Company WellnessCompany wellness programs and company wellness consulting

According to Gordian Health Solutions, the effectiveness of Corporate Health Promotion Programs in improving health and lowering healthcare costs is directly linked to incentives: the more substantial the incentives, the higher the success rate. Incentives can range from tokens of achievement, such as t-shirts, water bottles and sports equipment, to more substantial financial awards, such as cash incentives or copay vouchers for the successful completion of a program.

Nationwide Insurance is seeing results from a small incentive program initiated by one of the corporation’s worplace nurses. To promote lunchtime walking, the worker has informally launched a “shoelace program” modeled after the karate-belt color system. Employees progress through the color scale until they reach “black-lace” status. The reward system has resulted in more workers making commitments to walk during their lunch hour.

At the high end of the reward spectrum, some corporations pay cash to workers who meet wellness goals. LuK, Inc. offers workers $250 for kicking the tobacco habit and remaining smoke free for 12 months. For logging fitness points that add up to 10 miles a month, workers are eligible for health assessments, which can result in reward amounts of up to $225.

The most effective motivator, according to Gordian research, comes through linking participation in Corporate Health Promotion Programs directly to insurance premiums. Doing so clearly demonstrates to workers the positive effects of wellness on their own healthcare costs. often, the first step in linking wellness programming to insurance coverage is lowering deductibles for wellness care or eliminating deductibles altogether. By adding this benefit, corporations can promote workers to undertake routine screenings and other procedures to respond to health problems before they become chronic. Early detection benefits both patient health and employer health costs.

Incentivizing Company Wellness Program participation with healthcare credits

More frequently, corporations are going beyond improved wellness care coverage and looking to demonstrate the importance of wellness by linking participation to workers’ bottom lines. Worthington Industries has recently rolled out a program that allows workers to eliminate their portion of the insurance premium by enrolling in a Healthy Choices Corporate Health Promotion Program.

During the first year of the Healthy Choices program, workers and their spouses complete Individual Health Assessments and medical screenings to determine their levels of health risks. Nurses, dietitians and physical fitness specialists are available to help moderate- and high-risk participants develop individual action plans for enhanced health through the use of educational materials, behavior modification, telephone help from third-party program health coordinators, and formal health management initiatives. By completing the assessments, workers earn their full premium credit. Because some plans at Worthington require no worker contribution, a cash award takes the place of a credit in those cases.  During year two of the program, the wellness bar is raised slightly. To continue to receive the wellness credit, participants in the moderate- to high-risk category will be needed to work at setting goals with third-party health coordinators.

Year three raises the bar again, requiring participants to show progress in meeting goals and to continue to work with health coordinators to reach goals.

After year three, Worthington Industries workers will be on the wellness track. The corporation believes that will mean a healthier workforce and cost savings for workers and the corporation. The well being of Worthington workers is the foundation of this program, and both workers and the company are expected to benefit from the long-term advantages of the Healthy Choices Corporate Health Promotion Program.

While Worthington has taken a broad approach to wellness, other corporations have found success in offering incentives in specific areas. Longaberger, for example, offers a discount on healthcare policies for workers who do not use tobacco. An individual worker who doesn’t use tobacco saves $7 per bi-weekly pay. For tobacco-free workers with family coverage whose families are also tobacco-free, the savings increases to $14 per pay.

The next step: Penalizing harmful behaviors

As it stands, healthcare is the only type of insurance that doesn’t focus on penalizing for behaviors that put the insured party at risk. With healthcare costs rising so dramatically, that could soon change. Just as an accident likely raises auto insurance premiums, increasing premiums for those who engage in unhealthy behaviors is a possible next step in employers’ attempts to manage healthcare costs.

Reports that workers would support this type of action are stacking up. One Ohio employer conducted an informal survey that indicated workers would consider it a morale boost if health-conscious workers were relieved of some of the burden of subsidizing care for workers who engage in behaviors that adversely affect their health. Whether or not this type of program gains popularity, one thing is sure: the need to control the rise in healthcare costs is becoming ever more pressing.

The Last Step: Getting Started

Whatever the strategy, from offering workers health resources to offering incentives for healthy behaviors, corporations have a real opportunity to enhance morale and productivity, reduce rates of absence and control healthcare costs through wellness. The first step is committing to taking one, no matter what size effort is appropriate for your company.

Small steps lead to big strides.

Preventing injuries is a high priority for corporations, especially in factory settings such as Honda. That’s why the corporation offers several initiatives—including line-site process evaluations —to identify potential hazards and help reduce the chance of injury. As part of an early intervention program, Honda workers who are feeling pain can receive a massage of the affected area during work time.

