Health Promotion Strategies

Studies have repeatedly demonstrated that robust wellness programs, or Wellness Programs, can lower health care and insurance costs, lower rates of absenteeism, and improve performance and productivity.

Other benefits demonstrated in studies include improved ability to attract and retain key personnel, greater worker allegiance, and improved public image of the corporation.

Healthcare and Insurance Costs

A number of studies provide evidence of lower medical and insurance costs for participants in wellness programs, especially wellness programs involving exercise.

For $30 per individuals, the Bank of America conducted a wellness program for retirees using a risk assessment questionnaire, self-care books and other mailed materials. Insurance claims were decreased an average of $164 per year in this group while they increased $15 for the control group.

Since they were able to document meaningful changes in risk behavior, they anticipate greater savings in future years.

Pacific Bell’s FitWorks participants claim $300 less per case for a one-year savings of $700,000. Savings for conditions related to a sedentary lifestyle are $722 per case.

Coca Cola announced a reduction in health care claims with a fitness programalone, saving $500 per staff member per year for the staff members (60%) who joined their HealthWorks fitness program.

Prudential Insurance Business reports that the corporation’s major medical costs dropped from $574 to $312 for each participant in its wellness program.

Lowered Absenteeism

Absenteeism has been proven to be impacted by corporate wellness and wellness programs. the evidence indicates a meaningful reduction in absenteeism and resultant dollars saved as a result of staff member fitness programs.

Pacific Bell’s FitWorks program decreased absent days .8 percent to save $2 million in one year. FitWorks members also spent 3.3 days less on short-term disability for an additional savings of $4.7 million.

Focusing wellness efforts on high-risk staff members can lead to better results. A national manufacturing corporation reports a decrease of 12.2 percent in disease days for these staff members.

A two-year study by the DuPont Corporation of the effect of its comprehensive wellness program on absences among workers reports that blue-collar workers at intervention sites had a 14% decline in disability days vs. 5.8% decline for controls. There were a total of 11,726 fewer net disability days.

Enhanced Performance, Productivity and Morale

A number of corporations with wellness programs report documented betterment in job attitude, work performance, energy level, and/or overall morale among program participants–all critical factors in enhancing productivity.

A Johnson and Johnson study found that staff member attitude changes were greater at wellness intervention sites with meaningful positive attitude changes noted in the categories of organizational commitment, supervision, working conditions, job competence/security, and pay/benefits.

In a Canadian government study, the Canada Life Assurance Business experimental group realized a 4 percent increase in productivity after beginning an employee fitness program, compared to the control group.

Furthermore, 47% of program participants reported that they felt more alert, had better rapport with their colleagues, and usually enjoyed their work more.

Swedish investigators found that mental performance was significantly better in physically fit staff members than in non-fit staff members. Fit staff members committed 27 percent fewer errors on tasks involving concentration and short-term memory, as compared with the performance of non-fit staff members.

The Bottom Line

The following sample of corporate wellness wellness program results have been reported by individual corporations –

Company –  Dollars Saved/Dollars Spent

• Bank of America (Fries) –  $5.96/$1

• PacBell –  $3.10/$1

• Wisconsin School District Insurance Group –  $4.47/$1

• Prudential Insurance –  $2.90/$1

• Bank of America (Leigh) –  $4.73/$1

• General Mills –  $3.50/$1

Summary

There’s compelling evidence that a sizable portion of the billions of dollars currently spent by employers on health-related costs is preventable by means of wellness programming.

Well-planned, robust wellness programs (wellness programs and employee wellness programs) have been shown to be cost-effective, specifically when the wellness programming is matched to the health problems of the specific employee

Free Wellness Programs and Inexpensive Health Management Alternatives

Start a free wellness program or run a successful health management program in the office for little or no cost to your business. the benefits of corporate wellness and learning how to begin a health management program at work are many.

The articles on health management have generated a selection of questions, mainly from wellness providers but also from companies attempting to begin their own wellness workplace programs. There are a number of things to do to implement a successful health management program at work.

Suggestions for Beginning a Free or Affordable Wellness Program

Before starting a low cost or free wellness program for your business, learn more about what staff members want. Survey staff members to learn more about their wellness concerns.

Keep the survey confidential to protect employees’ identities. Generally the most popular corporate wellness topics are use of tobacco cessation, weight loss concerns and heart and cholesterol health.

Look for Corporate Wellness Freebies

Find out who will come in for free to talk to staff members and explore partnerships with outside agents related to corporate wellness.

For example, consult a local branch of a well-known weight loss corporation and ask when someone can come in and talk to staff members. Look for agencies that are willing to come in and talk about topics related to wellness at no cost to staff members, in exchange for something from you.

Find Corporate Wellness Partnerships

Working with a weight loss business to set up a speaking engagement for workers is the perfect opportunity to explore a potential wellness partnership.

The weight loss company might say that if 10 workers join the program, they’ll hold weekly meetings at company headquarters for the individuals  who joined. the weight loss group also might offer company workers a discount if several individuals  join the program.

Nonprofits an Untapped Health Management Resource

There are also plenty of nonprofit agencies who would be thrilled to visit a company to discuss health management. But it’s up to you to offer them something in return.

For  instance, when the MS Society came in and talked about the signs of MS, the company could offer to organize an MS walk (in keeping with company health management objectives, right?), or an auction with employee and company-donated items where the proceeds go to MS.

The individuals  at the nonprofit agencies would be happy to open a dialog with your company and to talk about what they would want in return for a speaking engagement. In many cases, they will not need anything at all for a first meeting.

Gathering Data and Evaluating Wellness Program Results

Accumulating data and investigating  results of a wellness program can be tricky because of HIPPA laws. Nonetheless, when at least 10 workers joined the weight loss program, or 20 individuals  participate daily in the all-new “Let’s Walk a Mile at Lunch” program, that sort of progress can speak strongly to senior-level management.

And, business successes will potentially give management more incentive to provide money for additional health management and wellness programs in the future.

Small corporation wellness programs are catching on. A well-designed wellness program can increase productivity, improve morale and vitality, reduce stress, decrease absenteeism, and control avoidable health care costs within an organization.

