Posts from — October 2008

Getting Started – Secure management support
• Justifications for having a Wellness Fair
• Health Risk Assessments / Health Risk Appraisals
• Help for high-risk population: smokers, obese staff members
• Early detection of diabetes, heart disease risk factors (high cholesterol, high blood pressure)

Wellness Fair Participation – Establish your audience
• Employees only, whole family, retirees?
• Community involvement? Theme?

Wellness Fair Time Line
• Set a date and time Allow 4-6 months of planning time

Wellness Fair Planning
• Establish health-related screenings, tests, other activities you’ll offer Establish educational literature and other learning opportunities Wellness Fair will provide Include any “fun” activities, or food/beverage needs for the fair

Wellness Fair Location & Logistics
• Look at location big enough to accommodate the largest volume of staff members at “peak time” periods
• Determine how booths/stations will be set up

Wellness Fair Vendors
• Target relevant health/safety-related community and corporate vendors to provide services, educational materials, incentives and giveaways

Wellness Fair Marketing
• Determine marketing tools to be used to inform staff members/members (posters, mailings, e-mail)
• Determine any incentives or giveaways that will be included in the fair or used to promote participation in the fair

Wellness Fair Scheduling
• Coordinate timing and events with staff and/or volunteers

Wellness Fair Personnel
• Schedule appropriate experts Physician or similar health care personnel to provide patient consultation for review of blood draw lab results
• Nurse(s) to administer vaccinations
• Administrative/all-purpose individual to facilitate paper work, finger sticks and to provide general assistance
• Pharmacist or pharmacist assistant if appropriate Dietitian for nutritional counseling suggested personnel designated for health fairs

Footnotes

1 The Robert Wood Johnson Foundation via Reuters Health E-Line.
2 Kaiser Daily Health Policy Report, (9/11/03)
3 www.cdc.gov/nccdphp/dnpa/press/archive/lower_cost.htm
4 “Is Stress Nibbling Away at Your Bottom Line?” By Stephen Alper, Nov. 15, 2002.
5 Health Promotion in the Workplace, Michael P. O’Donnell, page 415.
6 http://www.bmpcoe.org/bestpractices/internal/dayto/dayto_6.html

According to Gordian Health Solutions, the effectiveness of Workplace Wellness Programs in improving health and reducing health care 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 company’s on-site 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 staff members making commitments to walk during their lunch hour.

At the high end of the reward spectrum, some businesses pay cash to staff members who meet wellness goals. LuK, Inc. offers staff members $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, staff members 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 Workplace Wellness Programs directly to insurance premiums. Doing so clearly demonstrates to staff members the positive effects of wellness on their own health care costs. frequently, the first step in linking wellness programming to insurance coverage is lowering deductibles for wellness care or eliminating deductibles altogether. By adding this benefit, businesses can promote staff members 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 Worksite Wellness Plan participation with health care credits

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

During the first year of the Healthy Choices program, staff members 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 members develop individual action plans for improved health through the use of educational materials, behavior modification, telephone help from third-party program health coordinators, and formal health management programs. By completing the assessments, staff members 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, members 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 members to show progress in meeting goals and to continue to work with health coordinators to reach goals.

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

While Worthington has taken a broad approach to wellness, other businesses have found success in offering incentives in specific areas. Longaberger, for example, offers a discount on health care policies for staff members who do not use tobacco. An individual worker who doesn’t use tobacco saves $7 per bi-weekly pay. For tobacco-free staff members 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, health care is the only type of insurance that doesn’t focus on penalizing for behaviors that put the insured party at risk. With health care costs increasing 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 health care costs.

Reports that staff members would support this type of action are stacking up. One Ohio employer conducted an informal survey that indicated staff members would consider it a morale boost if health-conscious staff members were relieved of some of the burden of subsidizing care for staff members 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 health care costs is becoming ever more pressing.

The Last Step: Getting Started

No matter what strategy, from offering staff members health resources to providing incentives for healthy behaviors, businesses have a real opportunity to enhance morale and productivity, reduce absenteeism and control health care 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 businesses, especially in factory settings such as Honda. That’s why the company offers several programs—including line-site process evaluations —to identify potential hazards and help reduce the chance of injury. As part of an early intervention program, Honda staff members who are feeling pain can receive a massage of the affected area during work time.

Stretching programs 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 beginning a program that required production staff members to stretch for 10 to 15 minutes at the beginning of their shifts, they saw a dramatic reduction in injuries.

While the DPI Worksite Wellness Plan costs about $75,000 a year to operate, in conjunction with other company programs, 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 information 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 businesses in providing Workplace Wellness Programs that aim to reduce injuries. The plan includes information on safety and health programs to prevent occurrences of on-the-job accidents, including:

worker involvement – To ensure the success of any Workplace Wellness Program, staff members 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 staff members on the company’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 staff members informed and provides suggestions and feedback on the effectiveness of the Workplace Wellness Program. Through memos, bulletin boards and staff meetings, important safety and health information can be conveyed throughout the company, keeping all management staff and staff members knowledgeable about the company’s safe practices.

The company 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 establish a disability management policy to help injured or ill staff members obtain quality medical treatment, making their transition back to work quick and effortless.

Timely notification of claims – Employers should document worksite injuries immediately after they occur and promptly send that documentation to a claims handler. Quickly providing 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 company’s safety efforts. Business 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 health care 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.
• Offer educational materials about well-baby care and vaccinations.
• Choose health care coverage plans that include wellness check-ups and vaccinations.
• Offer on-site mammograms for staff members.
• Sponsor on-site flu vaccinations to coincide with flu season.

