have never happened without Mari involved in the organization.

Oh God, thank you.