The beauty of it is that you are simply assisting staff members to make smart choices so the costs of starting a wellness program are minimal compared to the benefits.

Employee health is a major concern for small company owners. In a small shop, even a few sick staff members can disrupt the flow of the workplace and bring the operation to a standstill.

Instead of sitting back and hoping for the best, some owners are taking the matter of employee health into their own hands by beginning employee wellness programs. Here’s how they work . . .

Overview of worker wellness programs

Staff Member wellness programs are programs initiated by the company to improve the overall health of their labor force and to help individual employees overcome specific health-related hurdles.

These programs could be offered in a variety of formats –  In mandatory staff training sessions, as voluntary seminars, or through a third-party provider offering a wide-range of employee assistance programs.

In every case, nonetheless, the business foots the bill for the programs because an investment in employee health is a corporation investment that directly impacts the corporation’s bottom line.

Why offer worker wellness programs?

Apart from the obvious concern for the health of your workers, there are several other reasons why employee wellness programs make sense for small businesses. Right off the bat, your corporation will benefit from the lowered level of absenteeism that goes hand in hand with a healthy workforce.

Wellness programs will also reduce the number of injuries that occur in the workplace, not just from accidents, but also from repetitive motion and other recurring sources.

Since even a minor blip in employee attendance can have a large impact on a small corporation, a more reliable workforce will inevitably translate into a smoother work cycle and a more robust bottom line.

Wellness Program Features

Wellness programs can cover a wide range of health-related topics. Based on your employees’ needs, it’s entirely up to you to determine the type of programming you want to offer.

However, most employee wellness programs offer some at least some programs in the following areas –

• Nutrition. Diet can significantly impact an employee’s ability to do their job effectively. Nutritional programs educate workers about food choices and equip them to make healthful dietary choices.

• Fitness. In addition to diet, exercise is an important factor in a healthful lifestyle. Wellness programs frequently provide workers with opportunities to incorporate exercise into their daily lives.

• Tobacco use Cessation. Statistics prove that smokers tend to fall ill more frequently than their non-tobacco use colleagues. Since sick employees disrupt the workplace, tobacco use cessation programs are a no-brainer for both businesss and employees.

• Physiological Testing. A lot of corporations offer physiological as a regular part of their wellness programs. Cholesterol tests, blood pressure screenings, and other simple exams can provide early warning signs for more serious problems.

• Stress Management. Stress itself takes a toll on staff members. Notwithstanding, stress is also linked to other medical problems like depression, cardiovascular illness, diabetes, and obesity. Wellness programs that help staff members deal with stress improve not only the psychological health of your staff members, but their physical health as well.

Begin a Wellness Program for Your Staff Members Today

The benefits to beginning a wellness program are many.

A few corporate wellness tips to get workers started on the path to a healthier lifestyle –

1. Look around, and determine when workers lead a healthy lifestyle before starting an staff member wellness program.

• How many workers dash outside at lunch for a smoke break?
• Would a use of tobacco cessation program help?
• How often do the junk food-laden vending machines have to be replenished?
• is anyone exercising or taking benefit of local walking trails as part of their healthful living goals?

The answers to these questions will give businesses a better idea of the employee wellness program that’s right for them.

2. Survey workers to determine their healthful lifestyle habits.

• Are they exercising regularly?
• Eat three square meals a day?
Have regular physicals? Really? Then what planet are they on?

Because we would love to visit! A wellness program benefits most corporations because workers do not have the time or energy to stay on top of wellness concerns at work or when they leave the office to go home.

3. Give wellness programs a big kick-off with a healthful living “fair.” Offer employees free flu shots, blood pressure (BP) checks, cholesterol screenings, body/fat ratio assessments, use of tobacco cessation programs and free mammograms- and contact the local hospital, because there’s plenty more where this came from.

Businesses keep their workers hopping during the week. Give workers a chance to amp up their healthful lifestyle on the business dime. A wellness program is an added benefit that workers get for working for the company!

4. Incent to live- offer cash for employees to lose weight, commit to a smoking cessation program and ordinarily enjoy a healthier lifestyle.

Be sure to encourage humankind’s innate competitive nature by offering prizes for wellness staff member “winners.” And, encourage a healthier lifestyle by sponsoring staff members who want to enter a local 5K for charity race, run a marathon or play a sport.

Wellness Program Introduction

The last ten years has brought major changes in company attitudes toward wellness programs. Interest in self-help and self-care programs has increased as growth in health care costs have encroached substantially into profits.

Changes in the organizational structures of health care facilities, namely the growth of the for-profit health care sector, and the need to contain costs are changing the ways in which purchasers of health care plans are viewing their own efforts toward provision of worksite health care programs and facilities.

Projections for the next decade indicate that worksite health programs will continue to become important factors in the provision of healthcare, including avoidance activities, for both government and private industry.

In businesses with existing wellness programs, administrative rationale for sponsoring these activities ranged from improving worker health (28%) to improving worker morale (9.7%).

Programs include interventions associated with safety, health risk (assessment|appraisal}, use of tobacco cessation, blood pressure control, nutrition programs and stress management. Benefits cited range from improved health and productivity to reducing health care costs.

Demographics of the United States  Workforce

• 110 million Americans were in the civilian labor force in 1981; by the year 2000 the civilian labor force is expected to be almost 140 million.

• 44% of the 1984 labor force was female; 10% was Black.

• the median age of the workforce is 32 years and is expected to increase to 32 years by 2030.

• 57.9% of all workers work in corporations with between 2 and 500 employees; 45% work in corporations with fewer than 100 workers. an additional 7.5 million American Citizens are self-employed and 3 million are farmers.

• 18 percent of all wage and salaried staff members in 1985 were union members.            

• 45% of all employees are employed in offices.            

Prevalence of Corporate Wellness Activities            

Based on a 1985 survey, nearly 66% of worksites with 50 or more staff members had corporate wellness activities in 1985.  The frequency of worksite-based activities by selected categories in 1985 was –             

Wellness Program Activities            

Tobacco use Control          35.60%   

Health Risk (Assessment|Appraisal}    29.50%         

Back Care             28.60%

Stress Management       26.60%      

Exercise             22.10%

Off the Job Accidents    19.80%         

Nutrition             16.80%

Blood Pressure (BP) Control    16.50%         

Weight Control          14.70%   

Worksite size is the strongest indicator of program prevalence.            