Stretching initiatives are another effective tool in injury prevention. According to the Best Practices in Manufacturing Web site, Dayton Parts, Inc. (DPI) in Harrisburg, Pa., conducted research that revealed approximately 80 percent of all manufacturing injuries occurred within the first two hours of each shift. After starting a program that mandated production workers to stretch for 10 to 15 minutes at the beginning of their shifts, they saw a dramatic reduction in injuries.

While the DPI Company Wellness Program costs about $75,000 a year to operate, in conjunction with other corporation initiatives, it has helped bring the annual cost of workers’ compensation from $700,000 to $200,000 per year.6

To help prevent lengthy absences and reduce workers’ compensation claims, Honda instituted a work recovery program. Through the program, workers who have had an injury can work in a modified job—getting better. Employees in the program spend their work days receiving physical conditioning to increase overall fitness, physical therapy to restore functionality, health education and nutrition counseling. The program is based on data that shows fewer work days are lost when an worker stays connected to the work environment.

The Ohio Bureau of Workers’ Compensation, www.ohiobwc.com, provides a “10-Step Business Plan” as a guide for corporations in offering Corporate Health Promotion Programs that aim to reduce injuries. The plan includes information on safety and health initiatives to prevent occurrences of on-the-job accidents, including:

worker involvement – To ensure the success of any Corporate Health Promotion Program, workers must participate in the safety and health-management process. This can be done through safety and health audits, accident investigations, or by forming safety and health involvement teams, focus groups or committees.

Orientation and training plan – Conduct orientation and training sessions to educate workers on the corporation’s safety policies. These sessions should include procedures for the safe use of machinery and tools, chemical hazards and how to prevent contact or exposure, specific job/task safe practices, and hazard recognition and prevention.

Communication – Open communication keeps workers informed and provides suggestions and feedback on the effectiveness of the Corporate Health Promotion Program. Through memos, bulletin boards and staff meetings, important health and safety information can be conveyed throughout the company, keeping all management staff and workers knowledgeable about the corporation’s safe practices.

The corporation plan also outlines incentives for post-injury procedures, including:

Medical treatment and return-to-work practices – arly return-to-work strategies help injured or ill workers return to work in a timely manner. Companies should start a disability management policy to help injured or ill workers obtain quality medical treatment, making their transition back to work quick and effortless.

Timely notification of claims – Organizations should document workplace injuries immediately after they occur and promptly send that documentation to a claims handler. Quickly offering claim information demonstrates care and concern for the injured worker, prevents delays and confusion with the claim process, and reduces the potential for abuse or needless litigation.

Record keeping – Internal documents should be kept to record work-time injuries and to assess the success of the corporation’s safety efforts. Organization audits, surveys and injury or illness reports can all be used to analyze which safety practices and policies have proven successful, and what areas of health and wellness need improvement.

Dr. Moore of Nationwide maintains that immunization is the most cost-effective treatment in medicine. By way of example, vaccinating children against the influenza virus averages a savings (including healthcare costs, parents’ missed work, etc.) of up to $35 per vaccine recipient. And experts predict that estimate is low, because it doesn’t take into account the rapid spread of the flu.

The American Association of Family Physicians’ Web site, www.aafp.org, offers a recommended adult immunization schedule created by the Advisory Committee on Immunization Practices. This schedule, tiered by age and chances of exposure, recommends diphtheria, tetanus, influenza, pneumonococcal, hepatitis B, hepatitis C, measles, mumps and rubella, varicella and meningococcal vaccinations.

Ideas to incorporate prevention and early detection:

• Hold a wellness fair and invite businesses that provide screening services for such conditions as blood pressure, blood iron, cholesterol, body mass index (BMI) and diabetes.
• Provide educational materials about well-baby care and immunizations.
• Choose healthcare coverage plans that include wellness check-ups and immunizations.
• Provide worplace mammograms for workers.
• Sponsor worplace flu vaccinations to coincide with flu season.

Advantages of Stress Reduction Programs

While stress cannot be eliminated from life, or even from the workplace, coping skills can be developed with relative ease. Stress management skills lead to reduced rates of absence and more effective, more productive workers. Because stress has been shown to contribute to such physical conditions as ulcers, high blood pressure and stroke, stress reduction has a direct impact on improving physical health.

Studies have shown that heart patients who attend stress management initiatives have 42 percent lower healthcare costs. Other research studies have documented a 50 percent reduction in medical services use when stress management initiatives are employed. Further, Employee Assistance Program (EAP) experts estimate that 20 percent of any workforce is affected by individual problems that can influence work performance.