Advantages of Stress Reduction Programs

While stress cannot be eliminated from life, or even from the worksite, coping skills can be developed with relative ease. Stress management skills lead to reduced absenteeism and more effective, more productive staff members. 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 programs have 42 percent lower health care costs. Other studies have documented a 50 percent reduction in medical services use when stress management programs 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:

• Offer on-site yoga or meditation classes.
• Organize support groups among staff members.
• Sponsor stress management classes during the workday.
• Offer an employee assistance program that includes both counseling and referral.
• Offer on-site counseling for staff members 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 company 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 staff members at lunchtime.
• Offer educational materials about the effects of alcohol, drugs and smoking on an unborn child.
• Offer incentives for adopting healthy lifestyles during pregnancy.
• Offer prenatal programs and education as part of the company health care package.

Advantages of smoking Cessation Programs

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

The American Cancer Society reports that smoking staff members cost businesses an average of $1,429 per smoker per year in increased health care costs over non-smoking staff members. Implementing a smoking cessation program costs an average of $45 per worker per year, saving businesses 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 frequently 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 programs:

1.    Start a company policy prohibiting tobacco use anywhere on the property.
2.    Offer prompts/posters to support no tobacco use policy.
3.    Policy supporting participation in smoking cessation activities during duty time (flex-time).
4.    Offer counseling through an individual, group, or telephone counseling program onsite.
5.    Offer counseling through a healthcare plan sponsored individual, group, or telephone counseling program.
6.    Offer 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. company to exceed $12.5 billion in health care, sick leave, and life and disability insurance. Further, one research study reports that obesity raises health care costs by 36 percent and medication costs by 77 percent. To offset the health risks of obesity and poor diet, many businesses have committed to helping staff members ensure proper nutrition and undertake weight control programs.

Popular nutrition programs:

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

Sweetened Beverage Consumption
1.    Make water available throughout the day.
2.    Offer appealing, low-cost healthful drink options in vending machines and the cafeteria.
3.    Modify worksite vending 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.    Offer food models, food scales for weighing and pictures to help staff members assess portion size.
3.    Offer appropriate portion sizes at meetings, worksite events and in the cafeteria.

Nutrition programs in action

While many businesses address weight management through fitness initiatives, businesses are increasingly focusing on nutrition through separate programming. Recognizing the productivity boost and lowered medical expenditures that come with maintaining a healthy weight, many businesses may help pay for obesity treatments for staff members. By way of example, to enhance the health of dangerously obese staff members, 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 businesses offer weight loss programs. 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 staff members at any time.

At Grange Insurance’s Columbus headquarters, the cafeteria chef analyzes meals and provides staff members basic nutrition information, including Weight Watchers points. Many businesses partner with the American Cancer Society to offer nutrition information through the ”5-ADay” program, which provides businesses 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 staff members a free portion of fruit or vegetables after he or she has purchased a preset number.

Advantages of Fitness Programs

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 staff members.

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. businesses help staff members pay for gym memberships, according to an Associated Press report. Subsidizing gym memberships is just one way businesses promote active lifestyles.

Popular Fitness Initiatives:

1.    Allow access to on- and off- worksite gyms and recreational activities before, during, and after work hours.
2.    Offer and promote participation in after work recreation or leagues.
3.    Offer cash incentives or reduced insurance costs for participation in physical activity and/or weight management or maintenance activities.
4.    Offer shower and/or changing facilities onsite.
5.    Offer outdoor physical fitness areas such as fields and trails for worker use.
6.    Offer bicycle racks in safe, convenient, and accessible locations.
7.    Offer onsite fitness opportunities, such as group classes or personal training.
8.    Offer an onsite physical fitness facility.
9.    Create programs that have strong social support systems and incentives, such as:
• Buddy or team physical activity goals
• Programs that involve workers and family
• Programs to promote physical activity, such as pedometer walking challenges
• Explore discounted or subsidized memberships at local health clubs, recreation centers, or YMCAs
10.     Offer 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 staff members 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. Offer exercise/physical fitness messages and information to staff members.
17. Offer 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. Offer onsite child care facilities to facilitate physical activity.
20. Sponsor a bike to work day and reward staff members who participate.
21. Create a box and solicit fitness and health tips.

Wellness programming means different things to different businesses. Effective wellness initiatives can be as simple as bringing bushel 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 businesses of all types, sizes and cultures: that is, health care expenses are spilling over the company belt buckle. The annual cost of medical services in the United States is increasing 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 businesses to maintain current levels of insurance coverage. In 2003, health care inflation forced 65 percent of businesses to increase staff members’ 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.

Employers are searching for another way. While businesses cannot control many of the supply-side elements contributing to increasing health care 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 Workplace Wellness 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 health care 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 businesses 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.

Data shows that healthier staff members are more productive, spending more time at work and showing increased “presenteeism,” or productivity, while there. Further, healthier staff members use fewer medical services. The five leading causes of death in the United States — 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 staff members’ well being, reduce the need for health care 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 frequently the right thing to do for staff members and businesses.

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

The challenge arises in selecting the programs that will deliver the most impact based on trends in your staff members’ health risks and medical claims costs. From large businesses to the corner deli, company owners welcome ways to boost productivity, reduce absenteeism and cut costs. Likewise, Workplace Wellness Programs can range from modest to elaborate.

In determining where to focus a company’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 staff members and businesses.