Most employees believe the benefits of their corporate wellness activities outweigh the costs, even though few formal analysiss exist.            

The most frequently cited reason for starting programs and perceived benefit from programs is improved worker health.

At most worksites with activities (85.4%), all workers are eligible to participate. 30% of worksites with activities offer them to business dependents, and an equal% offer them to retirees.

When worksites seek outside program assistance, they turn to voluntary, not-for-profit organizations (57.1%), private for-profit providers-consultants (50%), local hospitals (44%), and insurance companies (43%).

Smoking Cessation Programs

Tobacco use related health problems cost USA  companies $26 billion per year in lost productivity and $7 to $8 billion in smoking-related healthcare costs.

Staff Members who smoke are 50% more likely to be hospitalized than nonsmokers, have 2 times as many job-related accidents as nonsmokers and have absenteeism rates approximately 50% higher than nonsmokers.

Individuals  who smoked an average of one or more packs of cigarettes per day had 118 percent higher health expenses than nonsmokers.

76% of current smokers and 80% of former smokers and nonsmokers feel that businesses should restrict tobacco use to certain areas.

In 1985, 65 percent of smokers, 85 percent of nonsmokers and 78 percent of former smokers, felt that smokers should refrain from tobacco use in the presence of nonsmokers.

In 1986, 17 states had laws regulating tobacco use in offices or workplaces either in government-controlled offices or offices of private staff members.

Examples of smoking cessation intervention program used by companies include –

• offering nonsmokers a discount of health and life insurance;

• paying full or partial fees for use of tobacco cessation programs;

• providing cessation programs on company or shared time;

• offering cash payments to quitters after 6 of 12 tobacco-free months;

• participating in national quit use of tobacco days; and

• adopting a smoke free business policy and setting deadlines for implementing the policy.

Fitness Programs

An active 55-year-old man can lead as vigorous a lifestyle as a sedentary 35-year-old.

Differences in work-related activity has been proven to yield a two- to three-fold difference in cardiovascular deaths between active workers and their more sedentary counterparts.

In addition to bettering strength, balance, and flexibility, exercise programs could reduce  the probability of back injuries among certain occupational groups.

93 million workdays in the United States are lost annually as the result of back problems.

Research findings support the notion that worksite fitness programs improve fitness and help reduce other health risks, although results related to improved productivity are weak due to lack of methods for accurately measuring productivity.

A very small proportion of worksites have on-site physical fitness facilities.

The majority of workers sponsored physical fitness programs involve skills training like aerobic dance, low impact aerobics, weight training, preand post-natal exercise classes, and walking/jogging groups.

Some businesses subsidize staff member participation in community “Ys,” health clubs or other community programs when no on-site facilities are available.

Worksite physical fitness programs could reduce costs to companys by decreasing staff member health care claims and expenditures.

People  whose weekly exercise was equivalent to climbing less than five flights of stairs or walking less than a half mile, spent 114% more on health claims than those who ascended at least 15 flights of stairs or walked 1 1/2 miles weekly.

Health care costs for obese individuals  are roughly 11% higher than those for thin individuals .

Nutrition and Weight Control

One-third of the United States  population is obese to the extent of reducing their life expectancy.

Improvements in eating habits can reduce  the risk of serious health problems such as high blood pressure (BP) and cholesterol levels and is instrumental in the control of non-insulin-dependent diabetes.

The workplace offers a few advantages for nutrition education; support and influence of coworkers and management, availability of a daily eating situation, and opportunities for follow-up and monitoring.

Worksite nutrition programs may be grouped in 6 wide categories –

• cafeteria programs;

• multi-component programs;

• weight control programs;

• cholesterol reduction programs;

• programs for pregnant and lactating women; and

• other nutrition education topics.

Men are less likely to participate in weight-loss programs than are female workers.

Stress Management

Estimates suggest that 50 percent to 80 percent of physician visits could be attributed to psychosomatic or stress-related origins.

Business pays many of the costs related to employee stress, both directly in the form of healthcare costs and in lower productivity.

Job factors which are associated with stress include –

• not permitting staff members to participate in decisions about the work process;

• positions which require more or less skill than the staff member has;

• changes in work demands;

• lack of clarity about expectations and standards; and

• conflict with coworkers or supervisors.

Most worksite stress management programs are implemented as a result of requests from workers.

Stress management programs focus on three types of skills –  relaxation skills, coping skills, and interpersonal skills.

Worksite stress management programs are often delivered in one of three formats –

• seminars conducted by trained experts;

• self-learning tools; and

• personal teaching to assist with self-assessment, planning for changes, learning new skills and responding to life crises.

The two major techniques used in worksite stress management programs are –

• teaching people  to reduce the negative physical effects of stress; and

• teaching people  to recognize and control sources of stress at work and in personal life.

Seat Belt Usage

Motor automobile accidents are the biggest single cause of lost work time and on-the-job fatalities of U.S.  business.

Motor car accidents account for 27 percent of all work-related deaths and 45 million days of lost work yearly.

More than 36 percent of the 11,300 accidental work deaths in 1983 involved automobiles.

Workers who routinely fail to use seat belts may spend up to 54 percent more days in the hospital.

Traffic accidents caused about 3 times as many days of restricted activity as any other kind of disability.

Motor car crashes cost $15.2 billion in lost productivity, 88% of which is attributed to losses from workforce activities and future earnings.

In corporate settings where safety belt policies, requiring use of belts by anybody riding in a business car or using a private car on business business, have been enforced, 60% to 90% use has been reported.

Incentive programs, accompanied by education and use requirement restrictions have resulted in 40 percent to 70 percent initial usage rates.

Factors influencing the sources of worksite safety belt programs include –

• active commitment for management;

• clearly defined and well enforced policy of required belt use on the job;

• positive incentives; and

• ongoing education and training programs.