Stress reduction tactics to consider:

• Provide worplace yoga or meditation classes.
• Organize support groups among workers.
• Sponsor stress management classes during the workday.
• Provide an employee assistance program that includes both counseling and referral.
• Provide worplace counseling for workers in the case of a work-related trauma, such as the death of a co-worker.

Advantages of Prenatal Care and Breastfeeding

The old adage “an ounce of prevention is worth a pound of cure” is particularly relevant to when applied to preventive measures taken during pregnancy, when a few extra ounces of birth weight can save a child’s life. During pregnancy, simple precautions can help avoid catastrophic results; giving up smoking, for instance, drastically reduces the risk of miscarriage and pre-term labor.

The March of Dimes reports that if all women took adequate folic acid before conception and during pregnancy, the number of babies born with a neural tube defect could drop by as much as 70 percent. The physical and emotional benefits of proper prenatal care to a mother and child are underscored by a strong corporation case for offering prenatal wellness benefits. Nationwide’s Chief Medical Director, Dr. Michael Moore, estimates costs to care for one baby delivered prematurely could approach $500,000.

First steps in fostering a prenatal program:
• Invite the March of Dimes to present information about prenatal health at an worker brownbag lunch or breakfast meeting.
• Hold prenatal care information classes for interested workers at lunchtime.
• Provide educational materials about the effects of alcohol, drugs and smoking on an unborn child.
• Provide incentives for adopting healthy lifestyles during pregnancy.
• Provide prenatal initiatives and education as part of the corporation healthcare package.

Advantages of smoking Cessation Programs

Instances of respiratory diseases, cancer and other illnesses can be reduced through smoking cessation efforts. smoking cessation initiatives can provide huge opportunities for enhanced health.

The American Cancer Society reports that smoking workers cost corporations an average of $1,429 per smoker per year in increased healthcare costs over non-smoking workers. Implementing a smoking cessation program costs an average of $45 per worker per year, saving corporations an average of $1,383 per year for each worker who quits smoking. Additionally, the American Cancer Society reports that smokers are absent from work 50 percent more often than nonsmokers. They are also 50 percent more likely to be hospitalized and have 15 percent higher disability rates. smoking decreases onthe- job productivity as well. Employees who take four 10- minute smoking breaks a day work more than a month less per year than workers who don’t take smoke breaks.

Places to start with smoking cessation initiatives:

1.    Start a corporation policy prohibiting tobacco use anywhere on the property.
2.    Provide prompts/posters to support no tobacco use policy.
3.    Policy supporting participation in smoking cessation activities during duty time (flex-time).
4.    Provide counseling through an individual, group, or telephone counseling program onsite.
5.    Provide counseling through a medical plan sponsored individual, group, or telephone counseling program.
6.    Provide cessation medications through health insurance.

Advantages of Nutrition Programs

Nutrition directly impacts nearly every aspect of physical and mental health. A healthy diet can help protect against such conditions as heart disease, diabetes, arthritis, stroke, certain cancers and depression. Obesity, which is among the most common conditions linked to diet, affects a record number of Americans.

The American Journal of Health Promotion estimates the cost of obesity to U.S. corporation to exceed $12.5 billion in health care, sick leave, and life and disability insurance. Further, one research study reports that obesity raises healthcare costs by 36 percent and medication costs by 77 percent. To offset the health risks of obesity and poor diet, many corporations have committed to helping workers ensure proper nutrition and undertake weight control initiatives.

Popular nutrition initiatives:

Fruit and Vegetable Consumption
1.    Provide healthy eating reminders and prompts to workers via multiple means (i.e. e-mail, posters, payroll stuffers, etc.).
2.    Provide appealing, low-cost fruits and vegetables in snack machines and in the cafeteria.
3.    Provide cookbooks, food preparation, and cooking classes for workers’ families.
4.    Ensure onsite cafeterias follow healthy cooking practices and set nutritional standards for foods served that align with the U.S. Dietary Guidelines for Americans.
5.    Provide healthy foods at meetings, conferences, and catered events.
6.    Use point-of-decision prompts as a marketing technique to promote healthier choices.
7.    Provide healthy cooking demonstrations that teach skills (i.e. fruit and vegetable selection and preparation).
8.    Provide taste-testing opportunities at the workplace.
9.    Provide worker-led campaigns, demonstrations or programs.
10.    Provide local fruits and vegetables at the workplace (i.e. workplace farmer’s market or community-supported agriculture drop-off point).
11.    Use competitive pricing (price non-nutritious foods in snack machines and cafeterias at higher prices).
12.    Provide protected time and dedicated space away from the work area for breaks and lunch.
13.    Make kitchen equipment available to workers.
14.    Provide an opportunity for onsite gardening if possible.