Case Studies of Wellness Programs

Based on an extensive evaluation of its extensive worker wellness program, LIVE FOR LIFE, Johnson and Johnson announced the break-even point for the program occurs in year 3 and by year 5 they have a net benefit of $316 per worker. Their year 9 projected benefit is $677 per worker.

Workers at four Johnson and Johnson companies who were exposed to the wellness program increased their daily energy expenditure in vigorous activity by 104% compared to an increase of 33% among staff members at companies that were offered only an annual biometric test.

Participants in the United Methodist Publishing House’s wellness program submitted more claims (1.14 per participating worker and .82 for the control in 1984, 1.44 and 1.3 respectively in 1985), but the typical cost per claim was less for participants ($316 for participants and $567 for control, in 1984, $262 and $602 respectively in 1985, $270 and $566 respectively in the first four months of 1986).

The United Methodist Publishing House attributes some lower than projected use in healthcare costs for 1985 ($902,116 projected with actual costs $142,884) to the wellness program even though the results are not conclusive.

In 1985, the Adolph Coors Corporation conducted a telephone interview of a random sample of its 10,000 workers to determine changes in health practices since the introduction of an worker wellness program 4 years earlier.

The sample of 495 employees was stratified to match the corporation profile in terms of age, sex and job description.

The survey announced that 65% of respondents began exercising in the last 4 years, 37% had improved their diets, 20% were regular users of the wellness center, 9% had stopped tobacco use as the result of the corporation’s tobacco use cessation program and regular participants of the wellness center miss an typical of 1.96 workdays annually because of illness or injury compared to 3.08 days for non-participating employees.

The Coors Business also achieved a cost savings from a cardiac rehabilitation program that was implemented in 1981. In 1980 employees were out of work 7.2 months after a heart attack or bypass operation.

In 1984, cardiac patients were out an typical 1.9 months saving $152,000 in lost work time and in 1985 cardiac patients missed an typical of 2.6 months, saving $125,000 that year.

Corporate Fitness Programs Improve Worker Wellness

Instituting a wellness program improves the health of employees, reduces staff member absenteeism and saves the company money, too. Learn more about beginning an staff member wellness program in the office.

Advantages of Wellness Programs

• A business investment of $100-$150 per staff member each year to participate in an staff member wellness program can save businesses $300 to $450 for each staff member every year, as reported by Ron Goetzel, Director, Cornell University Institute for Health and Productivity Studies.

The savings can take several years to actualize, says Goetzel, and are seen in decreased health expenditures.

• the Wellness Councils of America announced a $24 return for every $1 spent on a corporation wellness program for small corporations.

• According to a 2005 survey by the Art of Wellness, corporations who instituted staff member wellness programs realized a 30 percent reduction in medical and absenteeism costs in less than four years.

A successful wellness program starts with corporation leaders. Company owners should lead by example, taking part in their corporation’s corporate fitness program and working closely with a wellness coach.

Company leaders should be sure workers are well aware of their wellness efforts, posting weight loss results or tobacco use cessation results on business intranet or bulletin boards for everyone to see.

Employee Wellness Programs that Really Work

• Be sure to encourage employees to kick start their own wellness programs by visiting their physician. A complete physical ought to include information about blood sugar, cholesterol levels and general health.

• Target specific health-related concerns in a corporate fitness program. Information about how to fight obesity, use of tobacco, alcoholism and drug abuse should be at the forefront of an staff member wellness program, along with related conditions.

• Hire a wellness coach to instruct workers on how to lead a healthful lifestyle.

• Reward staff members for participating in business wellness programs. Let staff members accrue wellness points that they can redeem for prizes.

Make the prizes healthy, too- a free massage, private training session with the corporation’s wellness coach or health food gift certificate encourages even healthier lifestyle choices.

• Acknowledge staff member wellness leaders in company newsletters, in posted bulletins and on the company intranet.

Business Wellness Programs Yield Big Results

For business owners who want to elevate employee participation in a business wellness program, consider Johnson and Johnson’s approach.

Faced with only 26 percent of employees participating in their employee wellness program, Johnson and Johnson offered employees a $500 discount on medical insurance costs when they completed a health risk profile.

The number of employees participating in the Johnson and Johnson corporate fitness program jumped after they offered the incentive — to more than 93%.

Ron Goetzel encourages those looking to pitch a corporate fitness program to company leaders to use basic facts about the benefits of employee wellness programs as part of their argument.

Keep it simple, and share results from other corporation’s employee wellness program success stories.

Five reasons to have a wellness program   

1   The USA spends more dollars on health care than any other nation yet we aren’t the world’s healthiest

• Largely sedentary   

• Use of tobacco is still popular   

• Stress is at epidemic levels (WHO)   

• Alcohol continues to take its toll on Americans   

2   Much of the disease in the United States is preventable

• Tobacco and alcohol are leading causes of death   

• as much as 70% of the cost of healthcare is driven by preventable illness   

3   Health Care costs continue to rise

• Health Care premiums continue to rise and to be passed on to the employee   

• Healthcare cost are normally the number one benefit cost to most employers    

4   The worksite is an ideal setting to address health and well being

• Most American Citizens work   

• Poor health habits take a toll on American business   

• Companys have a vested interest in health related issues.   

5   Research validates that wellness programs can improve health, save money, and even produce a ROI.

• Aldana,S.G. (1998). Financial impact of corporate wellness and methodological quality of the evidence. the Art of Wellness. Vol 2, Number 1.   

• Wilson, M.G. (1996). A comprehensive review of the effects of corporate wellness on health related outcomes –  an update. the American Journal of wellness. Vol 10, Number 6.   

• Wilson, M.G. (1996). A comprehensive review of the effects of corporate wellness on health related outcomes –  an update. the American Journal of wellness. Vol 11, Number 2.   

• Chapman, L.S. Proof Positive –  an analysis of the cost-effectiveness of corporate wellness. 3rd ed. Seattle –  Summex Business, 1996.   

• Pelletier, K.R. A review of the health and cost-effective outcomes studies of robust wellness and disease prevention programs at the worksite –  1993-1995 Update. the American Journal of Health and Promotion. Vol. 10, Number 5.   

Key Components of a Wellness Program   

Physical Wellness – Focuses on the development, maintenance, or betterment of one’s physical fitness   

Sample Physical Wellness Programs / Workshops

• Annual medical screening

• Regular physical activity

• Good safety habits

Emotional Wellness – Focuses on all aspects of mental fitness

Sample Emotional Wellness Programs / Seminars

• Stress management workshops

• Dealing with aging

• Addictive behaviors

• Parenting

Financial Wellness – Focuses on improving the quality of life of workers by helping families and individuals in becoming financially stable

Sample Financial Wellness Programs / Seminars

• Financial management

• Savings and Investing

• Credit and Purchasing

• Insurance and Estate Planning

Spiritual Wellness – Focuses on promoting a healthy inner self

Sample Spiritual Wellness Programs / Workshops

• Be sure to encourage daily devotional readings

• Give regular service opportunities

• Give a daily/weekly/monthly chapel (meditation) time during work hours

Nutritional Wellness – Will meet the needs of the employees through group and individual nutritional services

Sample Nutritional Wellness Programs / Workshops

• Individual nutritional Assessment

• Individual and group counseling

• Educational classes

• Weight loss programs

Many companys, as part of their efforts to contain rising healthcare costs, are implementing worksite programs variously described as wellness, lifestyle programs, health and productivity management, population health management and, simply, wellness programs.

The purpose of this article is to consider whether such programs improve health. When so, do they in turn reduce utilization of healthcare services and reduce healthcare expenditures?

The popular media have done much to promote the theory of corporate wellness. Last year, In Business –  Madison1 magazine printed a story accompanied by a table reporting an impressive range of returns on investment (ROI) –

Return on Investment (Per dollar ROI for lifestyle programs)

• Coors $6.15

• Kennecott $5.78

• Equitable Life $5.52

• Citibank $4.56

• General Mills $3.90

• Travelers $3.40

• Motorola $3.15

• PepsiCo $3.00

• Unum Life $1.81

Source –  2004 T.E. Brennan Business, as reported

Would these ROIs stand up to rigorous empirical analysis of the data? What factors produce such disparate returns among these programs? and does the published literature, subject to colleague review of scientific methods, support the ROIs reported here?

Health and Productivity Management

Disease and injury associated with an unhealthful lifestyle or modifiable risk factors is announced to account for at least 25 percent of worker health care expenditures.

The most significant of these risk factors are stress, tobacco use, overweight or obesity, lack of exercise, excessive alcohol use, and poor nutritional habits.

Over the past two decades, a selection of groups at the local, state, and national levels have promoted the theory that health risk reduction and care management programs can improve employee health, and that worksite health education, health risk management, and benefit counseling should complement standard medical insurance benefits.

The intensity of wellness programs range from bulletin board,  pamphlet or newsletter information to onsite fitness facilities, health risk reduction classes, and personal lifestyle change coaching.

Wellness programs today often include a health risk (assessment|appraisal}  to evaluate each employee’s modifiable risk factors of illness. Program coordinators then target interventions to those that are at increased risk through personal communications and individual follow-up.

Robust wellness programs may include courses on health risk reduction and job safety, fitness and exercise activities, gym memberships, and reductions in co-payments or premiums for employees who adhere to recommended biometric testing guidelines.

Along with this, some businesss are restructuring health benefits and encouraging employees’ cost-sensitivity when accessing healthcare.5 These changes are intended to reduce employees’ need for and utilization of healthcare, yielding decreased group medical care costs.

Demonstrated reductions in healthcare expenditures should then provide corporations with a powerful bargaining chip in negotiating lower health insurance premiums during future terms.

Evidence basis –  A range of ROI estimates

The empirical research has produced results as varied as the well-liked media on ROI. However, evidence continues to grow that well-designed and well-resourced wellness and illness prevention programs provide multi-faceted payback on investment.

Colleague-reviewed analysiss and meta analyses show that ROI is achieved through improved staff member health, decreased benefit expense, and enhanced productivity.

• Goetzel and peers, in their meta-analysis of two dozen articles summarizing economic examinations of health and productivity management programs, found an typical return of $3.14 per $1 invested in traditional wellness programs. the ROI estimates for the individual programs ranged from $1.49 to $13.7,

• Aldana reviewed 72 articles and concluded that wellness programs achieve an typical ROI of $3.48 when considering healthcare costs alone, $5.82 per $1 when examining absenteeism, and $4.30 when both outcomes are considered.

• Ozminkowski and collagues conducted a 38 month case study of 23,000 participants in Citibank, N.A.’s health management program and stated that within a 2 year period, Citibank realized a ROI between $4.56 and $4.73.10  

Follow-up studies found improvements in the risk profiles of participants, with the high-risk group improving more than the “usual care” group1 thus of more intensive programming.

• Chapman’s 2004 meta-evaluation of 42 studies, ranking overall validity of the studies, reports cost-benefit ratios from $2.05-$4.64.

In addition to immediately quantifiable cost reductions, scientists have announced a selection of spin-off benefits –  greater productivity, intellectual capacity, and reductions in disability12 and absenteeism.9,13,14,15

Such programs might also have positive effects on staff member perceptions of the company and staff member morale, even among nonparticipants.  These outcomes go beyond savings in direct health care costs to provide non-health related ROI.

Tailoring program to maximize ROI Wellness programs aim to reduce the health risks of employees at high risk while maintaining the health status of those at low risk.

A variety of disease management (DM) interventions are available to fit the specific risk profiles of various worksites. Insurers and companies now seek to calibrate their interventions in order to achieve optimal risk reduction and costeffectiveness.

In 2001, Univ. of Michigan researchers reported on stable trends in healthcare costs for over 2 million current and former workers in an 18 year data set.

The mean cost increase per risk factor gained ($350) was found to be more than double the mean cost decrease per eliminated risk factor ($150).

In other words, increases in costs when groups of employees moved from low risk to high risk were much greater than the decreases in costs when groups moved from high risk to low risk. Their conclusion –  Programs designed to keep healthful people  healthful will likely provide the greatest return on investment.