Sweetened Beverage Consumption
1.    Make water available throughout the day.
2.    Provide appealing, low-cost healthful drink options in snack machines and the cafeteria.
3.    Modify worksite snack contracts to increase the number of healthy options.

4.    Price non-nutritious beverages at a higher cost.
5.    Use point-of-decision prompts to promote healthier choices.

Portion Control
1.    Label foods to show serving size and/or nutritional content.
2.    Provide food models, food scales for weighing and pictures to help workers assess portion size.
3.    Provide appropriate portion sizes at meetings, workplace events and in the cafeteria.

Nutrition initiatives in action

While many corporations address weight management through fitness programs, corporations are increasingly focusing on nutrition through separate programming. Recognizing the productivity boost and lowered medical expenditures that come with maintaining a healthy weight, many corporations may help pay for obesity treatments for workers. By way of example, to enhance the health of dangerously obese workers, drug maker Wyeth reportedly pays for stomach-shrinking surgeries that carry price tags of up to $40,000.

A 2003 Society of Human Resource Management research study shows that 24 percent of corporations offer weight loss initiatives. In Ohio, Honda offers an onsite, registered dietitian who provides individual or group consultations on weight management. Body fat assessment and body mass index (BMI) measurements are available to workers at any time.

At Grange Insurance’s Columbus headquarters, the cafeteria chef analyzes meals and provides workers basic nutrition information, including Weight Watchers points. Many corporations partner with the American Cancer Society to offer nutrition information through the ”5-ADay” program, which provides corporations free signage and educational materials about the importance of eating five servings of fruits and vegetables a day. The program also offers a fruit and vegetable ”frequency card” that gives workers a free portion of fruit or vegetables after he or she has purchased a preset number.

Advantages of Exercise Initiatives

Exercise reduces weight, lowers risks of heart attack and stroke, helps to control blood pressure and diabetes, and improves mood. Studies increasingly show that physical fitness may also help reduce the occurrence of certain types of cancer. Researchers at the Centers for Disease Control and Prevention (CDC) recently documented another major advantage: physical fitness improves the health of the nation’s medical care expenditures.3 According to the CDC, physically active individuals incur $865 less per year in medical costs than inactive workers.

Dr. Michael Moore, vice president and chief medical director at Nationwide Insurance in Columbus, maintains that physical fitness is the most effective tool in health maintenance. “If you could prescribe exercise in a pill, it would be the number-one prescribed treatment in the world,” he said. In step with Dr. Moore’s prescription, nearly one-third of U.S. corporations help workers pay for gym memberships, according to an Associated Press report. Subsidizing gym memberships is just one way corporations promote active lifestyles.

Popular Exercise Initiatives:

1.    Allow access to on- and off- worksite gyms and recreational activities before, during, and after work hours.
2.    Provide and promote participation in after work recreation or leagues.
3.    Provide cash incentives or reduced insurance costs for participation in physical activity and/or weight management or maintenance activities.
4.    Provide shower and/or changing facilities onsite.
5.    Provide outdoor physical fitness areas such as fields and trails for worker use.
6.    Provide bicycle racks in safe, convenient, and accessible locations.
7.    Provide onsite fitness opportunities, such as group classes or personal training.
8.    Provide an onsite physical fitness facility.
9.    Create initiatives that have strong social support systems and incentives, such as:
• Buddy or team physical activity goals
• Initiatives that involve workers and family
• Initiatives to promote physical activity, such as pedometer walking challenges
• Consider discounted or subsidized memberships at local health clubs, recreation centers, or YMCAs
10.     Provide flexible work hours to allow for physical activity during the day.
11.    Support physical activity breaks during the workday, such as stretching or walking.
12.    Host walk-and-talk meetings.
13. Map out onsite trails or nearby walking routes and destinations.
14. Have workers map out their own biking or walking route to and from work.
15. Post motivational signs at elevators and escalators to promote stair usage.
16. Provide exercise/physical fitness messages and information to workers.
17. Provide or support recreation leagues and other physical activity events onsite or in the community.
18. Start worker activity clubs such as walking or bicycling clubs.
19. Provide onsite child care facilities to facilitate physical activity.
20. Sponsor a bike to work day and reward workers who participate.
21. Create a box and solicit fitness and health tips.