On the other hand, Pelletier’s meta-analysis and other program analysiss18 suggest that individualized risks reduction for high-risk staff members within the context of extensive programming is the vital element in achieving positive clinical and cost outcomes in worksite interventions.

Dose-Response?

Several factors may affect the impact of various programs and the ultimate ROI, including cultural and environmental factors, workforce demographics, level of participation and longevity of the program.

Most cost-benefit studies have been conducted in large businesses with more than fifty employees. But scientists have shown that similar results can be obtained by small businesses with as few as five employees actively involved in a well-managed program.

Various studies also suggest that even relatively modest levels of participation can achieve substantial program impact. Contrary to reports by the popular media that such programs require more than 70 percent participation, published reports of at least one case showed positive ROI with 51 percent participation.

Length of intervention appears to be a more salient variable –  an impact on medical costs normally requires three-to five years of programming.

Future developments

Despite the abundance of positive program investigations, a few caveats remain. Negative results are less likely to be announced or published, hence biasing the ROI upward.

Uncertainty persists regarding the specific impact of the various program components. But as these programs take hold, further research and investigation will enable fine-tuning of program investments.

Meanwhile, the preponderance of data and the strength of the published research stand in favor of a positive ROI for wellness programs.

In fact, the corporation case for such programs is now well enough defined that some insurance agents offer discounted rates to corporations that institute or subscribe to wellness programs.

Future questions will focus on how to best to combine robust and focused interventions, the intensity of elements, and how to calibrate the dose-response model to achieve a target ROI.

Here, employers, employees, and researchers will need to collaborate to define mutual goals respecting both clinical and cost outcomes.

Sources –

1. In Business –  Madison. Madison, WI –  September 2004. p. 39.

2. Anderson DR, Whitmer RW, Goetzel RZ, Ozminkowski RJ, Wasserman J, Serxner S. Health Enhancement Research Organization Committee. American Journal of Wellness 2000; 15(1) –  45-52.

3. Manning J. Wellness movement gains ground among corporations, health insurers. Milwaukee Journal Sentinel. August 19, 2004.

4. Chapman LS. Specialist opinions on “best practices” in corporate wellness (WHP). the Art of Wellness Newsletter, July/August 2004 – 1-6.

5. Fronstin, P, and Werntz, R. EBRI Issue Brief No. 267, March 2004. Washington, DC –  Employee Benefits Research Institute (EBRI).

6. Powell C. Professionals urge companies to promote worker wellness strategies. Akron Beacon Journal. October 25, 2004.

7. Goetzel RZ, Juday TR, Ozminkowski RJ. AWHP’s Worksite Health, Summer, 1999.

8. Goetzel, RZ. Absolute Advantage. Washington DC –  Wellness Councils of America. Vol 1(8); 2002.

9. Aldana SG. American Journal of Wellness 2001; 15(5) –  296-320.

10. Ozminkowski RJ, Dunn RL, Goetzel RZ, Cantor RI, Murnane J, Harrison M. American Journal of Wellness 1999; 14(1) –  31-43.

11. Ozminkowski RJ, Goetzel RZ, Smith MW, Cantor RI, Shaughnessy A, Harrison M. the impact of the Citibank, N.A. J Occup Environ Med. 2000; 42(5) –  502-511.

12. Serxner S, Gold D, Anderson D, Williams D. J Occup Environ Med. 2001; 43(1) –  25-29.

13. Riedel JE, Lynch W, Baase C, Hymel P, Peterson KW. American Journal of Wellness 2001; 15(3) –  167-191.

14. Edington MD, Karjalainen T, Hirschland D, Edington DW. AAOHN J. 2002 Jan; 50(1) –  26-31.

15. Aldana SG, Pronk NP. J Occup Environ Med. 2001 Jan; 43(1) –  36-46.

16. Pelletier KR. American Journal of Wellness. 2001; 16(2) –  107-16.

17. Edington DW. American Journal of Wellness 2001; 15(5) –  341-349.

18. Leatherman S, Berwick D, Iles D, Lewin LS, Davidoff F, Nolan T, Bisognano M. Health Affairs 2003; 22(2) –  17-30.

19. Erfurt JC, Holtyn K. J Occup Med 1991; 33(1) –  66-73.

20. Serxner S, Anderson DR, Gold D. American Journal of Wellness. 18(4) –  1-6, iii, 2004 Mar-Apr.

21. Serxner SA, Gold DB, Grossmeier JJ, Anderson DR.

As organizations today continue to compete in the global economy, cost containment strategies will be increasingly important. Controlling the rising cost of employee ill health is becoming a priority for corporate leaders.

The emerging corporate culture in the United States  is one which has an worker population centered in health, safety and wellness.

Developing a corporate strategy for wellness and disability management makes good company sense. the following eight-step process ensures a strategic, integrated, needs-driven and results-oriented approach.

The following process works best in organizations with strong leadership and a long-term commitment to employee health.

1. Identify Your Program Champion

This individuals ought to be a leader in your organization and a strong advocate of health. Typically this is a personal who actively pursues his or her own personal quest for optimal health.

The program champion must’ve the resources and authority to drive the program forward. the program champion’s key role is to ensure the strategic plan for health is aligned with the corporation’s corporation objectives, strategic focus and organizational values.

For  instance if the organization promotes that “our strength is our people ” the wellness program must demonstrate how programs will nurture and protect that valuable resource.

2. Form Your Wellness Strategy Team

The Wellness Strategy Team should include decision makers and stakeholders from areas of the business that can influence health and the corporation’s bottom line.

These areas may include; finance, human resources, training and development, health services, compensation and benefits, worker assistance services (EAP), advertising, facilities, health and safety, rehabilitation, cafeteria or food services and the union. A team of six to eight representatives is advised.

The role of the Strategy Team is to develop and implement the strategic plan, look for opportunities to promote health, ensure the program is integrated into key areas of the organization, streamline efforts, maximize business resources and program examination.

3. Complete an Organizational Health Audit

The purpose of an Organizational Health Audit is to evaluate your existing programs and services, physical environment and policies and procedures that support health.

It is also important to look at your organizational culture or “how things are done” around the corporation.

Members of the Strategy Team complete the Audit independently and then meet to discuss their evaluation. During the evaluation process, health issues and opportunities are discussed in preparation for the development of the strategic plan.

4. Analyze Your Corporation’s Cost Pressures

Cost pressures are identified by evaluating  a number of areas including; benefit costs, Workplace Safety Insurance Board (WSIB) claims, drug usage, type of paramedic claims, absenteeism data and employee assistance program utilization.

This process assists to target areas that could be positively impacted by a wellness program and to provide a baseline for reviewing  change.

5. Conduct a Health Risk (Assessment|Appraisal} or Staff Member Needs and Interest Survey

The next step is to determine your employee’s health risks, interests and readiness to change. A confidential health risk (assessment|appraisal} can accomplish many goals.

It provides a baseline from which to measure personal lifestyle changes, provides workers with relevant medical information, excites workers to take charge of their health and helps in program planning.

Most health risk (assessment|appraisal}s provide individual reports and a corporate report identifying high-risk areas in the company.

Many organizations prefer to administer personalized needs and interest survey to evaluate worker needs. the benefit of this approach is that the company is able to gather information on the employees’ perceived wellness needs and program interests.

This information may be incorporated into the strategic plan. Administering a recent survey also has the added advantage of fostering a sense of worker ownership to the program.

6. Create Your Strategic Plan for Wellness

The strategic plan should incorporate information collected from the Organizational Health Audit, your corporation’s cost pressures, and health risk (assessment|appraisal} data or worker survey results.

The strategic plan ought to include your program mission, three or four goals and a few programs under each objective. the strategic plan provides a framework to encourage, support and evaluate “best health practices.”

It is also important that the plan align itself with the vision, goals and goals of the organization.

The sample strategic plan that follows was created for blue jeans maker Levi Strauss and Co. (Canada) Inc. Levi Strauss and Co.’s mission statement and aspirations (how workers interact with each other in a corporation environment) guided the development of the plan.

Levi Strauss and Co.’s aspirations include the following statement –  Above all, we want satisfaction from accomplishments and friendships, balanced personal and specialist lives, and to have fun in our endeavors.

The wellness program plan included a number of components to ensure that it embraced this statement including the following –

1. A vision statement, which tied in with the corporation’s aspirations.

2. an incentive system to encourage and reward the accomplishment of healthful milestones.

3. A recognition system to applaud success.

4. Friendly competitions between Levi Strauss and Co. locations to ensure a fun environment.

5. Opportunities to participate in small group educational programs to foster team support.

6. Initiation of support groups for staff members completing wellness programs (i.e. use of tobacco control support group).

7. Programs dealing with work and family balance.

Other information that was analyzed and used to develop the plan included –

1. Corporation demographics

2. Focus groups

3. Cultural audit

4. Top drug report

5. employee assistance program utilization

6. Staff Member benefit services report

7. Health and dental claims

8. Operational performance summaries

9. Health risk (assessment|appraisal}s

7. Prepare a Corporation Case to Support Your Plan

Your corporation case for wellness provides the necessary details for approval at the  upper-level management level. the corporation case includes –

1. the Strategic Plan for Health

2. A proposed program budget

3. Advertising and Marketing strategies

4. Program leadership options

5. an implementation plan

6. Investigation methodology.

In presenting the strategic plan it is important to highlight how the plan aligns itself with the strategic direction of the organization.

The program budget ought to include educational resources, advertising and marketing costs, rewards and incentives, leadership costs and supplies.

Marketing strategies should address how the program will be promoted and rolled out to various groups within the organization i.e. decentralized locations, high risk staff members, older staff members.

Program leadership should address how volunteers will be used, internal resources  and whether consultants have been proposed. All play an equally important role in the implementation of your wellness program.

The program implementation plan should incorporate the following kinds of programs that help create awareness of positive health practices, assist workers in making lifestyle changes and initiatives, which support long-term change.

Awareness programs create an awareness of the importance of healthful lifestyle practices and motivate workers to take the next step. Examples of awareness programs include posting educational posters, newsletter articles and lunch and learn seminars.

Lifestyle change programs are more comprehensive and longer in duration. They’re designed to assist workers in changing behavior. Examples of lifestyle change programs are nutrition education programs, stress management programs, back care classes and smoking control programs.

A supportive corporate environment encompasses everything from corporate policies and procedures, the physical environment and creating a corporate culture that supports good health practices. Follow-up sessions and support groups for staff members who have completed 6-10 week wellness programs also provide a supportive environment for long-term change.

Evaluating the effectiveness of wellness is ongoing. A formal investigation should be conducted yearly and may include; re-administering steps three to five, program participation statistics and a year end survey to revisit “soft” issues like morale, program satisfaction and future program direction.

8. Solicit Input and Communicate Your Plan

Staff Member input is vital to the long-term success of your program. an Staff Member Advisory Committee should be formed to roll out the plan. Another key responsibility of this team is to solicit feedback from all levels of the organization to ensure buy-in.

Front line Manager’s Information Sessions and focus groups are also important. This group needs to buy-in to the notion that they play a key role in supporting positive health practices.

Regular meetings are advised with front line managers to receive ongoing input, address issues and orient new managers.

Conclusions

The World Health Corporation’s definition of health is “a state of complete physical, mental and social wellness and not merely the absence of illness and infirmity.”

In order for us to create healthful workplaces, wellness programs must have a program champion, have employee ownership, be management supported, results driven and strategically aligned with the overall corporation goals of the organization.

Wellness program that embrace these qualities will have a positive impact on an corporation’s bottom line. Canadian research points to many case studies where onsite programs have resulted in lowered absenteeism, lower claims and increased productivity.

Organizations who have embraced wellness as part of “how they do business” have one thing in common. They demonstrate a commitment to their most valuable resource – their individuals .

They understand the increased pressures associated with downsized organizations, a rapidly changing workplace, an aging work force and the challenge of balancing work and family obligations. and they share a common belief that healthful staff members are happier, absent less and more productive.

References –

Design of Wellness Programs by Michael P. O’Donnell. 1995. Published by the American Journal of Wellness.

Pro Fit-ability by Veronica Marsden. Group Healthcare Management. May 1997.