Wellness programming means different things to different corporations. Effective wellness initiatives can be as simple as bringing baskets of fresh fruit into break rooms to encourage better eating. They can be as extensive as building fitness facilities onsite or paying for obesity treatments.

A driving factor behind the push toward wellness spans corporations of all types, sizes and cultures: that is, healthcare expenses are spilling over the company belt buckle. The annual cost of medical services in the U.S. is rising at seven times the rate of inflation. And the rise in medical costs is one boom pundits expect our economy to sustain.1

This trend makes it increasingly challenging for corporations to maintain current levels of insurance coverage. In 2003, healthcare inflation forced 65 percent of corporations to increase workers’ share of health costs.

Seventy-nine percent of large firms said they will increase workers’ share of health costs in 2004.2 But with lost benefits and increased financial burdens come lost morale and productivity.

Organizations are searching for another way. While corporations cannot control many of the supply-side elements contributing to rising healthcare costs—malpractice insurance rates, the nursing shortage—they can help curb demand. That’s why efforts are being redirected from illness to wellness.

The case for Corporate Health Promotion Programs is supported by an ever growing body of evidence demonstrating the high costs associated with controllable health risks:

• One research study reports that obesity raises healthcare costs by 36 percent and medication costs by 77 percent.
• Michigan officials estimate physical inactivity cost the state nearly $8.9 billion in 2002, a cost estimated to be largely borne by corporations through insurance premiums and lost productivity.
• The not-for-profit National Committee for Quality Assurance reports that the estimated average cost for postnatal care for women who did not receive prenatal care was $2,341 more than for women who had. And the indirect costs of unhealthful behavior can be just as high.

Information shows that healthier workers are more productive, spending more time at work and showing increased “presenteeism,” or productivity, while there. Further, healthier workers use fewer medical services. The five leading causes of death in the U.S. — heart disease, cancer, stroke, chronic obstructive pulmonary disease and diabetes —  are directly linked to unhealthy lifestyles. Clearly, encouraging healthful habits presents an opportunity to enhance workers’ well being, reduce the need for healthcare services and help control costs.

Offering worker wellness benefits — large or small — represents an intersection between company social responsibility and responsibility to stakeholders. Between worker health and corporate health. It’s often the right thing to do for workers and corporations.

Research by Traveler’s Corp. shows a $3.40 return for every dollar invested in Corporate Health Promotion Programs. For many corporations, the choice to offer worker wellness benefits is easy—one where conscience and pragmatism align.

The challenge arises in selecting the initiatives that will deliver the most impact based on trends in your workers’ health risks and medical claims costs. From large corporations to the corner deli, corporation owners welcome ways to boost productivity, reduce rates of absence and cut costs. Likewise, Corporate Health Promotion Programs can range from modest to elaborate.

In determining where to focus a corporation’s limited resources, looking at costs, benefits and best practices is a good starting point. This section profiles six aspects of wellness and explores their benefits to workers and corporations.

When it comes to working wellness into your workforce, you want someone who knows the ins and outs of health promotion, and who can counsel workers and provide primary care – all within the context of the current regulatory and legal environment.

AAOHN’s survey reported that more than half of workers (61 percent) want to receive health and wellness information from a healthcare professional, such as a consultant or an worksite occupational health nurse (OHN), compared to pamphlets or brochures (18 percent) or human resources staff (15 percent).

OHNs can develop, start and evaluate components of work site Corporate Health Promotion Programs such as screening initiatives, exercise/fitness courses, Stress Management Programs, smoking cessation, nutrition and weight control initiatives, as well as chronic illness management initiatives. Plus, OHNs can help workers navigate through complicated health plans and may even serve as a triage point between workers and their personal healthcare providers.

Employees might refrain from seeing their healthcare provider when it means time away from work, inconvenient parking, waiting time in the office and co-pays. In situations where workers are under treatment for chronic diseases like heart disease, worksite nurses can routinely monitor risk factors such as blood pressure or cholesterol on a regular basis.

It’s often easier for an worker to ask an worksite nurse for information about symptoms or prescription medication than it is to schedule a follow-up visit to a personal healthcare provider. Advantages realized by corporations include enhanced worker morale and retention, a recruitment advantage, increased productivity and decreased time away from work.

In corporations with a safety department, the OHN can evaluate and address work-related health issues, including participation in workstation evaluations to correct potential ergonomic problems, and proactively addressing muscle strains by developing stretching initiatives and involving workers in leading stretches.