Meeting Expectations by Laura Mensch. Employee Health and Productivity. August 1999

7 Steps to Wellness by Daphne Woolf and Veronica Marsden. Group Health Care Management. February 1996.

Published in the Journal of Wellness for Northern Ireland, Issue 9, March 2000

Want some wellness program ideas and wellness policy ideas to get you started? Or maybe you want to jump begin or improve upon your current wellness program?

The list below provides “best practices’ that can help meet any wellness program budget! the Wellness Program ideas are divided into topic areas.

General Wellness Progam Ideas

• Policy – Conduct an Worker Needs and Interest Survey

• Policy – Develop a management/employee Wellness Committee

• Policy – Select health plans that cover costs for weight control and smoking cessation

• Policy – Waive co-pay or reimburse for preventive healthcare visits

• Program – Display  brochures on a selection of wellness topics for employees to take

• Program – Establish a wellness resource center or library with videos, books, magazines, DVD’s on a selection of topics of interest to employees

• Program – Identify staff members who are mentors or champions for healthful activities and ask them to present or to list as a contact for other employees

• Program – Plan and promote periodic or regular educational sessions.

• Program – Plan monthly educational sessions on the national health observance topic

• Program – Post a Wellness Bulletin Board and update it monthly

• Program – Promote messages from national health observances during the month

• Program – Publish and/or post healthful tips in newsletters, paycheck stuffers, bulletin boards, etc.

• Program – Sponsor a benefits fair

• Program – Sponsor company fitness and healthy eating challenges

• Program – Sponsor company health fairs or other onsite events

Nutrition Programs

• Policy – Offer free, healthy snacks for staff members (fruit, nuts, popcorn)

• Policy – Give healthful meal choices in cafeterias and at corporation events

• Policy – Give information to employees about the nutritional content of food served in the cafeteria

• Policy – Start a fresh fruit “snack basket” in the breakroom or cafeteria

• Policy – Stock vending machines with healthier options

• Policy – Subsidize healthful foods in the cafeteria or vending machines (10¡ apples might  be more appealing than $1.00 candy bars)

• Program – Coordinate a weekly or monthly healthy lunch club

• Program – Have  handouts available on a selection of healthful consuming topics

• Program – Include nutrition articles in company newsletters

• Program – Schedule a healthful food tasting contest Free

• Program – Schedule educational sessions at lunch-time on a selection of nutrition topics of interest

• Program – Sponsor an employee healthy food cookbook. Either sell the cookbook and use profits for programs, or purchase a cookbook for all employees

Weight Loss Programs / Weight Management Programs

• Policy – Consider flexible work schedules so that staff members can participate in weight-loss programs

• Policy – Subsidize registration costs for weight-management programs

• Program – Form a support group to help employees who are trying to lose weight

• Program – Locate registered dieticians near your worksite as a resource for employees who want information on healthful consuming, meal planning or weight control

• Program – Offer individual counseling for employees trying to lose weight

• Program – Offer onsite fitness and weight-management programs through your local hospital, Weight Watchers, TOPS or local, registered dietician

• Program – Schedule an educational session on diet myths and healthy eating

Physical Activity Programs

• Policy – Allow flexible work schedules to encourage exercise

• Policy – Develop a fitness space with aerobic equipment, and weights

• Policy – Create accessible walking paths, trails, and/or bike routes

• Policy – Make sure to encourage workers to walk more by parking farther away from the entrance

• Policy – Establish a health club with aerobic equipment, weights, aerobics classes, fitness professionals

• Policy – Hold walking meetings

• Policy – Make the stairwells more appealing (carpet, fresh paint, artwork, posters)

• Policy – Offer lowered health club membership fees to all staff members

• Policy – Provide facilities for staff members to secure bikes

• Policy – Schedule 5 – 10 minute stretch breaks during the day

• Policy – Subsidize fitness club membership for workers who participate a minimal number of days per week (ex., 3 days per week)

• Policy – Support lunchtime walking/running clubs or corporation sports team

• Program – Make sure to encourage stairwell use and incentives

• Program – Install a basketball hoop outside

• Program – Promote and support community walks or fitness events

• Program – Promote walking during breaks and other off-time periods

• Program – Provide periodic fitness incentive programs to encourage exercise

• Program – Schedule educational sessions on fitness activities

Smoking Cessation Programs / Tobacco Cessation Programs

• Policy – Develop a tobacco-free grounds

• Policy – Create a smoke-free workplace

• Policy – Make sure to encourage the use of 1-800-QUIT-NOW, North Carolina’s free Tobacco Use Quitline. Or check www.QuitlineNC.com

• Policy – Reimburse for tobacco replacement products

• Policy – Subsidize the cost of tobacco use cessation workshops

• Program – Provide  pamphlets and information on health effects from tobacco use and tobacco cessation

• Program – Schedule awareness sessions to motivate workers to try to quit tobacco use

• Program – Schedule onsite tobacco use cessation workshops

Employee Health Screening

• Policy – Discount medical insurance premiums or reduce co-payments for workers who participate in screenings and who participate in managing their risk factors

• Policy – Install blood pressure monitoring equipment

• Program – Offer flu shots for employees and family members

• Program – Offer Health Risk (Assessment|Appraisal}s to all workers, including counseling and follow-up

• Program – Offer periodic blood pressure screenings and follow-up

• Program – Offer periodic screenings for cholesterol, blood sugar, body composition, etc.

Stress Management Programs / Be sure to work Life Balance Programs

• Program – Allow flexible schedules for family/work life balance

• Program – Offer and promote an worker assistance program

• Program – Give information on substance abuse prevention

• Program – Provide  brochures and information on stress management and mental health

• Program – Provide  pamphlets and information on work life balance, like financial planning, childcare, parenting, elder care, etc.

• Program – Give supervisor and manager training on communication, relationship building, organizational stressors, etc.

• Program – Review company policies and work schedules to identify organizational stressors

• Program – Review the employee assistance program to ensure it’s meeting the needs of the workers and company

• Program – Schedule educational sessions on stress management and work life balance

• Program – Schedule seminars on relaxation, stress management, and work life balance topics